|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
IP
|
$13,517.92
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,138.44 |
| Max. Negotiated Rate |
$13,517.92 |
| Rate for Payer: Aetna Commercial |
$12,166.13
|
| Rate for Payer: ASR ASR |
$13,112.38
|
| Rate for Payer: BCBS Trust/PPO |
$11,100.92
|
| Rate for Payer: BCN Commercial |
$11,100.92
|
| Rate for Payer: Cash Price |
$10,814.34
|
| Rate for Payer: Cofinity Commercial |
$12,706.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,814.34
|
| Rate for Payer: Healthscope Commercial |
$13,112.38
|
| Rate for Payer: Healthscope Whirlpool |
$13,517.92
|
| Rate for Payer: Mclaren Commercial |
$12,166.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,490.23
|
| Rate for Payer: Nomi Health Commercial |
$11,084.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,138.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,895.77
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
IP
|
$545.27
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$408.95 |
| Max. Negotiated Rate |
$545.27 |
| Rate for Payer: Aetna Commercial |
$490.74
|
| Rate for Payer: ASR ASR |
$528.91
|
| Rate for Payer: BCBS Trust/PPO |
$447.78
|
| Rate for Payer: BCN Commercial |
$447.78
|
| Rate for Payer: Cash Price |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$512.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.22
|
| Rate for Payer: Healthscope Commercial |
$528.91
|
| Rate for Payer: Healthscope Whirlpool |
$545.27
|
| Rate for Payer: Mclaren Commercial |
$490.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.48
|
| Rate for Payer: Nomi Health Commercial |
$447.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.84
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
OP
|
$545.27
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$201.75 |
| Max. Negotiated Rate |
$545.27 |
| Rate for Payer: Aetna Commercial |
$490.74
|
| Rate for Payer: Aetna Medicare |
$201.75
|
| Rate for Payer: ASR ASR |
$528.91
|
| Rate for Payer: BCBS Complete |
$218.11
|
| Rate for Payer: BCBS Trust/PPO |
$449.58
|
| Rate for Payer: BCN Commercial |
$449.58
|
| Rate for Payer: Cash Price |
$436.22
|
| Rate for Payer: Cash Price |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$512.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.22
|
| Rate for Payer: Healthscope Commercial |
$528.91
|
| Rate for Payer: Healthscope Whirlpool |
$545.27
|
| Rate for Payer: Mclaren Commercial |
$490.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$436.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.48
|
| Rate for Payer: Nomi Health Commercial |
$447.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$344.41
|
| Rate for Payer: Priority Health Narrow Network |
$275.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$479.84
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
OP
|
$1,787.98
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$661.55 |
| Max. Negotiated Rate |
$1,787.98 |
| Rate for Payer: Aetna Commercial |
$1,609.18
|
| Rate for Payer: Aetna Medicare |
$661.55
|
| Rate for Payer: ASR ASR |
$1,734.34
|
| Rate for Payer: BCBS Complete |
$715.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,474.19
|
| Rate for Payer: BCN Commercial |
$1,474.19
|
| Rate for Payer: Cash Price |
$1,430.38
|
| Rate for Payer: Cofinity Commercial |
$1,680.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.38
|
| Rate for Payer: Healthscope Commercial |
$1,734.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,787.98
|
| Rate for Payer: Mclaren Commercial |
$1,609.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,430.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,519.78
|
| Rate for Payer: Nomi Health Commercial |
$1,466.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,340.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,566.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,253.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,573.42
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
IP
|
$1,787.98
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,340.98 |
| Max. Negotiated Rate |
$1,787.98 |
| Rate for Payer: Aetna Commercial |
$1,609.18
|
| Rate for Payer: ASR ASR |
$1,734.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.29
|
| Rate for Payer: BCN Commercial |
$1,468.29
|
| Rate for Payer: Cash Price |
$1,430.38
|
| Rate for Payer: Cofinity Commercial |
$1,680.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.38
|
| Rate for Payer: Healthscope Commercial |
$1,734.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,787.98
|
| Rate for Payer: Mclaren Commercial |
$1,609.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,519.78
|
| Rate for Payer: Nomi Health Commercial |
$1,466.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,340.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,573.42
|
|
|
HC GUIDEWIRE
|
Facility
|
IP
|
$50.37
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$50.37 |
| Rate for Payer: Aetna Commercial |
$45.33
|
| Rate for Payer: ASR ASR |
$48.86
|
| Rate for Payer: BCBS Trust/PPO |
$41.36
|
| Rate for Payer: BCN Commercial |
$41.36
|
| Rate for Payer: Cash Price |
$40.30
|
| Rate for Payer: Cofinity Commercial |
$47.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.30
|
| Rate for Payer: Healthscope Commercial |
$48.86
|
| Rate for Payer: Healthscope Whirlpool |
$50.37
|
| Rate for Payer: Mclaren Commercial |
$45.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.81
|
| Rate for Payer: Nomi Health Commercial |
$41.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.33
|
|
|
HC GUIDEWIRE
|
Facility
|
OP
|
$50.37
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.64 |
| Max. Negotiated Rate |
$50.37 |
| Rate for Payer: Aetna Commercial |
$45.33
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: ASR ASR |
$48.86
|
| Rate for Payer: BCBS Complete |
$20.15
|
| Rate for Payer: BCBS Trust/PPO |
$41.53
|
| Rate for Payer: BCN Commercial |
$41.53
|
| Rate for Payer: Cash Price |
$40.30
|
| Rate for Payer: Cofinity Commercial |
$47.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.30
|
| Rate for Payer: Healthscope Commercial |
$48.86
|
| Rate for Payer: Healthscope Whirlpool |
$50.37
|
| Rate for Payer: Mclaren Commercial |
$45.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.81
|
| Rate for Payer: Nomi Health Commercial |
$41.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$44.13
|
| Rate for Payer: Priority Health Narrow Network |
$35.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.33
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
OP
|
$1,372.36
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$507.77 |
| Max. Negotiated Rate |
$1,372.36 |
| Rate for Payer: Aetna Commercial |
$1,235.12
|
| Rate for Payer: Aetna Medicare |
$507.77
|
| Rate for Payer: ASR ASR |
$1,331.19
|
| Rate for Payer: BCBS Complete |
$548.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.51
|
| Rate for Payer: BCN Commercial |
$1,131.51
|
| Rate for Payer: Cash Price |
$1,097.89
|
| Rate for Payer: Cofinity Commercial |
$1,290.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.89
|
| Rate for Payer: Healthscope Commercial |
$1,331.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,372.36
|
| Rate for Payer: Mclaren Commercial |
$1,235.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,097.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.51
|
| Rate for Payer: Nomi Health Commercial |
$1,125.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,202.46
|
| Rate for Payer: Priority Health Narrow Network |
$962.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,207.68
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
IP
|
$1,372.36
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,029.27 |
| Max. Negotiated Rate |
$1,372.36 |
| Rate for Payer: Aetna Commercial |
$1,235.12
|
| Rate for Payer: ASR ASR |
$1,331.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.98
|
| Rate for Payer: BCN Commercial |
$1,126.98
|
| Rate for Payer: Cash Price |
$1,097.89
|
| Rate for Payer: Cofinity Commercial |
$1,290.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.89
|
| Rate for Payer: Healthscope Commercial |
$1,331.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,372.36
|
| Rate for Payer: Mclaren Commercial |
$1,235.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.51
|
| Rate for Payer: Nomi Health Commercial |
$1,125.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,207.68
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.44 |
| Max. Negotiated Rate |
$79.56 |
| Rate for Payer: Aetna Commercial |
$71.60
|
| Rate for Payer: Aetna Medicare |
$29.44
|
| Rate for Payer: ASR ASR |
$77.17
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: BCBS Trust/PPO |
$65.60
|
| Rate for Payer: BCN Commercial |
$65.60
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$74.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$77.17
|
| Rate for Payer: Healthscope Whirlpool |
$79.56
|
| Rate for Payer: Mclaren Commercial |
$71.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.71
|
| Rate for Payer: Priority Health Narrow Network |
$55.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.01
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$79.56 |
| Rate for Payer: Aetna Commercial |
$71.60
|
| Rate for Payer: ASR ASR |
$77.17
|
| Rate for Payer: BCBS Trust/PPO |
$65.33
|
| Rate for Payer: BCN Commercial |
$65.33
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$74.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$77.17
|
| Rate for Payer: Healthscope Whirlpool |
$79.56
|
| Rate for Payer: Mclaren Commercial |
$71.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.01
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$545.75 |
| Max. Negotiated Rate |
$1,475.00 |
| Rate for Payer: Aetna Commercial |
$1,327.50
|
| Rate for Payer: Aetna Medicare |
$545.75
|
| Rate for Payer: ASR ASR |
$1,430.75
|
| Rate for Payer: BCBS Complete |
$590.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,216.14
|
| Rate for Payer: BCN Commercial |
$1,216.14
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,386.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Commercial |
$1,430.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,475.00
|
| Rate for Payer: Mclaren Commercial |
$1,327.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Nomi Health Commercial |
$1,209.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,292.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,033.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,298.00
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,106.25 |
| Max. Negotiated Rate |
$1,475.00 |
| Rate for Payer: Aetna Commercial |
$1,327.50
|
| Rate for Payer: ASR ASR |
$1,430.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.27
|
| Rate for Payer: BCN Commercial |
$1,211.27
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,386.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Commercial |
$1,430.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,475.00
|
| Rate for Payer: Mclaren Commercial |
$1,327.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Nomi Health Commercial |
$1,209.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,298.00
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.74 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: Aetna Medicare |
$57.74
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: BCBS Complete |
$62.42
|
| Rate for Payer: BCBS Trust/PPO |
$128.67
|
| Rate for Payer: BCN Commercial |
$128.67
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$151.38
|
| Rate for Payer: Healthscope Whirlpool |
$156.06
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$136.74
|
| Rate for Payer: Priority Health Narrow Network |
$109.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.05 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$140.45
|
| Rate for Payer: ASR ASR |
$151.38
|
| Rate for Payer: BCBS Trust/PPO |
$128.16
|
| Rate for Payer: BCN Commercial |
$128.16
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$146.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$151.38
|
| Rate for Payer: Healthscope Whirlpool |
$156.06
|
| Rate for Payer: Mclaren Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.33
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
OP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.07 |
| Max. Negotiated Rate |
$324.51 |
| Rate for Payer: Aetna Commercial |
$292.06
|
| Rate for Payer: Aetna Medicare |
$120.07
|
| Rate for Payer: ASR ASR |
$314.77
|
| Rate for Payer: BCBS Complete |
$129.80
|
| Rate for Payer: BCBS Trust/PPO |
$267.56
|
| Rate for Payer: BCN Commercial |
$267.56
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Commercial |
$305.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Healthscope Commercial |
$314.77
|
| Rate for Payer: Healthscope Whirlpool |
$324.51
|
| Rate for Payer: Mclaren Commercial |
$292.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Nomi Health Commercial |
$266.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$284.34
|
| Rate for Payer: Priority Health Narrow Network |
$227.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$285.57
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
IP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$243.38 |
| Max. Negotiated Rate |
$324.51 |
| Rate for Payer: Aetna Commercial |
$292.06
|
| Rate for Payer: ASR ASR |
$314.77
|
| Rate for Payer: BCBS Trust/PPO |
$266.49
|
| Rate for Payer: BCN Commercial |
$266.49
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Commercial |
$305.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Healthscope Commercial |
$314.77
|
| Rate for Payer: Healthscope Whirlpool |
$324.51
|
| Rate for Payer: Mclaren Commercial |
$292.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Nomi Health Commercial |
$266.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$285.57
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
OP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.96 |
| Max. Negotiated Rate |
$462.06 |
| Rate for Payer: Aetna Commercial |
$415.85
|
| Rate for Payer: Aetna Medicare |
$170.96
|
| Rate for Payer: ASR ASR |
$448.20
|
| Rate for Payer: BCBS Complete |
$184.82
|
| Rate for Payer: BCBS Trust/PPO |
$380.97
|
| Rate for Payer: BCN Commercial |
$380.97
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Commercial |
$434.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Healthscope Commercial |
$448.20
|
| Rate for Payer: Healthscope Whirlpool |
$462.06
|
| Rate for Payer: Mclaren Commercial |
$415.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Nomi Health Commercial |
$378.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$404.86
|
| Rate for Payer: Priority Health Narrow Network |
$323.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$406.61
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
IP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$346.55 |
| Max. Negotiated Rate |
$462.06 |
| Rate for Payer: Aetna Commercial |
$415.85
|
| Rate for Payer: ASR ASR |
$448.20
|
| Rate for Payer: BCBS Trust/PPO |
$379.44
|
| Rate for Payer: BCN Commercial |
$379.44
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Commercial |
$434.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Healthscope Commercial |
$448.20
|
| Rate for Payer: Healthscope Whirlpool |
$462.06
|
| Rate for Payer: Mclaren Commercial |
$415.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Nomi Health Commercial |
$378.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$406.61
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
OP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$248.51 |
| Max. Negotiated Rate |
$671.65 |
| Rate for Payer: Aetna Commercial |
$604.49
|
| Rate for Payer: Aetna Medicare |
$248.51
|
| Rate for Payer: ASR ASR |
$651.50
|
| Rate for Payer: BCBS Complete |
$268.66
|
| Rate for Payer: BCBS Trust/PPO |
$553.78
|
| Rate for Payer: BCN Commercial |
$553.78
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Commercial |
$631.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Healthscope Commercial |
$651.50
|
| Rate for Payer: Healthscope Whirlpool |
$671.65
|
| Rate for Payer: Mclaren Commercial |
$604.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$537.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Nomi Health Commercial |
$550.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$588.50
|
| Rate for Payer: Priority Health Narrow Network |
$470.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$591.05
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
IP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$503.74 |
| Max. Negotiated Rate |
$671.65 |
| Rate for Payer: Aetna Commercial |
$604.49
|
| Rate for Payer: ASR ASR |
$651.50
|
| Rate for Payer: BCBS Trust/PPO |
$551.56
|
| Rate for Payer: BCN Commercial |
$551.56
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Commercial |
$631.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Healthscope Commercial |
$651.50
|
| Rate for Payer: Healthscope Whirlpool |
$671.65
|
| Rate for Payer: Mclaren Commercial |
$604.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Nomi Health Commercial |
$550.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$591.05
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
IP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.92 |
| Max. Negotiated Rate |
$43.89 |
| Rate for Payer: Aetna Commercial |
$39.50
|
| Rate for Payer: ASR ASR |
$42.57
|
| Rate for Payer: BCBS Trust/PPO |
$36.04
|
| Rate for Payer: BCN Commercial |
$36.04
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$41.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Healthscope Commercial |
$42.57
|
| Rate for Payer: Healthscope Whirlpool |
$43.89
|
| Rate for Payer: Mclaren Commercial |
$39.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Nomi Health Commercial |
$35.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.62
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
OP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.24 |
| Max. Negotiated Rate |
$43.89 |
| Rate for Payer: Aetna Commercial |
$39.50
|
| Rate for Payer: Aetna Medicare |
$16.24
|
| Rate for Payer: ASR ASR |
$42.57
|
| Rate for Payer: BCBS Complete |
$17.56
|
| Rate for Payer: BCBS Trust/PPO |
$36.19
|
| Rate for Payer: BCN Commercial |
$36.19
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$41.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Healthscope Commercial |
$42.57
|
| Rate for Payer: Healthscope Whirlpool |
$43.89
|
| Rate for Payer: Mclaren Commercial |
$39.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Nomi Health Commercial |
$35.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$30.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.62
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
OP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$661.93 |
| Max. Negotiated Rate |
$1,789.01 |
| Rate for Payer: Aetna Commercial |
$1,610.11
|
| Rate for Payer: Aetna Medicare |
$661.93
|
| Rate for Payer: ASR ASR |
$1,735.34
|
| Rate for Payer: BCBS Complete |
$715.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.04
|
| Rate for Payer: BCN Commercial |
$1,475.04
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Commercial |
$1,681.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Healthscope Commercial |
$1,735.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,789.01
|
| Rate for Payer: Mclaren Commercial |
$1,610.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,431.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Nomi Health Commercial |
$1,466.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,567.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,574.33
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
IP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,341.76 |
| Max. Negotiated Rate |
$1,789.01 |
| Rate for Payer: Aetna Commercial |
$1,610.11
|
| Rate for Payer: ASR ASR |
$1,735.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,469.14
|
| Rate for Payer: BCN Commercial |
$1,469.14
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Commercial |
$1,681.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Healthscope Commercial |
$1,735.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,789.01
|
| Rate for Payer: Mclaren Commercial |
$1,610.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Nomi Health Commercial |
$1,466.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,574.33
|
|
