|
HC GUIDING CATHETER LVL19
|
Facility
|
OP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$732.00 |
| Max. Negotiated Rate |
$1,978.37 |
| Rate for Payer: Aetna Commercial |
$1,780.53
|
| Rate for Payer: Aetna Medicare |
$732.00
|
| Rate for Payer: ASR ASR |
$1,919.02
|
| Rate for Payer: BCBS Complete |
$791.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.17
|
| Rate for Payer: BCN Commercial |
$1,631.17
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Commercial |
$1,859.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Healthscope Commercial |
$1,919.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,978.37
|
| Rate for Payer: Mclaren Commercial |
$1,780.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,582.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Nomi Health Commercial |
$1,622.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,733.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,740.97
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
IP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,483.78 |
| Max. Negotiated Rate |
$1,978.37 |
| Rate for Payer: Aetna Commercial |
$1,780.53
|
| Rate for Payer: ASR ASR |
$1,919.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,624.64
|
| Rate for Payer: BCN Commercial |
$1,624.64
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Commercial |
$1,859.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Healthscope Commercial |
$1,919.02
|
| Rate for Payer: Healthscope Whirlpool |
$1,978.37
|
| Rate for Payer: Mclaren Commercial |
$1,780.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Nomi Health Commercial |
$1,622.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,740.97
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
IP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$285.99 |
| Rate for Payer: Aetna Commercial |
$257.39
|
| Rate for Payer: ASR ASR |
$277.41
|
| Rate for Payer: BCBS Trust/PPO |
$234.85
|
| Rate for Payer: BCN Commercial |
$234.85
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Commercial |
$268.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Healthscope Commercial |
$277.41
|
| Rate for Payer: Healthscope Whirlpool |
$285.99
|
| Rate for Payer: Mclaren Commercial |
$257.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Nomi Health Commercial |
$234.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.67
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
OP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.82 |
| Max. Negotiated Rate |
$285.99 |
| Rate for Payer: Aetna Commercial |
$257.39
|
| Rate for Payer: Aetna Medicare |
$105.82
|
| Rate for Payer: ASR ASR |
$277.41
|
| Rate for Payer: BCBS Complete |
$114.40
|
| Rate for Payer: BCBS Trust/PPO |
$235.80
|
| Rate for Payer: BCN Commercial |
$235.80
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Commercial |
$268.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Healthscope Commercial |
$277.41
|
| Rate for Payer: Healthscope Whirlpool |
$285.99
|
| Rate for Payer: Mclaren Commercial |
$257.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Nomi Health Commercial |
$234.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Narrow Network |
$200.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.67
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
OP
|
$2,527.27
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$935.09 |
| Max. Negotiated Rate |
$2,527.27 |
| Rate for Payer: Aetna Commercial |
$2,274.54
|
| Rate for Payer: Aetna Medicare |
$935.09
|
| Rate for Payer: ASR ASR |
$2,451.45
|
| Rate for Payer: BCBS Complete |
$1,010.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,083.73
|
| Rate for Payer: BCN Commercial |
$2,083.73
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cofinity Commercial |
$2,375.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,021.82
|
| Rate for Payer: Healthscope Commercial |
$2,451.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,527.27
|
| Rate for Payer: Mclaren Commercial |
$2,274.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,021.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,148.18
|
| Rate for Payer: Nomi Health Commercial |
$2,072.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,214.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,771.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,224.00
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
IP
|
$2,527.27
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,895.45 |
| Max. Negotiated Rate |
$2,527.27 |
| Rate for Payer: Aetna Commercial |
$2,274.54
|
| Rate for Payer: ASR ASR |
$2,451.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,075.39
|
| Rate for Payer: BCN Commercial |
$2,075.39
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cofinity Commercial |
$2,375.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,021.82
|
| Rate for Payer: Healthscope Commercial |
$2,451.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,527.27
|
| Rate for Payer: Mclaren Commercial |
$2,274.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,148.18
|
| Rate for Payer: Nomi Health Commercial |
$2,072.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,224.00
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
IP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.12 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$303.75
|
| Rate for Payer: ASR ASR |
$327.38
|
| Rate for Payer: BCBS Trust/PPO |
$277.15
|
| Rate for Payer: BCN Commercial |
$277.15
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$317.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$327.38
|
| Rate for Payer: Healthscope Whirlpool |
$337.50
|
| Rate for Payer: Mclaren Commercial |
$303.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.00
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
OP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.88 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$303.75
|
| Rate for Payer: Aetna Medicare |
$124.88
|
| Rate for Payer: ASR ASR |
$327.38
|
| Rate for Payer: BCBS Complete |
$135.00
|
| Rate for Payer: BCBS Trust/PPO |
$278.27
|
| Rate for Payer: BCN Commercial |
$278.27
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$317.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$327.38
|
| Rate for Payer: Healthscope Whirlpool |
$337.50
|
| Rate for Payer: Mclaren Commercial |
$303.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$295.72
|
| Rate for Payer: Priority Health Narrow Network |
$236.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.00
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
IP
|
$3,664.40
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,748.30 |
| Max. Negotiated Rate |
$3,664.40 |
| Rate for Payer: Aetna Commercial |
$3,297.96
|
| Rate for Payer: ASR ASR |
$3,554.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,009.21
|
| Rate for Payer: BCN Commercial |
$3,009.21
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cofinity Commercial |
$3,444.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.52
|
| Rate for Payer: Healthscope Commercial |
$3,554.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,664.40
|
| Rate for Payer: Mclaren Commercial |
$3,297.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,114.74
|
| Rate for Payer: Nomi Health Commercial |
$3,004.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,748.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,224.67
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
OP
|
$3,664.40
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,355.83 |
| Max. Negotiated Rate |
$3,664.40 |
| Rate for Payer: Aetna Commercial |
$3,297.96
|
| Rate for Payer: Aetna Medicare |
$1,355.83
|
| Rate for Payer: ASR ASR |
$3,554.47
|
| Rate for Payer: BCBS Complete |
$1,465.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,021.30
|
| Rate for Payer: BCN Commercial |
$3,021.30
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cofinity Commercial |
$3,444.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.52
|
| Rate for Payer: Healthscope Commercial |
$3,554.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,664.40
|
| Rate for Payer: Mclaren Commercial |
$3,297.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,931.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,114.74
|
| Rate for Payer: Nomi Health Commercial |
$3,004.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,748.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,210.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,568.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,224.67
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
OP
|
$490.52
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$181.49 |
| Max. Negotiated Rate |
$490.52 |
| Rate for Payer: Aetna Commercial |
$441.47
|
| Rate for Payer: Aetna Medicare |
$181.49
|
| Rate for Payer: ASR ASR |
$475.80
|
| Rate for Payer: BCBS Complete |
$196.21
|
| Rate for Payer: BCBS Trust/PPO |
$404.43
|
| Rate for Payer: BCN Commercial |
$404.43
|
| Rate for Payer: Cash Price |
$392.42
|
| Rate for Payer: Cofinity Commercial |
$461.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.42
|
| Rate for Payer: Healthscope Commercial |
$475.80
|
| Rate for Payer: Healthscope Whirlpool |
$490.52
|
| Rate for Payer: Mclaren Commercial |
$441.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$392.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.94
|
| Rate for Payer: Nomi Health Commercial |
$402.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$429.79
|
| Rate for Payer: Priority Health Narrow Network |
$343.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.66
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
IP
|
$490.52
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.89 |
| Max. Negotiated Rate |
$490.52 |
| Rate for Payer: Aetna Commercial |
$441.47
|
| Rate for Payer: ASR ASR |
$475.80
|
| Rate for Payer: BCBS Trust/PPO |
$402.82
|
| Rate for Payer: BCN Commercial |
$402.82
|
| Rate for Payer: Cash Price |
$392.42
|
| Rate for Payer: Cofinity Commercial |
$461.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.42
|
| Rate for Payer: Healthscope Commercial |
$475.80
|
| Rate for Payer: Healthscope Whirlpool |
$490.52
|
| Rate for Payer: Mclaren Commercial |
$441.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.94
|
| Rate for Payer: Nomi Health Commercial |
$402.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.66
|
|
|
HC GUIDING CATHETER LVL 42
|
Facility
|
IP
|
$4,295.53
|
|
| Hospital Charge Code |
27200130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,221.65 |
| Max. Negotiated Rate |
$4,295.53 |
| Rate for Payer: Aetna Commercial |
$3,865.98
|
| Rate for Payer: ASR ASR |
$4,166.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,527.49
|
| Rate for Payer: BCN Commercial |
$3,527.49
|
| Rate for Payer: Cash Price |
$3,436.42
|
| Rate for Payer: Cofinity Commercial |
$4,037.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,436.42
|
| Rate for Payer: Healthscope Commercial |
$4,166.66
|
| Rate for Payer: Healthscope Whirlpool |
$4,295.53
|
| Rate for Payer: Mclaren Commercial |
$3,865.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,651.20
|
| Rate for Payer: Nomi Health Commercial |
$3,522.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,221.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,780.07
|
|
|
HC GUIDING CATHETER LVL 42
|
Facility
|
OP
|
$4,295.53
|
|
| Hospital Charge Code |
27200130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,589.35 |
| Max. Negotiated Rate |
$4,295.53 |
| Rate for Payer: Aetna Commercial |
$3,865.98
|
| Rate for Payer: Aetna Medicare |
$1,589.35
|
| Rate for Payer: ASR ASR |
$4,166.66
|
| Rate for Payer: BCBS Complete |
$1,718.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,541.66
|
| Rate for Payer: BCN Commercial |
$3,541.66
|
| Rate for Payer: Cash Price |
$3,436.42
|
| Rate for Payer: Cofinity Commercial |
$4,037.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,436.42
|
| Rate for Payer: Healthscope Commercial |
$4,166.66
|
| Rate for Payer: Healthscope Whirlpool |
$4,295.53
|
| Rate for Payer: Mclaren Commercial |
$3,865.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,436.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,651.20
|
| Rate for Payer: Nomi Health Commercial |
$3,522.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,221.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,763.74
|
| Rate for Payer: Priority Health Narrow Network |
$3,011.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,780.07
|
|
|
HC GUIDING CATHETER LVL 57
|
Facility
|
IP
|
$5,712.15
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,284.11 |
| Max. Negotiated Rate |
$5,712.15 |
| Rate for Payer: Aetna Commercial |
$5,140.94
|
| Rate for Payer: ASR ASR |
$5,540.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,690.82
|
| Rate for Payer: BCN Commercial |
$4,690.82
|
| Rate for Payer: Cash Price |
$4,569.72
|
| Rate for Payer: Cofinity Commercial |
$5,369.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.72
|
| Rate for Payer: Healthscope Commercial |
$5,540.79
|
| Rate for Payer: Healthscope Whirlpool |
$5,712.15
|
| Rate for Payer: Mclaren Commercial |
$5,140.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,855.33
|
| Rate for Payer: Nomi Health Commercial |
$4,683.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,284.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,026.69
|
|
|
HC GUIDING CATHETER LVL 57
|
Facility
|
OP
|
$5,712.15
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,113.50 |
| Max. Negotiated Rate |
$5,712.15 |
| Rate for Payer: Aetna Commercial |
$5,140.94
|
| Rate for Payer: Aetna Medicare |
$2,113.50
|
| Rate for Payer: ASR ASR |
$5,540.79
|
| Rate for Payer: BCBS Complete |
$2,284.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,709.67
|
| Rate for Payer: BCN Commercial |
$4,709.67
|
| Rate for Payer: Cash Price |
$4,569.72
|
| Rate for Payer: Cofinity Commercial |
$5,369.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.72
|
| Rate for Payer: Healthscope Commercial |
$5,540.79
|
| Rate for Payer: Healthscope Whirlpool |
$5,712.15
|
| Rate for Payer: Mclaren Commercial |
$5,140.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,569.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,855.33
|
| Rate for Payer: Nomi Health Commercial |
$4,683.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,284.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,004.99
|
| Rate for Payer: Priority Health Narrow Network |
$4,004.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,026.69
|
|
|
HC GUIDING CATHETER LVL 6
|
Facility
|
IP
|
$662.80
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$497.10 |
| Max. Negotiated Rate |
$662.80 |
| Rate for Payer: Aetna Commercial |
$596.52
|
| Rate for Payer: ASR ASR |
$642.92
|
| Rate for Payer: BCBS Trust/PPO |
$544.29
|
| Rate for Payer: BCN Commercial |
$544.29
|
| Rate for Payer: Cash Price |
$530.24
|
| Rate for Payer: Cofinity Commercial |
$623.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.24
|
| Rate for Payer: Healthscope Commercial |
$642.92
|
| Rate for Payer: Healthscope Whirlpool |
$662.80
|
| Rate for Payer: Mclaren Commercial |
$596.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.38
|
| Rate for Payer: Nomi Health Commercial |
$543.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.26
|
|
|
HC GUIDING CATHETER LVL 6
|
Facility
|
OP
|
$662.80
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$245.24 |
| Max. Negotiated Rate |
$662.80 |
| Rate for Payer: Aetna Commercial |
$596.52
|
| Rate for Payer: Aetna Medicare |
$245.24
|
| Rate for Payer: ASR ASR |
$642.92
|
| Rate for Payer: BCBS Complete |
$265.12
|
| Rate for Payer: BCBS Trust/PPO |
$546.48
|
| Rate for Payer: BCN Commercial |
$546.48
|
| Rate for Payer: Cash Price |
$530.24
|
| Rate for Payer: Cofinity Commercial |
$623.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.24
|
| Rate for Payer: Healthscope Commercial |
$642.92
|
| Rate for Payer: Healthscope Whirlpool |
$662.80
|
| Rate for Payer: Mclaren Commercial |
$596.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$530.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.38
|
| Rate for Payer: Nomi Health Commercial |
$543.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$580.75
|
| Rate for Payer: Priority Health Narrow Network |
$464.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.26
|
|
|
HC HAEMOPHILUS INFLUENZAE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600269
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.49
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC HAEMOPHILUS INFLUENZAE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600269
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB) PRP-T CONJUGATE, 4 DOSE IM
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
63600069
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.90 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: BCBS Trust/PPO |
$28.00
|
| Rate for Payer: BCN Commercial |
$28.00
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14.87
|
| Rate for Payer: Priority Health Narrow Network |
$11.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
|
|
HC HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB) PRP-T CONJUGATE, 4 DOSE IM
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
63600069
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna Commercial |
$30.56
|
| Rate for Payer: ASR ASR |
$32.94
|
| Rate for Payer: BCBS Trust/PPO |
$27.89
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$31.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$32.94
|
| Rate for Payer: Healthscope Whirlpool |
$33.96
|
| Rate for Payer: Mclaren Commercial |
$30.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.88
|
|
|
HC HAI ESTABLISHED PATIENT LEVEL I
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000014
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$111.14 |
| Max. Negotiated Rate |
$148.19 |
| Rate for Payer: Aetna Commercial |
$133.37
|
| Rate for Payer: ASR ASR |
$143.74
|
| Rate for Payer: BCBS Trust/PPO |
$121.69
|
| Rate for Payer: BCN Commercial |
$121.69
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$139.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Healthscope Whirlpool |
$148.19
|
| Rate for Payer: Mclaren Commercial |
$133.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.41
|
|
|
HC HAI ESTABLISHED PATIENT LEVEL I
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000014
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$148.19 |
| Rate for Payer: Aetna Commercial |
$133.37
|
| Rate for Payer: Aetna Medicare |
$54.83
|
| Rate for Payer: ASR ASR |
$143.74
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS Trust/PPO |
$122.18
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$122.18
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$139.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$143.74
|
| Rate for Payer: Healthscope Whirlpool |
$148.19
|
| Rate for Payer: Mclaren Commercial |
$133.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.41
|
|
|
HC HAI PICC FLUSH
|
Facility
|
OP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$134.71 |
| Rate for Payer: Aetna Commercial |
$121.24
|
| Rate for Payer: Aetna Medicare |
$49.84
|
| Rate for Payer: ASR ASR |
$130.67
|
| Rate for Payer: BCBS Complete |
$53.88
|
| Rate for Payer: BCBS Trust/PPO |
$111.07
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$111.07
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$126.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Healthscope Commercial |
$130.67
|
| Rate for Payer: Healthscope Whirlpool |
$134.71
|
| Rate for Payer: Mclaren Commercial |
$121.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.50
|
| Rate for Payer: Nomi Health Commercial |
$110.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.95
|
| Rate for Payer: Priority Health Narrow Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.54
|
|
