|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
OP
|
$107.21
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.88 |
| Max. Negotiated Rate |
$107.21 |
| Rate for Payer: Aetna Commercial |
$96.49
|
| Rate for Payer: Aetna Medicare |
$53.60
|
| Rate for Payer: ASR ASR |
$103.99
|
| Rate for Payer: ASR Commercial |
$103.99
|
| Rate for Payer: BCBS Complete |
$42.88
|
| Rate for Payer: BCBS Trust/PPO |
$87.79
|
| Rate for Payer: BCN Commercial |
$83.12
|
| Rate for Payer: Cash Price |
$85.77
|
| Rate for Payer: Cofinity Commercial |
$100.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.77
|
| Rate for Payer: Healthscope Commercial |
$107.21
|
| Rate for Payer: Healthscope Whirlpool |
$103.99
|
| Rate for Payer: Mclaren Commercial |
$96.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.13
|
| Rate for Payer: Nomi Health Commercial |
$87.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.94
|
| Rate for Payer: Priority Health Narrow Network |
$75.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.34
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$16.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.84
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$9.38
|
| Rate for Payer: BCBS MAPPO |
$16.67
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$16.67
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.67
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.67
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$8.94
|
| Rate for Payer: Mclaren Medicare |
$16.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.50
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$15.84
|
| Rate for Payer: PACE SWMI |
$16.67
|
| Rate for Payer: PHP Commercial |
$18.34
|
| Rate for Payer: PHP Medicaid |
$8.94
|
| Rate for Payer: PHP Medicare Advantage |
$16.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.09
|
| Rate for Payer: Priority Health Medicare |
$16.67
|
| Rate for Payer: Priority Health Narrow Network |
$46.48
|
| Rate for Payer: Railroad Medicare Medicare |
$16.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.67
|
| Rate for Payer: UHC Exchange |
$25.84
|
| Rate for Payer: UHC Medicare Advantage |
$16.67
|
| Rate for Payer: UHCCP DNSP |
$16.67
|
| Rate for Payer: UHCCP Medicaid |
$8.94
|
| Rate for Payer: VA VA |
$16.67
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Trust/PPO |
$551.08
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.14 |
| Max. Negotiated Rate |
$676.26 |
| Rate for Payer: Aetna Commercial |
$608.63
|
| Rate for Payer: Aetna Medicare |
$205.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$256.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$256.85
|
| Rate for Payer: ASR ASR |
$655.97
|
| Rate for Payer: ASR Commercial |
$655.97
|
| Rate for Payer: BCBS Complete |
$115.64
|
| Rate for Payer: BCBS MAPPO |
$205.48
|
| Rate for Payer: BCBS Trust/PPO |
$553.79
|
| Rate for Payer: BCN Commercial |
$524.30
|
| Rate for Payer: BCN Medicare Advantage |
$205.48
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$635.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.48
|
| Rate for Payer: Healthscope Commercial |
$676.26
|
| Rate for Payer: Healthscope Whirlpool |
$655.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$205.48
|
| Rate for Payer: Mclaren Commercial |
$608.63
|
| Rate for Payer: Mclaren Medicaid |
$110.14
|
| Rate for Payer: Mclaren Medicare |
$205.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.75
|
| Rate for Payer: Meridian Medicaid |
$115.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Medicare |
$195.21
|
| Rate for Payer: PACE SWMI |
$205.48
|
| Rate for Payer: PHP Commercial |
$226.03
|
| Rate for Payer: PHP Medicaid |
$110.14
|
| Rate for Payer: PHP Medicare Advantage |
$205.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.54
|
| Rate for Payer: Priority Health Medicare |
$205.48
|
| Rate for Payer: Priority Health Narrow Network |
$474.06
|
| Rate for Payer: Railroad Medicare Medicare |
$205.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.48
|
| Rate for Payer: UHC Exchange |
$318.49
|
| Rate for Payer: UHC Medicare Advantage |
$205.48
|
| Rate for Payer: UHCCP DNSP |
$205.48
|
| Rate for Payer: UHCCP Medicaid |
$110.14
|
| Rate for Payer: VA VA |
$205.48
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.23
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$145.08 |
| Rate for Payer: Aetna Commercial |
$130.57
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: ASR ASR |
$140.73
|
| Rate for Payer: ASR Commercial |
$140.73
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$118.81
|
| Rate for Payer: BCN Commercial |
$112.48
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$136.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$145.08
|
| Rate for Payer: Healthscope Whirlpool |
$140.73
|
| Rate for Payer: Mclaren Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.12
|
| Rate for Payer: Priority Health Narrow Network |
$101.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.67
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
IP
|
$576.50
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$374.73 |
| Max. Negotiated Rate |
$576.50 |
| Rate for Payer: Aetna Commercial |
$518.85
|
| Rate for Payer: ASR ASR |
$559.21
|
| Rate for Payer: ASR Commercial |
$559.21
|
| Rate for Payer: BCBS Trust/PPO |
$469.79
|
| Rate for Payer: BCN Commercial |
$446.96
|
| Rate for Payer: Cash Price |
$461.20
|
| Rate for Payer: Cofinity Commercial |
$541.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.20
|
| Rate for Payer: Healthscope Commercial |
$576.50
|
| Rate for Payer: Healthscope Whirlpool |
$559.21
|
| Rate for Payer: Mclaren Commercial |
$518.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.02
|
| Rate for Payer: Nomi Health Commercial |
$472.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.32
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
OP
|
$576.50
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$230.60 |
| Max. Negotiated Rate |
$576.50 |
| Rate for Payer: Aetna Commercial |
$518.85
|
| Rate for Payer: Aetna Medicare |
$288.25
|
| Rate for Payer: ASR ASR |
$559.21
|
| Rate for Payer: ASR Commercial |
$559.21
|
| Rate for Payer: BCBS Complete |
$230.60
|
| Rate for Payer: BCBS Trust/PPO |
$472.10
|
| Rate for Payer: BCN Commercial |
$446.96
|
| Rate for Payer: Cash Price |
$461.20
|
| Rate for Payer: Cofinity Commercial |
$541.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.20
|
| Rate for Payer: Healthscope Commercial |
$576.50
|
| Rate for Payer: Healthscope Whirlpool |
$559.21
|
| Rate for Payer: Mclaren Commercial |
$518.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.02
|
| Rate for Payer: Nomi Health Commercial |
$472.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.13
|
| Rate for Payer: Priority Health Narrow Network |
$404.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$507.32
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
OP
|
$5,821.41
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,328.56 |
| Max. Negotiated Rate |
$5,821.41 |
| Rate for Payer: Aetna Commercial |
$5,239.27
|
| Rate for Payer: Aetna Medicare |
$2,910.70
|
| Rate for Payer: ASR ASR |
$5,646.77
|
| Rate for Payer: ASR Commercial |
$5,646.77
|
| Rate for Payer: BCBS Complete |
$2,328.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,767.15
|
| Rate for Payer: BCN Commercial |
$4,513.34
|
| Rate for Payer: Cash Price |
$4,657.13
|
| Rate for Payer: Cofinity Commercial |
$5,472.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,657.13
|
| Rate for Payer: Healthscope Commercial |
$5,821.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,646.77
|
| Rate for Payer: Mclaren Commercial |
$5,239.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,948.20
|
| Rate for Payer: Nomi Health Commercial |
$4,773.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,783.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,100.72
|
| Rate for Payer: Priority Health Narrow Network |
$4,080.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,122.84
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
IP
|
$5,821.41
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,783.92 |
| Max. Negotiated Rate |
$5,821.41 |
| Rate for Payer: Aetna Commercial |
$5,239.27
|
| Rate for Payer: ASR ASR |
$5,646.77
|
| Rate for Payer: ASR Commercial |
$5,646.77
|
| Rate for Payer: BCBS Trust/PPO |
$4,743.87
|
| Rate for Payer: BCN Commercial |
$4,513.34
|
| Rate for Payer: Cash Price |
$4,657.13
|
| Rate for Payer: Cofinity Commercial |
$5,472.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,657.13
|
| Rate for Payer: Healthscope Commercial |
$5,821.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,646.77
|
| Rate for Payer: Mclaren Commercial |
$5,239.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,948.20
|
| Rate for Payer: Nomi Health Commercial |
$4,773.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,783.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,122.84
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
OP
|
$10,353.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,141.20 |
| Max. Negotiated Rate |
$10,353.00 |
| Rate for Payer: Aetna Commercial |
$9,317.70
|
| Rate for Payer: Aetna Medicare |
$5,176.50
|
| Rate for Payer: ASR ASR |
$10,042.41
|
| Rate for Payer: ASR Commercial |
$10,042.41
|
| Rate for Payer: BCBS Complete |
$4,141.20
|
| Rate for Payer: BCBS Trust/PPO |
$8,478.07
|
| Rate for Payer: BCN Commercial |
$8,026.68
|
| Rate for Payer: Cash Price |
$8,282.40
|
| Rate for Payer: Cofinity Commercial |
$9,731.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,282.40
|
| Rate for Payer: Healthscope Commercial |
$10,353.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,042.41
|
| Rate for Payer: Mclaren Commercial |
$9,317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,800.05
|
| Rate for Payer: Nomi Health Commercial |
$8,489.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,729.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,071.30
|
| Rate for Payer: Priority Health Narrow Network |
$7,257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,110.64
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
IP
|
$10,353.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,729.45 |
| Max. Negotiated Rate |
$10,353.00 |
| Rate for Payer: Aetna Commercial |
$9,317.70
|
| Rate for Payer: ASR ASR |
$10,042.41
|
| Rate for Payer: ASR Commercial |
$10,042.41
|
| Rate for Payer: BCBS Trust/PPO |
$8,436.66
|
| Rate for Payer: BCN Commercial |
$8,026.68
|
| Rate for Payer: Cash Price |
$8,282.40
|
| Rate for Payer: Cofinity Commercial |
$9,731.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,282.40
|
| Rate for Payer: Healthscope Commercial |
$10,353.00
|
| Rate for Payer: Healthscope Whirlpool |
$10,042.41
|
| Rate for Payer: Mclaren Commercial |
$9,317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,800.05
|
| Rate for Payer: Nomi Health Commercial |
$8,489.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,729.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,110.64
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
IP
|
$13,252.86
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,614.36 |
| Max. Negotiated Rate |
$13,252.86 |
| Rate for Payer: Aetna Commercial |
$11,927.57
|
| Rate for Payer: ASR ASR |
$12,855.27
|
| Rate for Payer: ASR Commercial |
$12,855.27
|
| Rate for Payer: BCBS Trust/PPO |
$10,799.76
|
| Rate for Payer: BCN Commercial |
$10,274.94
|
| Rate for Payer: Cash Price |
$10,602.29
|
| Rate for Payer: Cofinity Commercial |
$12,457.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,602.29
|
| Rate for Payer: Healthscope Commercial |
$13,252.86
|
| Rate for Payer: Healthscope Whirlpool |
$12,855.27
|
| Rate for Payer: Mclaren Commercial |
$11,927.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,264.93
|
| Rate for Payer: Nomi Health Commercial |
$10,867.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,614.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,662.52
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
OP
|
$13,252.86
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,301.14 |
| Max. Negotiated Rate |
$13,252.86 |
| Rate for Payer: Aetna Commercial |
$11,927.57
|
| Rate for Payer: Aetna Medicare |
$6,626.43
|
| Rate for Payer: ASR ASR |
$12,855.27
|
| Rate for Payer: ASR Commercial |
$12,855.27
|
| Rate for Payer: BCBS Complete |
$5,301.14
|
| Rate for Payer: BCBS Trust/PPO |
$10,852.77
|
| Rate for Payer: BCN Commercial |
$10,274.94
|
| Rate for Payer: Cash Price |
$10,602.29
|
| Rate for Payer: Cofinity Commercial |
$12,457.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,602.29
|
| Rate for Payer: Healthscope Commercial |
$13,252.86
|
| Rate for Payer: Healthscope Whirlpool |
$12,855.27
|
| Rate for Payer: Mclaren Commercial |
$11,927.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,264.93
|
| Rate for Payer: Nomi Health Commercial |
$10,867.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,614.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,612.16
|
| Rate for Payer: Priority Health Narrow Network |
$9,290.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,662.52
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
OP
|
$534.58
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.83 |
| Max. Negotiated Rate |
$534.58 |
| Rate for Payer: Aetna Commercial |
$481.12
|
| Rate for Payer: Aetna Medicare |
$267.29
|
| Rate for Payer: ASR ASR |
$518.54
|
| Rate for Payer: ASR Commercial |
$518.54
|
| Rate for Payer: BCBS Complete |
$213.83
|
| Rate for Payer: BCBS Trust/PPO |
$437.77
|
| Rate for Payer: BCN Commercial |
$414.46
|
| Rate for Payer: Cash Price |
$427.66
|
| Rate for Payer: Cofinity Commercial |
$502.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.66
|
| Rate for Payer: Healthscope Commercial |
$534.58
|
| Rate for Payer: Healthscope Whirlpool |
$518.54
|
| Rate for Payer: Mclaren Commercial |
$481.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.39
|
| Rate for Payer: Nomi Health Commercial |
$438.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.40
|
| Rate for Payer: Priority Health Narrow Network |
$374.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.43
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
IP
|
$534.58
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$347.48 |
| Max. Negotiated Rate |
$534.58 |
| Rate for Payer: Aetna Commercial |
$481.12
|
| Rate for Payer: ASR ASR |
$518.54
|
| Rate for Payer: ASR Commercial |
$518.54
|
| Rate for Payer: BCBS Trust/PPO |
$435.63
|
| Rate for Payer: BCN Commercial |
$414.46
|
| Rate for Payer: Cash Price |
$427.66
|
| Rate for Payer: Cofinity Commercial |
$502.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.66
|
| Rate for Payer: Healthscope Commercial |
$534.58
|
| Rate for Payer: Healthscope Whirlpool |
$518.54
|
| Rate for Payer: Mclaren Commercial |
$481.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.39
|
| Rate for Payer: Nomi Health Commercial |
$438.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.43
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
IP
|
$1,752.92
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,139.40 |
| Max. Negotiated Rate |
$1,752.92 |
| Rate for Payer: Aetna Commercial |
$1,577.63
|
| Rate for Payer: ASR ASR |
$1,700.33
|
| Rate for Payer: ASR Commercial |
$1,700.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.45
|
| Rate for Payer: BCN Commercial |
$1,359.04
|
| Rate for Payer: Cash Price |
$1,402.34
|
| Rate for Payer: Cofinity Commercial |
$1,647.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,402.34
|
| Rate for Payer: Healthscope Commercial |
$1,752.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,700.33
|
| Rate for Payer: Mclaren Commercial |
$1,577.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,489.98
|
| Rate for Payer: Nomi Health Commercial |
$1,437.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,139.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,542.57
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
OP
|
$1,752.92
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$701.17 |
| Max. Negotiated Rate |
$1,752.92 |
| Rate for Payer: Aetna Commercial |
$1,577.63
|
| Rate for Payer: Aetna Medicare |
$876.46
|
| Rate for Payer: ASR ASR |
$1,700.33
|
| Rate for Payer: ASR Commercial |
$1,700.33
|
| Rate for Payer: BCBS Complete |
$701.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,435.47
|
| Rate for Payer: BCN Commercial |
$1,359.04
|
| Rate for Payer: Cash Price |
$1,402.34
|
| Rate for Payer: Cofinity Commercial |
$1,647.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,402.34
|
| Rate for Payer: Healthscope Commercial |
$1,752.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,700.33
|
| Rate for Payer: Mclaren Commercial |
$1,577.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,489.98
|
| Rate for Payer: Nomi Health Commercial |
$1,437.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,139.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,535.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,228.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,542.57
|
|
|
HC GUIDEWIRE
|
Facility
|
OP
|
$49.38
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$49.38 |
| Rate for Payer: Aetna Commercial |
$44.44
|
| Rate for Payer: Aetna Medicare |
$24.69
|
| Rate for Payer: ASR ASR |
$47.90
|
| Rate for Payer: ASR Commercial |
$47.90
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS Trust/PPO |
$40.44
|
| Rate for Payer: BCN Commercial |
$38.28
|
| Rate for Payer: Cash Price |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$46.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.50
|
| Rate for Payer: Healthscope Commercial |
$49.38
|
| Rate for Payer: Healthscope Whirlpool |
$47.90
|
| Rate for Payer: Mclaren Commercial |
$44.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.97
|
| Rate for Payer: Nomi Health Commercial |
$40.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.27
|
| Rate for Payer: Priority Health Narrow Network |
$34.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.45
|
|
|
HC GUIDEWIRE
|
Facility
|
IP
|
$49.38
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.10 |
| Max. Negotiated Rate |
$49.38 |
| Rate for Payer: Aetna Commercial |
$44.44
|
| Rate for Payer: ASR ASR |
$47.90
|
| Rate for Payer: ASR Commercial |
$47.90
|
| Rate for Payer: BCBS Trust/PPO |
$40.24
|
| Rate for Payer: BCN Commercial |
$38.28
|
| Rate for Payer: Cash Price |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$46.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.50
|
| Rate for Payer: Healthscope Commercial |
$49.38
|
| Rate for Payer: Healthscope Whirlpool |
$47.90
|
| Rate for Payer: Mclaren Commercial |
$44.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.97
|
| Rate for Payer: Nomi Health Commercial |
$40.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.45
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
OP
|
$1,345.45
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$538.18 |
| Max. Negotiated Rate |
$1,345.45 |
| Rate for Payer: Aetna Commercial |
$1,210.90
|
| Rate for Payer: Aetna Medicare |
$672.73
|
| Rate for Payer: ASR ASR |
$1,305.09
|
| Rate for Payer: ASR Commercial |
$1,305.09
|
| Rate for Payer: BCBS Complete |
$538.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.79
|
| Rate for Payer: BCN Commercial |
$1,043.13
|
| Rate for Payer: Cash Price |
$1,076.36
|
| Rate for Payer: Cofinity Commercial |
$1,264.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,076.36
|
| Rate for Payer: Healthscope Commercial |
$1,345.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,305.09
|
| Rate for Payer: Mclaren Commercial |
$1,210.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,143.63
|
| Rate for Payer: Nomi Health Commercial |
$1,103.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.88
|
| Rate for Payer: Priority Health Narrow Network |
$943.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,184.00
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
IP
|
$1,345.45
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$874.54 |
| Max. Negotiated Rate |
$1,345.45 |
| Rate for Payer: Aetna Commercial |
$1,210.90
|
| Rate for Payer: ASR ASR |
$1,305.09
|
| Rate for Payer: ASR Commercial |
$1,305.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.41
|
| Rate for Payer: BCN Commercial |
$1,043.13
|
| Rate for Payer: Cash Price |
$1,076.36
|
| Rate for Payer: Cofinity Commercial |
$1,264.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,076.36
|
| Rate for Payer: Healthscope Commercial |
$1,345.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,305.09
|
| Rate for Payer: Mclaren Commercial |
$1,210.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,143.63
|
| Rate for Payer: Nomi Health Commercial |
$1,103.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,184.00
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$79.56 |
| Rate for Payer: Aetna Commercial |
$71.60
|
| Rate for Payer: ASR ASR |
$77.17
|
| Rate for Payer: ASR Commercial |
$77.17
|
| Rate for Payer: BCBS Trust/PPO |
$64.83
|
| Rate for Payer: BCN Commercial |
$61.68
|
| 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 |
$79.56
|
| Rate for Payer: Healthscope Whirlpool |
$77.17
|
| 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: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.01
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$79.56 |
| Rate for Payer: Aetna Commercial |
$71.60
|
| Rate for Payer: Aetna Medicare |
$39.78
|
| Rate for Payer: ASR ASR |
$77.17
|
| Rate for Payer: ASR Commercial |
$77.17
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: BCBS Trust/PPO |
$65.15
|
| Rate for Payer: BCN Commercial |
$61.68
|
| 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 |
$79.56
|
| Rate for Payer: Healthscope Whirlpool |
$77.17
|
| 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: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: 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
|
|
