|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.78 |
| Max. Negotiated Rate |
$263.13 |
| Rate for Payer: Aetna Commercial |
$202.50
|
| Rate for Payer: Aetna Medicare |
$169.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: ASR ASR |
$218.25
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$185.51
|
| Rate for Payer: BCN Commercial |
$185.51
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$211.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$218.25
|
| Rate for Payer: Healthscope Whirlpool |
$225.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$169.76
|
| Rate for Payer: Mclaren Commercial |
$202.50
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$93.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.25
|
| Rate for Payer: Nomi Health Commercial |
$184.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$186.74
|
| Rate for Payer: PHP Medicaid |
$90.99
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$202.17
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health Narrow Network |
$161.73
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$263.13
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP DNSP |
$169.76
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: VA VA |
$169.76
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$168.75 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$202.50
|
| Rate for Payer: ASR ASR |
$218.25
|
| Rate for Payer: BCBS Trust/PPO |
$184.77
|
| Rate for Payer: BCN Commercial |
$184.77
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$211.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.00
|
| Rate for Payer: Healthscope Commercial |
$218.25
|
| Rate for Payer: Healthscope Whirlpool |
$225.00
|
| Rate for Payer: Mclaren Commercial |
$202.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.25
|
| Rate for Payer: Nomi Health Commercial |
$184.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.00
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$386.14
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$186.79 |
| Max. Negotiated Rate |
$553.60 |
| Rate for Payer: Aetna Commercial |
$347.53
|
| Rate for Payer: Aetna Medicare |
$357.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: ASR ASR |
$374.56
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$318.37
|
| Rate for Payer: BCN Commercial |
$318.37
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cofinity Commercial |
$362.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$374.56
|
| Rate for Payer: Healthscope Whirlpool |
$386.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$357.16
|
| Rate for Payer: Mclaren Commercial |
$347.53
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$196.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.22
|
| Rate for Payer: Nomi Health Commercial |
$316.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.61
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$392.88
|
| Rate for Payer: PHP Medicaid |
$191.44
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$338.34
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health Narrow Network |
$270.68
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$553.60
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP DNSP |
$357.16
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: VA VA |
$357.16
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
IP
|
$386.14
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$289.61 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$347.53
|
| Rate for Payer: ASR ASR |
$374.56
|
| Rate for Payer: BCBS Trust/PPO |
$317.10
|
| Rate for Payer: BCN Commercial |
$317.10
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cofinity Commercial |
$362.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.91
|
| Rate for Payer: Healthscope Commercial |
$374.56
|
| Rate for Payer: Healthscope Whirlpool |
$386.14
|
| Rate for Payer: Mclaren Commercial |
$347.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.22
|
| Rate for Payer: Nomi Health Commercial |
$316.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.80
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$47,152.14
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17,446.29 |
| Max. Negotiated Rate |
$47,152.14 |
| Rate for Payer: Aetna Commercial |
$42,436.93
|
| Rate for Payer: Aetna Medicare |
$17,446.29
|
| Rate for Payer: ASR ASR |
$45,737.58
|
| Rate for Payer: BCBS Complete |
$18,860.86
|
| Rate for Payer: BCBS Trust/PPO |
$38,876.94
|
| Rate for Payer: BCN Commercial |
$38,876.94
|
| Rate for Payer: Cash Price |
$37,721.71
|
| Rate for Payer: Cofinity Commercial |
$44,323.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,721.71
|
| Rate for Payer: Healthscope Commercial |
$45,737.58
|
| Rate for Payer: Healthscope Whirlpool |
$47,152.14
|
| Rate for Payer: Mclaren Commercial |
$42,436.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,721.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,079.32
|
| Rate for Payer: Nomi Health Commercial |
$38,664.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,364.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$41,314.71
|
| Rate for Payer: Priority Health Narrow Network |
$33,053.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41,493.88
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$47,152.14
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35,364.11 |
| Max. Negotiated Rate |
$47,152.14 |
| Rate for Payer: Aetna Commercial |
$42,436.93
|
| Rate for Payer: ASR ASR |
$45,737.58
|
| Rate for Payer: BCBS Trust/PPO |
$38,721.34
|
| Rate for Payer: BCN Commercial |
$38,721.34
|
| Rate for Payer: Cash Price |
$37,721.71
|
| Rate for Payer: Cofinity Commercial |
$44,323.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,721.71
|
| Rate for Payer: Healthscope Commercial |
$45,737.58
|
| Rate for Payer: Healthscope Whirlpool |
$47,152.14
|
| Rate for Payer: Mclaren Commercial |
$42,436.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,079.32
|
| Rate for Payer: Nomi Health Commercial |
$38,664.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,364.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41,493.88
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$346.24
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.68 |
| Max. Negotiated Rate |
$346.24 |
| Rate for Payer: Aetna Commercial |
$311.62
|
| Rate for Payer: ASR ASR |
$335.85
|
| Rate for Payer: BCBS Trust/PPO |
$284.33
|
| Rate for Payer: BCN Commercial |
$284.33
|
| Rate for Payer: Cash Price |
$276.99
|
| Rate for Payer: Cofinity Commercial |
$325.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.99
|
| Rate for Payer: Healthscope Commercial |
$335.85
|
| Rate for Payer: Healthscope Whirlpool |
$346.24
|
| Rate for Payer: Mclaren Commercial |
$311.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.30
|
| Rate for Payer: Nomi Health Commercial |
$283.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$304.69
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$346.24
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$128.11 |
| Max. Negotiated Rate |
$346.24 |
| Rate for Payer: Aetna Commercial |
$311.62
|
| Rate for Payer: Aetna Medicare |
$128.11
|
| Rate for Payer: ASR ASR |
$335.85
|
| Rate for Payer: BCBS Complete |
$138.50
|
| Rate for Payer: BCBS Trust/PPO |
$285.47
|
| Rate for Payer: BCN Commercial |
$285.47
|
| Rate for Payer: Cash Price |
$276.99
|
| Rate for Payer: Cofinity Commercial |
$325.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.99
|
| Rate for Payer: Healthscope Commercial |
$335.85
|
| Rate for Payer: Healthscope Whirlpool |
$346.24
|
| Rate for Payer: Mclaren Commercial |
$311.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.30
|
| Rate for Payer: Nomi Health Commercial |
$283.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$303.38
|
| Rate for Payer: Priority Health Narrow Network |
$242.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$304.69
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,989.19
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$2,989.19 |
| Rate for Payer: Aetna Commercial |
$2,690.27
|
| Rate for Payer: Aetna Medicare |
$1,106.00
|
| Rate for Payer: ASR ASR |
$2,899.51
|
| Rate for Payer: BCBS Complete |
$1,195.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,464.59
|
| Rate for Payer: BCN Commercial |
$2,464.59
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cofinity Commercial |
$2,809.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.35
|
| Rate for Payer: Healthscope Commercial |
$2,899.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,989.19
|
| Rate for Payer: Mclaren Commercial |
$2,690.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,391.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,540.81
|
| Rate for Payer: Nomi Health Commercial |
$2,451.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,630.49
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,989.19
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,241.89 |
| Max. Negotiated Rate |
$2,989.19 |
| Rate for Payer: Aetna Commercial |
$2,690.27
|
| Rate for Payer: ASR ASR |
$2,899.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.72
|
| Rate for Payer: BCN Commercial |
$2,454.72
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cofinity Commercial |
$2,809.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.35
|
| Rate for Payer: Healthscope Commercial |
$2,899.51
|
| Rate for Payer: Healthscope Whirlpool |
$2,989.19
|
| Rate for Payer: Mclaren Commercial |
$2,690.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,540.81
|
| Rate for Payer: Nomi Health Commercial |
$2,451.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,630.49
|
|
|
HC IMPELLA RP FLEX
|
Facility
|
OP
|
$31,250.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,562.50 |
| Max. Negotiated Rate |
$31,250.00 |
| Rate for Payer: Aetna Commercial |
$28,125.00
|
| Rate for Payer: Aetna Medicare |
$11,562.50
|
| Rate for Payer: ASR ASR |
$30,312.50
|
| Rate for Payer: BCBS Complete |
$12,500.00
|
| Rate for Payer: BCBS Trust/PPO |
$25,765.62
|
| Rate for Payer: BCN Commercial |
$25,765.62
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cofinity Commercial |
$29,375.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,000.00
|
| Rate for Payer: Healthscope Commercial |
$30,312.50
|
| Rate for Payer: Healthscope Whirlpool |
$31,250.00
|
| Rate for Payer: Mclaren Commercial |
$28,125.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,562.50
|
| Rate for Payer: Nomi Health Commercial |
$25,625.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23,437.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27,381.25
|
| Rate for Payer: Priority Health Narrow Network |
$21,906.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27,500.00
|
|
|
HC IMPELLA RP FLEX
|
Facility
|
IP
|
$31,250.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23,437.50 |
| Max. Negotiated Rate |
$31,250.00 |
| Rate for Payer: Aetna Commercial |
$28,125.00
|
| Rate for Payer: ASR ASR |
$30,312.50
|
| Rate for Payer: BCBS Trust/PPO |
$25,662.50
|
| Rate for Payer: BCN Commercial |
$25,662.50
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cofinity Commercial |
$29,375.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,000.00
|
| Rate for Payer: Healthscope Commercial |
$30,312.50
|
| Rate for Payer: Healthscope Whirlpool |
$31,250.00
|
| Rate for Payer: Mclaren Commercial |
$28,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,562.50
|
| Rate for Payer: Nomi Health Commercial |
$25,625.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23,437.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27,500.00
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,326.68
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,745.01 |
| Max. Negotiated Rate |
$6,326.68 |
| Rate for Payer: Aetna Commercial |
$5,694.01
|
| Rate for Payer: ASR ASR |
$6,136.88
|
| Rate for Payer: BCBS Trust/PPO |
$5,195.47
|
| Rate for Payer: BCN Commercial |
$5,195.47
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cofinity Commercial |
$5,947.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.34
|
| Rate for Payer: Healthscope Commercial |
$6,136.88
|
| Rate for Payer: Healthscope Whirlpool |
$6,326.68
|
| Rate for Payer: Mclaren Commercial |
$5,694.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.68
|
| Rate for Payer: Nomi Health Commercial |
$5,187.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,567.48
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,326.68
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,745.01 |
| Max. Negotiated Rate |
$44,299.33 |
| Rate for Payer: Aetna Commercial |
$5,694.01
|
| Rate for Payer: Aetna Medicare |
$28,580.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,725.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,725.26
|
| Rate for Payer: ASR ASR |
$6,136.88
|
| Rate for Payer: BCBS Complete |
$15,696.25
|
| Rate for Payer: BCBS MAPPO |
$28,580.21
|
| Rate for Payer: BCBS Trust/PPO |
$5,216.35
|
| Rate for Payer: BCN Commercial |
$5,216.35
|
| Rate for Payer: BCN Medicare Advantage |
$28,580.21
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cofinity Commercial |
$5,947.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,580.21
|
| Rate for Payer: Healthscope Commercial |
$6,136.88
|
| Rate for Payer: Healthscope Whirlpool |
$6,326.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$28,580.21
|
| Rate for Payer: Mclaren Commercial |
$5,694.01
|
| Rate for Payer: Mclaren Medicaid |
$28,580.21
|
| Rate for Payer: Mclaren Medicare |
$28,580.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,009.22
|
| Rate for Payer: Meridian Medicaid |
$15,696.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,867.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$31,438.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.68
|
| Rate for Payer: Nomi Health Commercial |
$5,187.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.01
|
| Rate for Payer: PACE Medicare |
$27,151.20
|
| Rate for Payer: PACE SWMI |
$28,580.21
|
| Rate for Payer: PHP Commercial |
$31,438.23
|
| Rate for Payer: PHP Medicaid |
$15,318.99
|
| Rate for Payer: PHP Medicare Advantage |
$28,580.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,947.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$37,035.40
|
| Rate for Payer: Priority Health Medicare |
$28,580.21
|
| Rate for Payer: Priority Health Narrow Network |
$29,628.32
|
| Rate for Payer: Railroad Medicare Medicare |
$28,580.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,567.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28,580.21
|
| Rate for Payer: UHC Exchange |
$44,299.33
|
| Rate for Payer: UHC Medicaid |
$14,947.45
|
| Rate for Payer: UHCCP DNSP |
$28,580.21
|
| Rate for Payer: UHCCP Medicaid |
$14,947.45
|
| Rate for Payer: VA VA |
$28,580.21
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$73,582.69
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$55,187.02 |
| Max. Negotiated Rate |
$73,582.69 |
| Rate for Payer: Aetna Commercial |
$66,224.42
|
| Rate for Payer: ASR ASR |
$71,375.21
|
| Rate for Payer: BCBS Trust/PPO |
$60,426.11
|
| Rate for Payer: BCN Commercial |
$60,426.11
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cofinity Commercial |
$69,167.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58,866.15
|
| Rate for Payer: Healthscope Commercial |
$71,375.21
|
| Rate for Payer: Healthscope Whirlpool |
$73,582.69
|
| Rate for Payer: Mclaren Commercial |
$66,224.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,545.29
|
| Rate for Payer: Nomi Health Commercial |
$60,337.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55,187.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64,752.77
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$73,582.69
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27,225.60 |
| Max. Negotiated Rate |
$73,582.69 |
| Rate for Payer: Aetna Commercial |
$66,224.42
|
| Rate for Payer: Aetna Medicare |
$27,225.60
|
| Rate for Payer: ASR ASR |
$71,375.21
|
| Rate for Payer: BCBS Complete |
$29,433.08
|
| Rate for Payer: BCBS Trust/PPO |
$60,668.93
|
| Rate for Payer: BCN Commercial |
$60,668.93
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cofinity Commercial |
$69,167.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58,866.15
|
| Rate for Payer: Healthscope Commercial |
$71,375.21
|
| Rate for Payer: Healthscope Whirlpool |
$73,582.69
|
| Rate for Payer: Mclaren Commercial |
$66,224.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58,866.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,545.29
|
| Rate for Payer: Nomi Health Commercial |
$60,337.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55,187.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64,473.15
|
| Rate for Payer: Priority Health Narrow Network |
$51,581.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64,752.77
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$554.20
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$689.94 |
| Rate for Payer: Aetna Commercial |
$498.78
|
| Rate for Payer: Aetna Medicare |
$445.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: ASR ASR |
$537.57
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$456.94
|
| Rate for Payer: BCN Commercial |
$456.94
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$520.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$537.57
|
| Rate for Payer: Healthscope Whirlpool |
$554.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$445.12
|
| Rate for Payer: Mclaren Commercial |
$498.78
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$244.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$489.63
|
| Rate for Payer: PHP Medicaid |
$238.58
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$485.59
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health Narrow Network |
$388.49
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$689.94
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP DNSP |
$445.12
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: VA VA |
$445.12
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$554.20
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$415.65 |
| Max. Negotiated Rate |
$554.20 |
| Rate for Payer: Aetna Commercial |
$498.78
|
| Rate for Payer: ASR ASR |
$537.57
|
| Rate for Payer: BCBS Trust/PPO |
$455.11
|
| Rate for Payer: BCN Commercial |
$455.11
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$520.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Healthscope Commercial |
$537.57
|
| Rate for Payer: Healthscope Whirlpool |
$554.20
|
| Rate for Payer: Mclaren Commercial |
$498.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$487.70
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$7,268.21
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$5,451.16 |
| Max. Negotiated Rate |
$7,268.21 |
| Rate for Payer: Aetna Commercial |
$6,541.39
|
| Rate for Payer: ASR ASR |
$7,050.16
|
| Rate for Payer: BCBS Trust/PPO |
$5,968.65
|
| Rate for Payer: BCN Commercial |
$5,968.65
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cofinity Commercial |
$6,832.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,814.57
|
| Rate for Payer: Healthscope Commercial |
$7,050.16
|
| Rate for Payer: Healthscope Whirlpool |
$7,268.21
|
| Rate for Payer: Mclaren Commercial |
$6,541.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,177.98
|
| Rate for Payer: Nomi Health Commercial |
$5,959.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,451.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,396.02
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$7,268.21
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$721.30 |
| Max. Negotiated Rate |
$7,268.21 |
| Rate for Payer: Aetna Commercial |
$6,541.39
|
| Rate for Payer: Aetna Medicare |
$1,379.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,723.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,723.94
|
| Rate for Payer: ASR ASR |
$7,050.16
|
| Rate for Payer: BCBS Complete |
$757.43
|
| Rate for Payer: BCBS MAPPO |
$1,379.15
|
| Rate for Payer: BCBS Trust/PPO |
$5,992.64
|
| Rate for Payer: BCN Commercial |
$5,992.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.15
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cofinity Commercial |
$6,832.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,814.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.15
|
| Rate for Payer: Healthscope Commercial |
$7,050.16
|
| Rate for Payer: Healthscope Whirlpool |
$7,268.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,379.15
|
| Rate for Payer: Mclaren Commercial |
$6,541.39
|
| Rate for Payer: Mclaren Medicaid |
$1,379.15
|
| Rate for Payer: Mclaren Medicare |
$1,379.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.11
|
| Rate for Payer: Meridian Medicaid |
$757.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,586.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,517.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,177.98
|
| Rate for Payer: Nomi Health Commercial |
$5,959.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,451.16
|
| Rate for Payer: PACE Medicare |
$1,310.19
|
| Rate for Payer: PACE SWMI |
$1,379.15
|
| Rate for Payer: PHP Commercial |
$1,517.07
|
| Rate for Payer: PHP Medicaid |
$739.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,368.41
|
| Rate for Payer: Priority Health Medicare |
$1,379.15
|
| Rate for Payer: Priority Health Narrow Network |
$5,095.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,396.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,379.15
|
| Rate for Payer: UHC Exchange |
$2,137.68
|
| Rate for Payer: UHC Medicaid |
$721.30
|
| Rate for Payer: UHCCP DNSP |
$1,379.15
|
| Rate for Payer: UHCCP Medicaid |
$721.30
|
| Rate for Payer: VA VA |
$1,379.15
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$4,131.00
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,098.25 |
| Max. Negotiated Rate |
$4,131.00 |
| Rate for Payer: Aetna Commercial |
$3,717.90
|
| Rate for Payer: ASR ASR |
$4,007.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,392.38
|
| Rate for Payer: BCN Commercial |
$3,392.38
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cofinity Commercial |
$3,883.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,304.80
|
| Rate for Payer: Healthscope Commercial |
$4,007.07
|
| Rate for Payer: Healthscope Whirlpool |
$4,131.00
|
| Rate for Payer: Mclaren Commercial |
$3,717.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,511.35
|
| Rate for Payer: Nomi Health Commercial |
$3,387.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,098.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,635.28
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$4,131.00
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$576.97 |
| Max. Negotiated Rate |
$4,294.16 |
| Rate for Payer: Aetna Commercial |
$3,717.90
|
| Rate for Payer: Aetna Medicare |
$1,103.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,378.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,378.99
|
| Rate for Payer: ASR ASR |
$4,007.07
|
| Rate for Payer: BCBS Complete |
$605.87
|
| Rate for Payer: BCBS MAPPO |
$1,103.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,406.01
|
| Rate for Payer: BCN Commercial |
$3,406.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.19
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cofinity Commercial |
$3,883.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,304.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.19
|
| Rate for Payer: Healthscope Commercial |
$4,007.07
|
| Rate for Payer: Healthscope Whirlpool |
$4,131.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,103.19
|
| Rate for Payer: Mclaren Commercial |
$3,717.90
|
| Rate for Payer: Mclaren Medicaid |
$1,103.19
|
| Rate for Payer: Mclaren Medicare |
$1,103.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,158.35
|
| Rate for Payer: Meridian Medicaid |
$605.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,268.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,213.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,511.35
|
| Rate for Payer: Nomi Health Commercial |
$3,387.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,098.25
|
| Rate for Payer: PACE Medicare |
$1,048.03
|
| Rate for Payer: PACE SWMI |
$1,103.19
|
| Rate for Payer: PHP Commercial |
$1,213.51
|
| Rate for Payer: PHP Medicaid |
$591.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,294.16
|
| Rate for Payer: Priority Health Medicare |
$1,103.19
|
| Rate for Payer: Priority Health Narrow Network |
$3,435.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,103.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,635.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,103.19
|
| Rate for Payer: UHC Exchange |
$1,709.94
|
| Rate for Payer: UHC Medicaid |
$576.97
|
| Rate for Payer: UHCCP DNSP |
$1,103.19
|
| Rate for Payer: UHCCP Medicaid |
$576.97
|
| Rate for Payer: VA VA |
$1,103.19
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,519.76
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,046.49 |
| Max. Negotiated Rate |
$5,519.76 |
| Rate for Payer: Aetna Commercial |
$4,967.78
|
| Rate for Payer: Aetna Medicare |
$2,000.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,501.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,501.18
|
| Rate for Payer: ASR ASR |
$5,354.17
|
| Rate for Payer: BCBS Complete |
$1,098.92
|
| Rate for Payer: BCBS MAPPO |
$2,000.94
|
| Rate for Payer: BCBS Trust/PPO |
$4,551.04
|
| Rate for Payer: BCN Commercial |
$4,551.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,000.94
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cofinity Commercial |
$5,188.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,415.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,000.94
|
| Rate for Payer: Healthscope Commercial |
$5,354.17
|
| Rate for Payer: Healthscope Whirlpool |
$5,519.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,000.94
|
| Rate for Payer: Mclaren Commercial |
$4,967.78
|
| Rate for Payer: Mclaren Medicaid |
$2,000.94
|
| Rate for Payer: Mclaren Medicare |
$2,000.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,100.99
|
| Rate for Payer: Meridian Medicaid |
$1,098.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,301.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,201.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,691.80
|
| Rate for Payer: Nomi Health Commercial |
$4,526.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,139.82
|
| Rate for Payer: PACE Medicare |
$1,900.89
|
| Rate for Payer: PACE SWMI |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$2,201.03
|
| Rate for Payer: PHP Medicaid |
$1,072.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,000.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,947.40
|
| Rate for Payer: Priority Health Medicare |
$2,000.94
|
| Rate for Payer: Priority Health Narrow Network |
$3,157.92
|
| Rate for Payer: Railroad Medicare Medicare |
$2,000.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,857.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,000.94
|
| Rate for Payer: UHC Exchange |
$3,101.46
|
| Rate for Payer: UHC Medicaid |
$1,046.49
|
| Rate for Payer: UHCCP DNSP |
$2,000.94
|
| Rate for Payer: UHCCP Medicaid |
$1,046.49
|
| Rate for Payer: VA VA |
$2,000.94
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,519.76
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$4,139.82 |
| Max. Negotiated Rate |
$5,519.76 |
| Rate for Payer: Aetna Commercial |
$4,967.78
|
| Rate for Payer: ASR ASR |
$5,354.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,532.83
|
| Rate for Payer: BCN Commercial |
$4,532.83
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cofinity Commercial |
$5,188.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,415.81
|
| Rate for Payer: Healthscope Commercial |
$5,354.17
|
| Rate for Payer: Healthscope Whirlpool |
$5,519.76
|
| Rate for Payer: Mclaren Commercial |
$4,967.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,691.80
|
| Rate for Payer: Nomi Health Commercial |
$4,526.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,139.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,857.39
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,627.68
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,220.76 |
| Max. Negotiated Rate |
$5,627.68 |
| Rate for Payer: Aetna Commercial |
$5,064.91
|
| Rate for Payer: ASR ASR |
$5,458.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,621.45
|
| Rate for Payer: BCN Commercial |
$4,621.45
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cofinity Commercial |
$5,290.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,502.14
|
| Rate for Payer: Healthscope Commercial |
$5,458.85
|
| Rate for Payer: Healthscope Whirlpool |
$5,627.68
|
| Rate for Payer: Mclaren Commercial |
$5,064.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,783.53
|
| Rate for Payer: Nomi Health Commercial |
$4,614.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,952.36
|
|
