|
HC INTRA ATRIAL RECORDING
|
Facility
|
OP
|
$3,098.73
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,172.21 |
| Max. Negotiated Rate |
$12,046.01 |
| Rate for Payer: Aetna Commercial |
$2,788.86
|
| Rate for Payer: Aetna Medicare |
$7,771.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: ASR ASR |
$3,005.77
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,554.90
|
| Rate for Payer: BCN Commercial |
$2,554.90
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cofinity Commercial |
$2,912.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$3,005.77
|
| Rate for Payer: Healthscope Whirlpool |
$3,098.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,771.62
|
| Rate for Payer: Mclaren Commercial |
$2,788.86
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$4,268.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.92
|
| Rate for Payer: Nomi Health Commercial |
$2,540.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.05
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$8,548.78
|
| Rate for Payer: PHP Medicaid |
$4,165.59
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,715.11
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,172.21
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,726.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Exchange |
$12,046.01
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP DNSP |
$7,771.62
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: VA VA |
$7,771.62
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
IP
|
$3,098.73
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,324.05 |
| Max. Negotiated Rate |
$3,098.73 |
| Rate for Payer: Aetna Commercial |
$2,788.86
|
| Rate for Payer: ASR ASR |
$3,005.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,544.68
|
| Rate for Payer: BCN Commercial |
$2,544.68
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cofinity Commercial |
$2,912.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.98
|
| Rate for Payer: Healthscope Commercial |
$3,005.77
|
| Rate for Payer: Healthscope Whirlpool |
$3,098.73
|
| Rate for Payer: Mclaren Commercial |
$2,788.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.92
|
| Rate for Payer: Nomi Health Commercial |
$2,540.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,726.88
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$5,621.61
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,216.21 |
| Max. Negotiated Rate |
$5,621.61 |
| Rate for Payer: Aetna Commercial |
$5,059.45
|
| Rate for Payer: ASR ASR |
$5,452.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,616.47
|
| Rate for Payer: BCN Commercial |
$4,616.47
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cofinity Commercial |
$5,284.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,497.29
|
| Rate for Payer: Healthscope Commercial |
$5,452.96
|
| Rate for Payer: Healthscope Whirlpool |
$5,621.61
|
| Rate for Payer: Mclaren Commercial |
$5,059.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,778.37
|
| Rate for Payer: Nomi Health Commercial |
$4,609.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,216.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,947.02
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$5,621.61
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,080.00 |
| Max. Negotiated Rate |
$5,621.61 |
| Rate for Payer: Aetna Commercial |
$5,059.45
|
| Rate for Payer: Aetna Medicare |
$2,080.00
|
| Rate for Payer: ASR ASR |
$5,452.96
|
| Rate for Payer: BCBS Complete |
$2,248.64
|
| Rate for Payer: BCBS Trust/PPO |
$4,635.02
|
| Rate for Payer: BCN Commercial |
$4,635.02
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cofinity Commercial |
$5,284.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,497.29
|
| Rate for Payer: Healthscope Commercial |
$5,452.96
|
| Rate for Payer: Healthscope Whirlpool |
$5,621.61
|
| Rate for Payer: Mclaren Commercial |
$5,059.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,497.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,778.37
|
| Rate for Payer: Nomi Health Commercial |
$4,609.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,216.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,925.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,940.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,947.02
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,125.00 |
| Max. Negotiated Rate |
$5,500.00 |
| Rate for Payer: Aetna Commercial |
$4,950.00
|
| Rate for Payer: ASR ASR |
$5,335.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,516.60
|
| Rate for Payer: BCN Commercial |
$4,516.60
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Commercial |
$5,170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Healthscope Commercial |
$5,335.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,500.00
|
| Rate for Payer: Mclaren Commercial |
$4,950.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Nomi Health Commercial |
$4,510.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,125.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,840.00
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,035.00 |
| Max. Negotiated Rate |
$5,500.00 |
| Rate for Payer: Aetna Commercial |
$4,950.00
|
| Rate for Payer: Aetna Medicare |
$2,035.00
|
| Rate for Payer: ASR ASR |
$5,335.00
|
| Rate for Payer: BCBS Complete |
$2,200.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,534.75
|
| Rate for Payer: BCN Commercial |
$4,534.75
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Commercial |
$5,170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Healthscope Commercial |
$5,335.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,500.00
|
| Rate for Payer: Mclaren Commercial |
$4,950.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,400.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Nomi Health Commercial |
$4,510.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,125.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,819.10
|
| Rate for Payer: Priority Health Narrow Network |
$3,855.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,840.00
|
|
|
HC INTRACAV APPL - I
|
Facility
|
IP
|
$584.73
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$438.55 |
| Max. Negotiated Rate |
$584.73 |
| Rate for Payer: Aetna Commercial |
$526.26
|
| Rate for Payer: ASR ASR |
$567.19
|
| Rate for Payer: BCBS Trust/PPO |
$480.18
|
| Rate for Payer: BCN Commercial |
$480.18
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cofinity Commercial |
$549.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.78
|
| Rate for Payer: Healthscope Commercial |
$567.19
|
| Rate for Payer: Healthscope Whirlpool |
$584.73
|
| Rate for Payer: Mclaren Commercial |
$526.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.02
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.56
|
|
|
HC INTRACAV APPL - I
|
Facility
|
OP
|
$584.73
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$287.94 |
| Max. Negotiated Rate |
$853.37 |
| Rate for Payer: Aetna Commercial |
$526.26
|
| Rate for Payer: Aetna Medicare |
$550.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$688.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$688.20
|
| Rate for Payer: ASR ASR |
$567.19
|
| Rate for Payer: BCBS Complete |
$302.37
|
| Rate for Payer: BCBS MAPPO |
$550.56
|
| Rate for Payer: BCBS Trust/PPO |
$482.11
|
| Rate for Payer: BCN Commercial |
$482.11
|
| Rate for Payer: BCN Medicare Advantage |
$550.56
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cofinity Commercial |
$549.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.56
|
| Rate for Payer: Healthscope Commercial |
$567.19
|
| Rate for Payer: Healthscope Whirlpool |
$584.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$550.56
|
| Rate for Payer: Mclaren Commercial |
$526.26
|
| Rate for Payer: Mclaren Medicaid |
$550.56
|
| Rate for Payer: Mclaren Medicare |
$550.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.09
|
| Rate for Payer: Meridian Medicaid |
$302.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$633.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.02
|
| Rate for Payer: Nomi Health Commercial |
$479.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.55
|
| Rate for Payer: PACE Medicare |
$523.03
|
| Rate for Payer: PACE SWMI |
$550.56
|
| Rate for Payer: PHP Commercial |
$605.62
|
| Rate for Payer: PHP Medicaid |
$295.10
|
| Rate for Payer: PHP Medicare Advantage |
$550.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$512.34
|
| Rate for Payer: Priority Health Medicare |
$550.56
|
| Rate for Payer: Priority Health Narrow Network |
$409.90
|
| Rate for Payer: Railroad Medicare Medicare |
$550.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.56
|
| Rate for Payer: UHC Exchange |
$853.37
|
| Rate for Payer: UHC Medicaid |
$287.94
|
| Rate for Payer: UHCCP DNSP |
$550.56
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: VA VA |
$550.56
|
|
|
HC INTRACAV APPL - S
|
Facility
|
OP
|
$445.71
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$287.94 |
| Max. Negotiated Rate |
$853.37 |
| Rate for Payer: Aetna Commercial |
$401.14
|
| Rate for Payer: Aetna Medicare |
$550.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$688.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$688.20
|
| Rate for Payer: ASR ASR |
$432.34
|
| Rate for Payer: BCBS Complete |
$302.37
|
| Rate for Payer: BCBS MAPPO |
$550.56
|
| Rate for Payer: BCBS Trust/PPO |
$367.49
|
| Rate for Payer: BCN Commercial |
$367.49
|
| Rate for Payer: BCN Medicare Advantage |
$550.56
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cofinity Commercial |
$418.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.56
|
| Rate for Payer: Healthscope Commercial |
$432.34
|
| Rate for Payer: Healthscope Whirlpool |
$445.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$550.56
|
| Rate for Payer: Mclaren Commercial |
$401.14
|
| Rate for Payer: Mclaren Medicaid |
$550.56
|
| Rate for Payer: Mclaren Medicare |
$550.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.09
|
| Rate for Payer: Meridian Medicaid |
$302.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$633.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Nomi Health Commercial |
$365.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: PACE Medicare |
$523.03
|
| Rate for Payer: PACE SWMI |
$550.56
|
| Rate for Payer: PHP Commercial |
$605.62
|
| Rate for Payer: PHP Medicaid |
$295.10
|
| Rate for Payer: PHP Medicare Advantage |
$550.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$390.53
|
| Rate for Payer: Priority Health Medicare |
$550.56
|
| Rate for Payer: Priority Health Narrow Network |
$312.44
|
| Rate for Payer: Railroad Medicare Medicare |
$550.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.56
|
| Rate for Payer: UHC Exchange |
$853.37
|
| Rate for Payer: UHC Medicaid |
$287.94
|
| Rate for Payer: UHCCP DNSP |
$550.56
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: VA VA |
$550.56
|
|
|
HC INTRACAV APPL - S
|
Facility
|
IP
|
$445.71
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$334.28 |
| Max. Negotiated Rate |
$445.71 |
| Rate for Payer: Aetna Commercial |
$401.14
|
| Rate for Payer: ASR ASR |
$432.34
|
| Rate for Payer: BCBS Trust/PPO |
$366.02
|
| Rate for Payer: BCN Commercial |
$366.02
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cofinity Commercial |
$418.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Healthscope Commercial |
$432.34
|
| Rate for Payer: Healthscope Whirlpool |
$445.71
|
| Rate for Payer: Mclaren Commercial |
$401.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Nomi Health Commercial |
$365.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.22
|
|
|
HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Facility
|
OP
|
$603.23
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
76100557
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$603.23 |
| Rate for Payer: Aetna Commercial |
$542.91
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$585.13
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$497.36
|
| Rate for Payer: BCN Commercial |
$497.36
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cofinity Commercial |
$567.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$482.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$585.13
|
| Rate for Payer: Healthscope Whirlpool |
$603.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$542.91
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.75
|
| Rate for Payer: Nomi Health Commercial |
$494.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.42
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$528.55
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$422.86
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$530.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Facility
|
IP
|
$603.23
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
76100557
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.42 |
| Max. Negotiated Rate |
$603.23 |
| Rate for Payer: Aetna Commercial |
$542.91
|
| Rate for Payer: ASR ASR |
$585.13
|
| Rate for Payer: BCBS Trust/PPO |
$495.37
|
| Rate for Payer: BCN Commercial |
$495.37
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cofinity Commercial |
$567.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$482.58
|
| Rate for Payer: Healthscope Commercial |
$585.13
|
| Rate for Payer: Healthscope Whirlpool |
$603.23
|
| Rate for Payer: Mclaren Commercial |
$542.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.75
|
| Rate for Payer: Nomi Health Commercial |
$494.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$530.84
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
IP
|
$494.59
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$370.94 |
| Max. Negotiated Rate |
$494.59 |
| Rate for Payer: Aetna Commercial |
$445.13
|
| Rate for Payer: ASR ASR |
$479.75
|
| Rate for Payer: BCBS Trust/PPO |
$406.16
|
| Rate for Payer: BCN Commercial |
$406.16
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cofinity Commercial |
$464.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.67
|
| Rate for Payer: Healthscope Commercial |
$479.75
|
| Rate for Payer: Healthscope Whirlpool |
$494.59
|
| Rate for Payer: Mclaren Commercial |
$445.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.40
|
| Rate for Payer: Nomi Health Commercial |
$405.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.24
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
OP
|
$494.59
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$689.94 |
| Rate for Payer: Aetna Commercial |
$445.13
|
| 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 |
$479.75
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$407.79
|
| Rate for Payer: BCN Commercial |
$407.79
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cofinity Commercial |
$464.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$479.75
|
| Rate for Payer: Healthscope Whirlpool |
$494.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$445.12
|
| Rate for Payer: Mclaren Commercial |
$445.13
|
| 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 |
$420.40
|
| Rate for Payer: Nomi Health Commercial |
$405.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.94
|
| 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 |
$433.36
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health Narrow Network |
$346.71
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.24
|
| 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 INTRASPINAL CATHETER
|
Facility
|
OP
|
$298.59
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.48 |
| Max. Negotiated Rate |
$298.59 |
| Rate for Payer: Aetna Commercial |
$268.73
|
| Rate for Payer: Aetna Medicare |
$110.48
|
| Rate for Payer: ASR ASR |
$289.63
|
| Rate for Payer: BCBS Complete |
$119.44
|
| Rate for Payer: BCBS Trust/PPO |
$246.19
|
| Rate for Payer: BCN Commercial |
$246.19
|
| Rate for Payer: Cash Price |
$238.87
|
| Rate for Payer: Cofinity Commercial |
$280.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.87
|
| Rate for Payer: Healthscope Commercial |
$289.63
|
| Rate for Payer: Healthscope Whirlpool |
$298.59
|
| Rate for Payer: Mclaren Commercial |
$268.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.80
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$261.62
|
| Rate for Payer: Priority Health Narrow Network |
$209.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.76
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
IP
|
$298.59
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$223.94 |
| Max. Negotiated Rate |
$298.59 |
| Rate for Payer: Aetna Commercial |
$268.73
|
| Rate for Payer: ASR ASR |
$289.63
|
| Rate for Payer: BCBS Trust/PPO |
$245.20
|
| Rate for Payer: BCN Commercial |
$245.20
|
| Rate for Payer: Cash Price |
$238.87
|
| Rate for Payer: Cofinity Commercial |
$280.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.87
|
| Rate for Payer: Healthscope Commercial |
$289.63
|
| Rate for Payer: Healthscope Whirlpool |
$298.59
|
| Rate for Payer: Mclaren Commercial |
$268.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.80
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.76
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
IP
|
$1,800.75
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,350.56 |
| Max. Negotiated Rate |
$1,800.75 |
| Rate for Payer: Aetna Commercial |
$1,620.67
|
| Rate for Payer: ASR ASR |
$1,746.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.78
|
| Rate for Payer: BCN Commercial |
$1,478.78
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cofinity Commercial |
$1,692.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.60
|
| Rate for Payer: Healthscope Commercial |
$1,746.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,800.75
|
| Rate for Payer: Mclaren Commercial |
$1,620.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.64
|
| Rate for Payer: Nomi Health Commercial |
$1,476.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,584.66
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
OP
|
$1,800.75
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$666.28 |
| Max. Negotiated Rate |
$1,800.75 |
| Rate for Payer: Aetna Commercial |
$1,620.67
|
| Rate for Payer: Aetna Medicare |
$666.28
|
| Rate for Payer: ASR ASR |
$1,746.73
|
| Rate for Payer: BCBS Complete |
$720.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.72
|
| Rate for Payer: BCN Commercial |
$1,484.72
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cofinity Commercial |
$1,692.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.60
|
| Rate for Payer: Healthscope Commercial |
$1,746.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,800.75
|
| Rate for Payer: Mclaren Commercial |
$1,620.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,440.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.64
|
| Rate for Payer: Nomi Health Commercial |
$1,476.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,210.40
|
| Rate for Payer: Priority Health Narrow Network |
$968.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,584.66
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,842.58
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,693.65 |
| Max. Negotiated Rate |
$12,046.01 |
| Rate for Payer: Aetna Commercial |
$3,458.32
|
| Rate for Payer: Aetna Medicare |
$7,771.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: ASR ASR |
$3,727.30
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,168.21
|
| Rate for Payer: BCN Commercial |
$3,168.21
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Commercial |
$3,612.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$3,727.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,842.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,771.62
|
| Rate for Payer: Mclaren Commercial |
$3,458.32
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$4,268.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,150.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$8,548.78
|
| Rate for Payer: PHP Medicaid |
$4,165.59
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,366.87
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health Narrow Network |
$2,693.65
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,381.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Exchange |
$12,046.01
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP DNSP |
$7,771.62
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: VA VA |
$7,771.62
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,842.58
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,881.93 |
| Max. Negotiated Rate |
$3,842.58 |
| Rate for Payer: Aetna Commercial |
$3,458.32
|
| Rate for Payer: ASR ASR |
$3,727.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,155.53
|
| Rate for Payer: BCN Commercial |
$3,155.53
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Commercial |
$3,612.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Healthscope Commercial |
$3,727.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,842.58
|
| Rate for Payer: Mclaren Commercial |
$3,458.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,150.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,381.47
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.45 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$48.44
|
| Rate for Payer: Healthscope Whirlpool |
$49.94
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: Aetna Medicare |
$15.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$41.18
|
| Rate for Payer: BCN Commercial |
$41.18
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$48.44
|
| Rate for Payer: Healthscope Whirlpool |
$49.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.08
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$15.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$8.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: PHP Medicaid |
$8.08
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$35.01
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.08
|
| Rate for Payer: UHC Exchange |
$23.37
|
| Rate for Payer: UHC Medicaid |
$7.89
|
| Rate for Payer: UHCCP DNSP |
$15.08
|
| Rate for Payer: UHCCP Medicaid |
$7.89
|
| Rate for Payer: VA VA |
$15.08
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,820.35
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,413.53 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna Commercial |
$3,438.32
|
| Rate for Payer: Aetna Medicare |
$1,413.53
|
| Rate for Payer: ASR ASR |
$3,705.74
|
| Rate for Payer: BCBS Complete |
$1,528.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,149.88
|
| Rate for Payer: BCN Commercial |
$3,149.88
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cofinity Commercial |
$3,591.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.28
|
| Rate for Payer: Healthscope Commercial |
$3,705.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,820.35
|
| Rate for Payer: Mclaren Commercial |
$3,438.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,056.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,247.30
|
| Rate for Payer: Nomi Health Commercial |
$3,132.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,865.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,347.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,678.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,361.91
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,820.35
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,865.26 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna Commercial |
$3,438.32
|
| Rate for Payer: ASR ASR |
$3,705.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.27
|
| Rate for Payer: BCN Commercial |
$3,137.27
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cofinity Commercial |
$3,591.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.28
|
| Rate for Payer: Healthscope Commercial |
$3,705.74
|
| Rate for Payer: Healthscope Whirlpool |
$3,820.35
|
| Rate for Payer: Mclaren Commercial |
$3,438.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,247.30
|
| Rate for Payer: Nomi Health Commercial |
$3,132.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,865.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,361.91
|
|
|
HC INTRODUCER
|
Facility
|
OP
|
$305.57
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.06 |
| Max. Negotiated Rate |
$305.57 |
| Rate for Payer: Aetna Commercial |
$275.01
|
| Rate for Payer: Aetna Medicare |
$113.06
|
| Rate for Payer: ASR ASR |
$296.40
|
| Rate for Payer: BCBS Complete |
$122.23
|
| Rate for Payer: BCBS Trust/PPO |
$251.94
|
| Rate for Payer: BCN Commercial |
$251.94
|
| Rate for Payer: Cash Price |
$244.46
|
| Rate for Payer: Cofinity Commercial |
$287.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.46
|
| Rate for Payer: Healthscope Commercial |
$296.40
|
| Rate for Payer: Healthscope Whirlpool |
$305.57
|
| Rate for Payer: Mclaren Commercial |
$275.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.73
|
| Rate for Payer: Nomi Health Commercial |
$250.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$267.74
|
| Rate for Payer: Priority Health Narrow Network |
$214.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.90
|
|
