|
HC INTRA ATRIAL PACING
|
Facility
|
OP
|
$3,148.49
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,046.52 |
| Max. Negotiated Rate |
$11,470.81 |
| Rate for Payer: Aetna Commercial |
$2,833.64
|
| Rate for Payer: Aetna Medicare |
$7,400.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,250.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,250.65
|
| Rate for Payer: ASR ASR |
$3,054.04
|
| Rate for Payer: ASR Commercial |
$3,054.04
|
| Rate for Payer: BCBS Complete |
$4,165.01
|
| Rate for Payer: BCBS MAPPO |
$7,400.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,578.30
|
| Rate for Payer: BCN Commercial |
$2,441.02
|
| Rate for Payer: BCN Medicare Advantage |
$7,400.52
|
| Rate for Payer: Cash Price |
$2,518.79
|
| Rate for Payer: Cash Price |
$2,518.79
|
| Rate for Payer: Cofinity Commercial |
$2,959.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,518.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,400.52
|
| Rate for Payer: Healthscope Commercial |
$3,148.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,054.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,400.52
|
| Rate for Payer: Mclaren Commercial |
$2,833.64
|
| Rate for Payer: Mclaren Medicaid |
$3,966.68
|
| Rate for Payer: Mclaren Medicare |
$7,400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,770.55
|
| Rate for Payer: Meridian Medicaid |
$4,165.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,510.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,676.22
|
| Rate for Payer: Nomi Health Commercial |
$2,581.76
|
| Rate for Payer: PACE Medicare |
$7,030.49
|
| Rate for Payer: PACE SWMI |
$7,400.52
|
| Rate for Payer: PHP Commercial |
$8,140.57
|
| Rate for Payer: PHP Medicaid |
$3,966.68
|
| Rate for Payer: PHP Medicare Advantage |
$7,400.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,966.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,758.71
|
| Rate for Payer: Priority Health Medicare |
$7,400.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,207.09
|
| Rate for Payer: Railroad Medicare Medicare |
$7,400.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,770.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,400.52
|
| Rate for Payer: UHC Exchange |
$11,470.81
|
| Rate for Payer: UHC Medicare Advantage |
$7,400.52
|
| Rate for Payer: UHCCP DNSP |
$7,400.52
|
| Rate for Payer: UHCCP Medicaid |
$3,966.68
|
| Rate for Payer: VA VA |
$7,400.52
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
IP
|
$3,037.97
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,974.68 |
| Max. Negotiated Rate |
$3,037.97 |
| Rate for Payer: Aetna Commercial |
$2,734.17
|
| Rate for Payer: ASR ASR |
$2,946.83
|
| Rate for Payer: ASR Commercial |
$2,946.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,475.64
|
| Rate for Payer: BCN Commercial |
$2,355.34
|
| Rate for Payer: Cash Price |
$2,430.38
|
| Rate for Payer: Cofinity Commercial |
$2,855.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.38
|
| Rate for Payer: Healthscope Commercial |
$3,037.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,946.83
|
| Rate for Payer: Mclaren Commercial |
$2,734.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,582.27
|
| Rate for Payer: Nomi Health Commercial |
$2,491.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,673.41
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
OP
|
$3,037.97
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,974.68 |
| Max. Negotiated Rate |
$11,470.81 |
| Rate for Payer: Aetna Commercial |
$2,734.17
|
| Rate for Payer: Aetna Medicare |
$7,400.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,250.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,250.65
|
| Rate for Payer: ASR ASR |
$2,946.83
|
| Rate for Payer: ASR Commercial |
$2,946.83
|
| Rate for Payer: BCBS Complete |
$4,165.01
|
| Rate for Payer: BCBS MAPPO |
$7,400.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,487.79
|
| Rate for Payer: BCN Commercial |
$2,355.34
|
| Rate for Payer: BCN Medicare Advantage |
$7,400.52
|
| Rate for Payer: Cash Price |
$2,430.38
|
| Rate for Payer: Cash Price |
$2,430.38
|
| Rate for Payer: Cofinity Commercial |
$2,855.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,400.52
|
| Rate for Payer: Healthscope Commercial |
$3,037.97
|
| Rate for Payer: Healthscope Whirlpool |
$2,946.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,400.52
|
| Rate for Payer: Mclaren Commercial |
$2,734.17
|
| Rate for Payer: Mclaren Medicaid |
$3,966.68
|
| Rate for Payer: Mclaren Medicare |
$7,400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,770.55
|
| Rate for Payer: Meridian Medicaid |
$4,165.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,510.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,582.27
|
| Rate for Payer: Nomi Health Commercial |
$2,491.14
|
| Rate for Payer: PACE Medicare |
$7,030.49
|
| Rate for Payer: PACE SWMI |
$7,400.52
|
| Rate for Payer: PHP Commercial |
$8,140.57
|
| Rate for Payer: PHP Medicaid |
$3,966.68
|
| Rate for Payer: PHP Medicare Advantage |
$7,400.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,966.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,661.87
|
| Rate for Payer: Priority Health Medicare |
$7,400.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,129.62
|
| Rate for Payer: Railroad Medicare Medicare |
$7,400.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,673.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,400.52
|
| Rate for Payer: UHC Exchange |
$11,470.81
|
| Rate for Payer: UHC Medicare Advantage |
$7,400.52
|
| Rate for Payer: UHCCP DNSP |
$7,400.52
|
| Rate for Payer: UHCCP Medicaid |
$3,966.68
|
| Rate for Payer: VA VA |
$7,400.52
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$5,511.38
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,204.55 |
| Max. Negotiated Rate |
$5,511.38 |
| Rate for Payer: Aetna Commercial |
$4,960.24
|
| Rate for Payer: Aetna Medicare |
$2,755.69
|
| Rate for Payer: ASR ASR |
$5,346.04
|
| Rate for Payer: ASR Commercial |
$5,346.04
|
| Rate for Payer: BCBS Complete |
$2,204.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,513.27
|
| Rate for Payer: BCN Commercial |
$4,272.97
|
| Rate for Payer: Cash Price |
$4,409.10
|
| Rate for Payer: Cofinity Commercial |
$5,180.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,409.10
|
| Rate for Payer: Healthscope Commercial |
$5,511.38
|
| Rate for Payer: Healthscope Whirlpool |
$5,346.04
|
| Rate for Payer: Mclaren Commercial |
$4,960.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,684.67
|
| Rate for Payer: Nomi Health Commercial |
$4,519.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,829.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,863.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,850.01
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$5,511.38
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,582.40 |
| Max. Negotiated Rate |
$5,511.38 |
| Rate for Payer: Aetna Commercial |
$4,960.24
|
| Rate for Payer: ASR ASR |
$5,346.04
|
| Rate for Payer: ASR Commercial |
$5,346.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,491.22
|
| Rate for Payer: BCN Commercial |
$4,272.97
|
| Rate for Payer: Cash Price |
$4,409.10
|
| Rate for Payer: Cofinity Commercial |
$5,180.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,409.10
|
| Rate for Payer: Healthscope Commercial |
$5,511.38
|
| Rate for Payer: Healthscope Whirlpool |
$5,346.04
|
| Rate for Payer: Mclaren Commercial |
$4,960.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,684.67
|
| Rate for Payer: Nomi Health Commercial |
$4,519.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,850.01
|
|
|
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 |
$2,200.00 |
| Max. Negotiated Rate |
$5,500.00 |
| Rate for Payer: Aetna Commercial |
$4,950.00
|
| Rate for Payer: Aetna Medicare |
$2,750.00
|
| Rate for Payer: ASR ASR |
$5,335.00
|
| Rate for Payer: ASR Commercial |
$5,335.00
|
| Rate for Payer: BCBS Complete |
$2,200.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,503.95
|
| Rate for Payer: BCN Commercial |
$4,264.15
|
| 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 |
$5,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,335.00
|
| 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: Priority Health Cigna Priority Health |
$3,575.00
|
| Rate for Payer: 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 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 |
$3,575.00 |
| 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: ASR Commercial |
$5,335.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,481.95
|
| Rate for Payer: BCN Commercial |
$4,264.15
|
| 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 |
$5,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,335.00
|
| 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: Priority Health Cigna Priority Health |
$3,575.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,840.00
|
|
|
HC INTRACAV APPL - I
|
Facility
|
OP
|
$573.26
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$874.46 |
| Rate for Payer: Aetna Commercial |
$515.93
|
| Rate for Payer: Aetna Medicare |
$564.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$705.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$705.21
|
| Rate for Payer: ASR ASR |
$556.06
|
| Rate for Payer: ASR Commercial |
$556.06
|
| Rate for Payer: BCBS Complete |
$317.51
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCBS Trust/PPO |
$469.44
|
| Rate for Payer: BCN Commercial |
$444.45
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$458.61
|
| Rate for Payer: Cash Price |
$458.61
|
| Rate for Payer: Cofinity Commercial |
$538.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Healthscope Commercial |
$573.26
|
| Rate for Payer: Healthscope Whirlpool |
$556.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$564.17
|
| Rate for Payer: Mclaren Commercial |
$515.93
|
| Rate for Payer: Mclaren Medicaid |
$302.40
|
| Rate for Payer: Mclaren Medicare |
$564.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Meridian Medicaid |
$317.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$648.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.27
|
| Rate for Payer: Nomi Health Commercial |
$470.07
|
| Rate for Payer: PACE Medicare |
$535.96
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Commercial |
$620.59
|
| Rate for Payer: PHP Medicaid |
$302.40
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$502.29
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: Priority Health Narrow Network |
$401.86
|
| Rate for Payer: Railroad Medicare Medicare |
$564.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Exchange |
$874.46
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP DNSP |
$564.17
|
| Rate for Payer: UHCCP Medicaid |
$302.40
|
| Rate for Payer: VA VA |
$564.17
|
|
|
HC INTRACAV APPL - I
|
Facility
|
IP
|
$573.26
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$372.62 |
| Max. Negotiated Rate |
$573.26 |
| Rate for Payer: Aetna Commercial |
$515.93
|
| Rate for Payer: ASR ASR |
$556.06
|
| Rate for Payer: ASR Commercial |
$556.06
|
| Rate for Payer: BCBS Trust/PPO |
$467.15
|
| Rate for Payer: BCN Commercial |
$444.45
|
| Rate for Payer: Cash Price |
$458.61
|
| Rate for Payer: Cofinity Commercial |
$538.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.61
|
| Rate for Payer: Healthscope Commercial |
$573.26
|
| Rate for Payer: Healthscope Whirlpool |
$556.06
|
| Rate for Payer: Mclaren Commercial |
$515.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.27
|
| Rate for Payer: Nomi Health Commercial |
$470.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.47
|
|
|
HC INTRACAV APPL - S
|
Facility
|
IP
|
$436.97
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$284.03 |
| Max. Negotiated Rate |
$436.97 |
| Rate for Payer: Aetna Commercial |
$393.27
|
| Rate for Payer: ASR ASR |
$423.86
|
| Rate for Payer: ASR Commercial |
$423.86
|
| Rate for Payer: BCBS Trust/PPO |
$356.09
|
| Rate for Payer: BCN Commercial |
$338.78
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$410.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Healthscope Commercial |
$436.97
|
| Rate for Payer: Healthscope Whirlpool |
$423.86
|
| Rate for Payer: Mclaren Commercial |
$393.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.53
|
|
|
HC INTRACAV APPL - S
|
Facility
|
OP
|
$436.97
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$284.03 |
| Max. Negotiated Rate |
$874.46 |
| Rate for Payer: Aetna Commercial |
$393.27
|
| Rate for Payer: Aetna Medicare |
$564.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$705.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$705.21
|
| Rate for Payer: ASR ASR |
$423.86
|
| Rate for Payer: ASR Commercial |
$423.86
|
| Rate for Payer: BCBS Complete |
$317.51
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCBS Trust/PPO |
$357.83
|
| Rate for Payer: BCN Commercial |
$338.78
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$410.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Healthscope Commercial |
$436.97
|
| Rate for Payer: Healthscope Whirlpool |
$423.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$564.17
|
| Rate for Payer: Mclaren Commercial |
$393.27
|
| Rate for Payer: Mclaren Medicaid |
$302.40
|
| Rate for Payer: Mclaren Medicare |
$564.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Meridian Medicaid |
$317.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$648.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: PACE Medicare |
$535.96
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Commercial |
$620.59
|
| Rate for Payer: PHP Medicaid |
$302.40
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.87
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: Priority Health Narrow Network |
$306.32
|
| Rate for Payer: Railroad Medicare Medicare |
$564.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Exchange |
$874.46
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP DNSP |
$564.17
|
| Rate for Payer: UHCCP Medicaid |
$302.40
|
| Rate for Payer: VA VA |
$564.17
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
OP
|
$484.89
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$208.60 |
| Max. Negotiated Rate |
$603.23 |
| Rate for Payer: Aetna Commercial |
$436.40
|
| Rate for Payer: Aetna Medicare |
$389.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: ASR ASR |
$470.34
|
| Rate for Payer: ASR Commercial |
$470.34
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCBS Trust/PPO |
$397.08
|
| Rate for Payer: BCN Commercial |
$375.94
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$387.91
|
| Rate for Payer: Cash Price |
$387.91
|
| Rate for Payer: Cofinity Commercial |
$455.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$484.89
|
| Rate for Payer: Healthscope Whirlpool |
$470.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.18
|
| Rate for Payer: Mclaren Commercial |
$436.40
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.16
|
| Rate for Payer: Nomi Health Commercial |
$397.61
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$428.10
|
| Rate for Payer: PHP Medicaid |
$208.60
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$424.86
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health Narrow Network |
$339.91
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$603.23
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP DNSP |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: VA VA |
$389.18
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
IP
|
$484.89
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$315.18 |
| Max. Negotiated Rate |
$484.89 |
| Rate for Payer: Aetna Commercial |
$436.40
|
| Rate for Payer: ASR ASR |
$470.34
|
| Rate for Payer: ASR Commercial |
$470.34
|
| Rate for Payer: BCBS Trust/PPO |
$395.14
|
| Rate for Payer: BCN Commercial |
$375.94
|
| Rate for Payer: Cash Price |
$387.91
|
| Rate for Payer: Cofinity Commercial |
$455.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.91
|
| Rate for Payer: Healthscope Commercial |
$484.89
|
| Rate for Payer: Healthscope Whirlpool |
$470.34
|
| Rate for Payer: Mclaren Commercial |
$436.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.16
|
| Rate for Payer: Nomi Health Commercial |
$397.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.70
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
OP
|
$292.74
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.10 |
| Max. Negotiated Rate |
$292.74 |
| Rate for Payer: Aetna Commercial |
$263.47
|
| Rate for Payer: Aetna Medicare |
$146.37
|
| Rate for Payer: ASR ASR |
$283.96
|
| Rate for Payer: ASR Commercial |
$283.96
|
| Rate for Payer: BCBS Complete |
$117.10
|
| Rate for Payer: BCBS Trust/PPO |
$239.72
|
| Rate for Payer: BCN Commercial |
$226.96
|
| Rate for Payer: Cash Price |
$234.19
|
| Rate for Payer: Cofinity Commercial |
$275.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.19
|
| Rate for Payer: Healthscope Commercial |
$292.74
|
| Rate for Payer: Healthscope Whirlpool |
$283.96
|
| Rate for Payer: Mclaren Commercial |
$263.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.83
|
| Rate for Payer: Nomi Health Commercial |
$240.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.50
|
| Rate for Payer: Priority Health Narrow Network |
$205.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.61
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
IP
|
$292.74
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$190.28 |
| Max. Negotiated Rate |
$292.74 |
| Rate for Payer: Aetna Commercial |
$263.47
|
| Rate for Payer: ASR ASR |
$283.96
|
| Rate for Payer: ASR Commercial |
$283.96
|
| Rate for Payer: BCBS Trust/PPO |
$238.55
|
| Rate for Payer: BCN Commercial |
$226.96
|
| Rate for Payer: Cash Price |
$234.19
|
| Rate for Payer: Cofinity Commercial |
$275.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.19
|
| Rate for Payer: Healthscope Commercial |
$292.74
|
| Rate for Payer: Healthscope Whirlpool |
$283.96
|
| Rate for Payer: Mclaren Commercial |
$263.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.83
|
| Rate for Payer: Nomi Health Commercial |
$240.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$257.61
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
OP
|
$1,765.44
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$706.18 |
| Max. Negotiated Rate |
$1,765.44 |
| Rate for Payer: Aetna Commercial |
$1,588.90
|
| Rate for Payer: Aetna Medicare |
$882.72
|
| Rate for Payer: ASR ASR |
$1,712.48
|
| Rate for Payer: ASR Commercial |
$1,712.48
|
| Rate for Payer: BCBS Complete |
$706.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,445.72
|
| Rate for Payer: BCN Commercial |
$1,368.75
|
| Rate for Payer: Cash Price |
$1,412.35
|
| Rate for Payer: Cofinity Commercial |
$1,659.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,412.35
|
| Rate for Payer: Healthscope Commercial |
$1,765.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,712.48
|
| Rate for Payer: Mclaren Commercial |
$1,588.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,500.62
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,546.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,237.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,553.59
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
IP
|
$1,765.44
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,147.54 |
| Max. Negotiated Rate |
$1,765.44 |
| Rate for Payer: Aetna Commercial |
$1,588.90
|
| Rate for Payer: ASR ASR |
$1,712.48
|
| Rate for Payer: ASR Commercial |
$1,712.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.66
|
| Rate for Payer: BCN Commercial |
$1,368.75
|
| Rate for Payer: Cash Price |
$1,412.35
|
| Rate for Payer: Cofinity Commercial |
$1,659.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,412.35
|
| Rate for Payer: Healthscope Commercial |
$1,765.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,712.48
|
| Rate for Payer: Mclaren Commercial |
$1,588.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,500.62
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,553.59
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,767.24
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,448.71 |
| Max. Negotiated Rate |
$11,470.81 |
| Rate for Payer: Aetna Commercial |
$3,390.52
|
| Rate for Payer: Aetna Medicare |
$7,400.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,250.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,250.65
|
| Rate for Payer: ASR ASR |
$3,654.22
|
| Rate for Payer: ASR Commercial |
$3,654.22
|
| Rate for Payer: BCBS Complete |
$4,165.01
|
| Rate for Payer: BCBS MAPPO |
$7,400.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,084.99
|
| Rate for Payer: BCN Commercial |
$2,920.74
|
| Rate for Payer: BCN Medicare Advantage |
$7,400.52
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cofinity Commercial |
$3,541.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,400.52
|
| Rate for Payer: Healthscope Commercial |
$3,767.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,654.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,400.52
|
| Rate for Payer: Mclaren Commercial |
$3,390.52
|
| Rate for Payer: Mclaren Medicaid |
$3,966.68
|
| Rate for Payer: Mclaren Medicare |
$7,400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,770.55
|
| Rate for Payer: Meridian Medicaid |
$4,165.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,510.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.15
|
| Rate for Payer: Nomi Health Commercial |
$3,089.14
|
| Rate for Payer: PACE Medicare |
$7,030.49
|
| Rate for Payer: PACE SWMI |
$7,400.52
|
| Rate for Payer: PHP Commercial |
$8,140.57
|
| Rate for Payer: PHP Medicaid |
$3,966.68
|
| Rate for Payer: PHP Medicare Advantage |
$7,400.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,966.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,300.86
|
| Rate for Payer: Priority Health Medicare |
$7,400.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,640.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7,400.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,400.52
|
| Rate for Payer: UHC Exchange |
$11,470.81
|
| Rate for Payer: UHC Medicare Advantage |
$7,400.52
|
| Rate for Payer: UHCCP DNSP |
$7,400.52
|
| Rate for Payer: UHCCP Medicaid |
$3,966.68
|
| Rate for Payer: VA VA |
$7,400.52
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,767.24
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,448.71 |
| Max. Negotiated Rate |
$3,767.24 |
| Rate for Payer: Aetna Commercial |
$3,390.52
|
| Rate for Payer: ASR ASR |
$3,654.22
|
| Rate for Payer: ASR Commercial |
$3,654.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,069.92
|
| Rate for Payer: BCN Commercial |
$2,920.74
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cofinity Commercial |
$3,541.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.79
|
| Rate for Payer: Healthscope Commercial |
$3,767.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,654.22
|
| Rate for Payer: Mclaren Commercial |
$3,390.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.15
|
| Rate for Payer: Nomi Health Commercial |
$3,089.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.17
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: ASR ASR |
$47.49
|
| Rate for Payer: ASR Commercial |
$47.49
|
| Rate for Payer: BCBS Trust/PPO |
$39.90
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| 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 |
$47.49
|
| Rate for Payer: ASR Commercial |
$47.49
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$40.09
|
| Rate for Payer: BCN Commercial |
$37.96
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Healthscope Whirlpool |
$47.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$15.08
|
| Rate for Payer: Mclaren Commercial |
$44.06
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| 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 |
$8.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| 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 |
$8.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.90
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$34.32
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$23.37
|
| Rate for Payer: UHC Medicare Advantage |
$15.08
|
| Rate for Payer: UHCCP DNSP |
$15.08
|
| Rate for Payer: UHCCP Medicaid |
$8.08
|
| Rate for Payer: VA VA |
$15.08
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,745.44
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,434.54 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,370.90
|
| Rate for Payer: ASR ASR |
$3,633.08
|
| Rate for Payer: ASR Commercial |
$3,633.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,052.16
|
| Rate for Payer: BCN Commercial |
$2,903.84
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,520.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Healthscope Whirlpool |
$3,633.08
|
| Rate for Payer: Mclaren Commercial |
$3,370.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,434.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,295.99
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,745.44
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,498.18 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,370.90
|
| Rate for Payer: Aetna Medicare |
$1,872.72
|
| Rate for Payer: ASR ASR |
$3,633.08
|
| Rate for Payer: ASR Commercial |
$3,633.08
|
| Rate for Payer: BCBS Complete |
$1,498.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,067.14
|
| Rate for Payer: BCN Commercial |
$2,903.84
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,520.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Healthscope Whirlpool |
$3,633.08
|
| Rate for Payer: Mclaren Commercial |
$3,370.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,434.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,281.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,625.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,295.99
|
|
|
HC INTRODUCER
|
Facility
|
OP
|
$299.58
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.83 |
| Max. Negotiated Rate |
$299.58 |
| Rate for Payer: Aetna Commercial |
$269.62
|
| Rate for Payer: Aetna Medicare |
$149.79
|
| Rate for Payer: ASR ASR |
$290.59
|
| Rate for Payer: ASR Commercial |
$290.59
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS Trust/PPO |
$245.33
|
| Rate for Payer: BCN Commercial |
$232.26
|
| Rate for Payer: Cash Price |
$239.66
|
| Rate for Payer: Cofinity Commercial |
$281.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.66
|
| Rate for Payer: Healthscope Commercial |
$299.58
|
| Rate for Payer: Healthscope Whirlpool |
$290.59
|
| Rate for Payer: Mclaren Commercial |
$269.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.64
|
| Rate for Payer: Nomi Health Commercial |
$245.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$262.49
|
| Rate for Payer: Priority Health Narrow Network |
$210.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.63
|
|
|
HC INTRODUCER
|
Facility
|
IP
|
$299.58
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.73 |
| Max. Negotiated Rate |
$299.58 |
| Rate for Payer: Aetna Commercial |
$269.62
|
| Rate for Payer: ASR ASR |
$290.59
|
| Rate for Payer: ASR Commercial |
$290.59
|
| Rate for Payer: BCBS Trust/PPO |
$244.13
|
| Rate for Payer: BCN Commercial |
$232.26
|
| Rate for Payer: Cash Price |
$239.66
|
| Rate for Payer: Cofinity Commercial |
$281.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.66
|
| Rate for Payer: Healthscope Commercial |
$299.58
|
| Rate for Payer: Healthscope Whirlpool |
$290.59
|
| Rate for Payer: Mclaren Commercial |
$269.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.64
|
| Rate for Payer: Nomi Health Commercial |
$245.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.63
|
|
