|
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: 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 |
$1,161.10
|
| Rate for Payer: Priority Health Narrow Network |
$928.88
|
| 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 |
$11,523.74 |
| Rate for Payer: Aetna Commercial |
$3,390.52
|
| Rate for Payer: Aetna Medicare |
$7,434.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,293.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,293.34
|
| Rate for Payer: ASR ASR |
$3,654.22
|
| Rate for Payer: ASR Commercial |
$3,654.22
|
| Rate for Payer: BCBS Complete |
$4,184.23
|
| Rate for Payer: BCBS MAPPO |
$7,434.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,084.99
|
| Rate for Payer: BCN Commercial |
$2,920.74
|
| Rate for Payer: BCN Medicare Advantage |
$7,434.67
|
| 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 |
$7,434.67
|
| Rate for Payer: Healthscope Commercial |
$3,767.24
|
| Rate for Payer: Healthscope Whirlpool |
$3,654.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,434.67
|
| Rate for Payer: Mclaren Commercial |
$3,390.52
|
| Rate for Payer: Mclaren Medicaid |
$3,984.98
|
| Rate for Payer: Mclaren Medicare |
$7,434.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,806.40
|
| Rate for Payer: Meridian Medicaid |
$4,184.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,549.87
|
| 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 |
$7,062.94
|
| Rate for Payer: PACE SWMI |
$7,434.67
|
| Rate for Payer: PHP Commercial |
$8,178.14
|
| Rate for Payer: PHP Medicaid |
$3,984.98
|
| Rate for Payer: PHP Medicare Advantage |
$7,434.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,984.98
|
| 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 |
$7,434.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,640.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7,434.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,434.67
|
| Rate for Payer: UHC Exchange |
$11,523.74
|
| Rate for Payer: UHC Medicare Advantage |
$7,434.67
|
| Rate for Payer: UHCCP DNSP |
$7,434.67
|
| Rate for Payer: UHCCP Medicaid |
$3,984.98
|
| Rate for Payer: VA VA |
$7,434.67
|
|
|
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
|
|
|
HC INTRODUCER LONG
|
Facility
|
OP
|
$254.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.97 |
| Max. Negotiated Rate |
$254.93 |
| Rate for Payer: Aetna Commercial |
$229.44
|
| Rate for Payer: Aetna Medicare |
$127.46
|
| Rate for Payer: ASR ASR |
$247.28
|
| Rate for Payer: ASR Commercial |
$247.28
|
| Rate for Payer: BCBS Complete |
$101.97
|
| Rate for Payer: BCBS Trust/PPO |
$208.76
|
| Rate for Payer: BCN Commercial |
$197.65
|
| Rate for Payer: Cash Price |
$203.94
|
| Rate for Payer: Cofinity Commercial |
$239.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.94
|
| Rate for Payer: Healthscope Commercial |
$254.93
|
| Rate for Payer: Healthscope Whirlpool |
$247.28
|
| Rate for Payer: Mclaren Commercial |
$229.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.69
|
| Rate for Payer: Nomi Health Commercial |
$209.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.37
|
| Rate for Payer: Priority Health Narrow Network |
$178.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.34
|
|
|
HC INTRODUCER LONG
|
Facility
|
IP
|
$254.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.70 |
| Max. Negotiated Rate |
$254.93 |
| Rate for Payer: Aetna Commercial |
$229.44
|
| Rate for Payer: ASR ASR |
$247.28
|
| Rate for Payer: ASR Commercial |
$247.28
|
| Rate for Payer: BCBS Trust/PPO |
$207.74
|
| Rate for Payer: BCN Commercial |
$197.65
|
| Rate for Payer: Cash Price |
$203.94
|
| Rate for Payer: Cofinity Commercial |
$239.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.94
|
| Rate for Payer: Healthscope Commercial |
$254.93
|
| Rate for Payer: Healthscope Whirlpool |
$247.28
|
| Rate for Payer: Mclaren Commercial |
$229.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.69
|
| Rate for Payer: Nomi Health Commercial |
$209.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$224.34
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
IP
|
$94.68
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.54 |
| Max. Negotiated Rate |
$94.68 |
| Rate for Payer: Aetna Commercial |
$85.21
|
| Rate for Payer: ASR ASR |
$91.84
|
| Rate for Payer: ASR Commercial |
$91.84
|
| Rate for Payer: BCBS Trust/PPO |
$77.15
|
| Rate for Payer: BCN Commercial |
$73.41
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$89.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$94.68
|
| Rate for Payer: Healthscope Whirlpool |
$91.84
|
| Rate for Payer: Mclaren Commercial |
$85.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.48
|
| Rate for Payer: Nomi Health Commercial |
$77.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.32
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
OP
|
$94.68
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.87 |
| Max. Negotiated Rate |
$94.68 |
| Rate for Payer: Aetna Commercial |
$85.21
|
| Rate for Payer: Aetna Medicare |
$47.34
|
| Rate for Payer: ASR ASR |
$91.84
|
| Rate for Payer: ASR Commercial |
$91.84
|
| Rate for Payer: BCBS Complete |
$37.87
|
| Rate for Payer: BCBS Trust/PPO |
$77.53
|
| Rate for Payer: BCN Commercial |
$73.41
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$89.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$94.68
|
| Rate for Payer: Healthscope Whirlpool |
$91.84
|
| Rate for Payer: Mclaren Commercial |
$85.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.48
|
| Rate for Payer: Nomi Health Commercial |
$77.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.96
|
| Rate for Payer: Priority Health Narrow Network |
$66.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.32
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
IP
|
$3,457.60
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,247.44 |
| Max. Negotiated Rate |
$3,457.60 |
| Rate for Payer: Aetna Commercial |
$3,111.84
|
| Rate for Payer: ASR ASR |
$3,353.87
|
| Rate for Payer: ASR Commercial |
$3,353.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,817.60
|
| Rate for Payer: BCN Commercial |
$2,680.68
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$3,250.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,457.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,353.87
|
| Rate for Payer: Mclaren Commercial |
$3,111.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: Nomi Health Commercial |
$2,835.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.69
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,247.44 |
| Max. Negotiated Rate |
$7,720.29 |
| Rate for Payer: Aetna Commercial |
$3,111.84
|
| Rate for Payer: Aetna Medicare |
$4,980.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,226.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,226.04
|
| Rate for Payer: ASR ASR |
$3,353.87
|
| Rate for Payer: ASR Commercial |
$3,353.87
|
| Rate for Payer: BCBS Complete |
$2,803.21
|
| Rate for Payer: BCBS MAPPO |
$4,980.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,831.43
|
| Rate for Payer: BCN Commercial |
$2,680.68
|
| Rate for Payer: BCN Medicare Advantage |
$4,980.83
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$3,250.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,980.83
|
| Rate for Payer: Healthscope Commercial |
$3,457.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,353.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,980.83
|
| Rate for Payer: Mclaren Commercial |
$3,111.84
|
| Rate for Payer: Mclaren Medicaid |
$2,669.72
|
| Rate for Payer: Mclaren Medicare |
$4,980.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,229.87
|
| Rate for Payer: Meridian Medicaid |
$2,803.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,727.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: Nomi Health Commercial |
$2,835.23
|
| Rate for Payer: PACE Medicare |
$4,731.79
|
| Rate for Payer: PACE SWMI |
$4,980.83
|
| Rate for Payer: PHP Commercial |
$5,478.91
|
| Rate for Payer: PHP Medicaid |
$2,669.72
|
| Rate for Payer: PHP Medicare Advantage |
$4,980.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,669.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,029.55
|
| Rate for Payer: Priority Health Medicare |
$4,980.83
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.78
|
| Rate for Payer: Railroad Medicare Medicare |
$4,980.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,980.83
|
| Rate for Payer: UHC Exchange |
$7,720.29
|
| Rate for Payer: UHC Medicare Advantage |
$4,980.83
|
| Rate for Payer: UHCCP DNSP |
$4,980.83
|
| Rate for Payer: UHCCP Medicaid |
$2,669.72
|
| Rate for Payer: VA VA |
$4,980.83
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
OP
|
$41.77
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$41.77 |
| Rate for Payer: Aetna Commercial |
$37.59
|
| Rate for Payer: Aetna Medicare |
$20.88
|
| Rate for Payer: ASR ASR |
$40.52
|
| Rate for Payer: ASR Commercial |
$40.52
|
| Rate for Payer: BCBS Complete |
$16.71
|
| Rate for Payer: BCBS Trust/PPO |
$34.21
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$33.42
|
| Rate for Payer: Cofinity Commercial |
$39.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.42
|
| Rate for Payer: Healthscope Commercial |
$41.77
|
| Rate for Payer: Healthscope Whirlpool |
$40.52
|
| Rate for Payer: Mclaren Commercial |
$37.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Nomi Health Commercial |
$34.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.60
|
| Rate for Payer: Priority Health Narrow Network |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.76
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
IP
|
$41.77
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$41.77 |
| Rate for Payer: Aetna Commercial |
$37.59
|
| Rate for Payer: ASR ASR |
$40.52
|
| Rate for Payer: ASR Commercial |
$40.52
|
| Rate for Payer: BCBS Trust/PPO |
$34.04
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$33.42
|
| Rate for Payer: Cofinity Commercial |
$39.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.42
|
| Rate for Payer: Healthscope Commercial |
$41.77
|
| Rate for Payer: Healthscope Whirlpool |
$40.52
|
| Rate for Payer: Mclaren Commercial |
$37.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Nomi Health Commercial |
$34.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.76
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
OP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$478.00 |
| Max. Negotiated Rate |
$1,195.00 |
| Rate for Payer: Aetna Commercial |
$1,075.50
|
| Rate for Payer: Aetna Medicare |
$597.50
|
| Rate for Payer: ASR ASR |
$1,159.15
|
| Rate for Payer: ASR Commercial |
$1,159.15
|
| Rate for Payer: BCBS Complete |
$478.00
|
| Rate for Payer: BCBS Trust/PPO |
$978.59
|
| Rate for Payer: BCN Commercial |
$926.48
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,123.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Healthscope Commercial |
$1,195.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,159.15
|
| Rate for Payer: Mclaren Commercial |
$1,075.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.75
|
| Rate for Payer: Nomi Health Commercial |
$979.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.06
|
| Rate for Payer: Priority Health Narrow Network |
$837.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.60
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
IP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$776.75 |
| Max. Negotiated Rate |
$1,195.00 |
| Rate for Payer: Aetna Commercial |
$1,075.50
|
| Rate for Payer: ASR ASR |
$1,159.15
|
| Rate for Payer: ASR Commercial |
$1,159.15
|
| Rate for Payer: BCBS Trust/PPO |
$973.81
|
| Rate for Payer: BCN Commercial |
$926.48
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,123.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Healthscope Commercial |
$1,195.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,159.15
|
| Rate for Payer: Mclaren Commercial |
$1,075.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.75
|
| Rate for Payer: Nomi Health Commercial |
$979.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,051.60
|
|
|
HC INTRO SHEATH NON GUIDE LVL 2
|
Facility
|
IP
|
$162.30
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$162.30 |
| Rate for Payer: Aetna Commercial |
$146.07
|
| Rate for Payer: ASR ASR |
$157.43
|
| Rate for Payer: ASR Commercial |
$157.43
|
| Rate for Payer: BCBS Trust/PPO |
$132.26
|
| Rate for Payer: BCN Commercial |
$125.83
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$152.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$162.30
|
| Rate for Payer: Healthscope Whirlpool |
$157.43
|
| Rate for Payer: Mclaren Commercial |
$146.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.82
|
|
|
HC INTRO SHEATH NON GUIDE LVL 2
|
Facility
|
OP
|
$162.30
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$162.30 |
| Rate for Payer: Aetna Commercial |
$146.07
|
| Rate for Payer: Aetna Medicare |
$81.15
|
| Rate for Payer: ASR ASR |
$157.43
|
| Rate for Payer: ASR Commercial |
$157.43
|
| Rate for Payer: BCBS Complete |
$64.92
|
| Rate for Payer: BCBS Trust/PPO |
$132.91
|
| Rate for Payer: BCN Commercial |
$125.83
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$152.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$162.30
|
| Rate for Payer: Healthscope Whirlpool |
$157.43
|
| Rate for Payer: Mclaren Commercial |
$146.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.21
|
| Rate for Payer: Priority Health Narrow Network |
$113.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.82
|
|
|
HC INTRO SHEATH NON GUIDE LVL 3
|
Facility
|
OP
|
$337.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$303.75
|
| Rate for Payer: Aetna Medicare |
$168.75
|
| Rate for Payer: ASR ASR |
$327.38
|
| Rate for Payer: ASR Commercial |
$327.38
|
| Rate for Payer: BCBS Complete |
$135.00
|
| Rate for Payer: BCBS Trust/PPO |
$276.38
|
| Rate for Payer: BCN Commercial |
$261.66
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$317.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Healthscope Whirlpool |
$327.38
|
| Rate for Payer: Mclaren Commercial |
$303.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.72
|
| Rate for Payer: Priority Health Narrow Network |
$236.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.00
|
|
|
HC INTRO SHEATH NON GUIDE LVL 3
|
Facility
|
IP
|
$337.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.38 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$303.75
|
| Rate for Payer: ASR ASR |
$327.38
|
| Rate for Payer: ASR Commercial |
$327.38
|
| Rate for Payer: BCBS Trust/PPO |
$275.03
|
| Rate for Payer: BCN Commercial |
$261.66
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$317.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Healthscope Whirlpool |
$327.38
|
| Rate for Payer: Mclaren Commercial |
$303.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.00
|
|
|
HC INTRO SHEATH NON GUIDE LVL 4
|
Facility
|
OP
|
$485.16
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.06 |
| Max. Negotiated Rate |
$485.16 |
| Rate for Payer: Aetna Commercial |
$436.64
|
| Rate for Payer: Aetna Medicare |
$242.58
|
| Rate for Payer: ASR ASR |
$470.61
|
| Rate for Payer: ASR Commercial |
$470.61
|
| Rate for Payer: BCBS Complete |
$194.06
|
| Rate for Payer: BCBS Trust/PPO |
$397.30
|
| Rate for Payer: BCN Commercial |
$376.14
|
| Rate for Payer: Cash Price |
$388.13
|
| Rate for Payer: Cofinity Commercial |
$456.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.13
|
| Rate for Payer: Healthscope Commercial |
$485.16
|
| Rate for Payer: Healthscope Whirlpool |
$470.61
|
| Rate for Payer: Mclaren Commercial |
$436.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.39
|
| Rate for Payer: Nomi Health Commercial |
$397.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.10
|
| Rate for Payer: Priority Health Narrow Network |
$340.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.94
|
|
