|
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 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 |
$127.47
|
| 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 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 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 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 |
$7,684.82 |
| Rate for Payer: Aetna Commercial |
$3,111.84
|
| Rate for Payer: Aetna Medicare |
$4,957.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,197.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,197.44
|
| Rate for Payer: ASR ASR |
$3,353.87
|
| Rate for Payer: ASR Commercial |
$3,353.87
|
| Rate for Payer: BCBS Complete |
$2,790.33
|
| Rate for Payer: BCBS MAPPO |
$4,957.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,831.43
|
| Rate for Payer: BCN Commercial |
$2,680.68
|
| Rate for Payer: BCN Medicare Advantage |
$4,957.95
|
| 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 |
$4,957.95
|
| Rate for Payer: Healthscope Commercial |
$3,457.60
|
| Rate for Payer: Healthscope Whirlpool |
$3,353.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,957.95
|
| Rate for Payer: Mclaren Commercial |
$3,111.84
|
| Rate for Payer: Mclaren Medicaid |
$2,657.46
|
| Rate for Payer: Mclaren Medicare |
$4,957.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,205.85
|
| Rate for Payer: Meridian Medicaid |
$2,790.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,701.64
|
| 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 |
$4,710.05
|
| Rate for Payer: PACE SWMI |
$4,957.95
|
| Rate for Payer: PHP Commercial |
$5,453.74
|
| Rate for Payer: PHP Medicaid |
$2,657.46
|
| Rate for Payer: PHP Medicare Advantage |
$4,957.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,657.46
|
| 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 |
$4,957.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.78
|
| Rate for Payer: Railroad Medicare Medicare |
$4,957.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,042.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,957.95
|
| Rate for Payer: UHC Exchange |
$7,684.82
|
| Rate for Payer: UHC Medicare Advantage |
$4,957.95
|
| Rate for Payer: UHCCP DNSP |
$4,957.95
|
| Rate for Payer: UHCCP Medicaid |
$2,657.46
|
| Rate for Payer: VA VA |
$4,957.95
|
|
|
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 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 |
$20.89
|
| 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
|
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 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 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 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 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
|
IP
|
$485.16
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$315.35 |
| Max. Negotiated Rate |
$485.16 |
| Rate for Payer: Aetna Commercial |
$436.64
|
| Rate for Payer: ASR ASR |
$470.61
|
| Rate for Payer: ASR Commercial |
$470.61
|
| Rate for Payer: BCBS Trust/PPO |
$395.36
|
| 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: UHC All Payor (Choice/PPO) + Core |
$426.94
|
|
|
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
|
|
|
HC IODINE, S
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100687
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.92 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$24.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.14
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Complete |
$13.57
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCBS Trust/PPO |
$51.12
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.11
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$12.92
|
| Rate for Payer: Mclaren Medicare |
$24.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.32
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Medicare |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$26.52
|
| Rate for Payer: PHP Medicaid |
$12.92
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.69
|
| Rate for Payer: Priority Health Medicare |
$24.11
|
| Rate for Payer: Priority Health Narrow Network |
$43.76
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.11
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP DNSP |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$12.92
|
| Rate for Payer: VA VA |
$24.11
|
|
|
HC IODINE, S
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100687
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: ASR ASR |
$60.55
|
| Rate for Payer: ASR Commercial |
$60.55
|
| Rate for Payer: BCBS Trust/PPO |
$50.87
|
| Rate for Payer: BCN Commercial |
$48.39
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$58.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Healthscope Whirlpool |
$60.55
|
| Rate for Payer: Mclaren Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.93
|
|
|
HC IOFLUPANE I-123 PER STUDY
|
Facility
|
OP
|
$5,436.63
|
|
|
Service Code
|
HCPCS A9584
|
| Hospital Charge Code |
34300035
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$743.98 |
| Max. Negotiated Rate |
$5,436.63 |
| Rate for Payer: Aetna Commercial |
$4,892.97
|
| Rate for Payer: Aetna Medicare |
$1,388.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,735.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,735.03
|
| Rate for Payer: ASR ASR |
$5,273.53
|
| Rate for Payer: ASR Commercial |
$5,273.53
|
| Rate for Payer: BCBS Complete |
$781.18
|
| Rate for Payer: BCBS MAPPO |
$1,388.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,452.06
|
| Rate for Payer: BCN Commercial |
$4,215.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,388.02
|
| Rate for Payer: Cash Price |
$4,349.30
|
| Rate for Payer: Cash Price |
$4,349.30
|
| Rate for Payer: Cofinity Commercial |
$5,110.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,349.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,388.02
|
| Rate for Payer: Healthscope Commercial |
$5,436.63
|
| Rate for Payer: Healthscope Whirlpool |
$5,273.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,388.02
|
| Rate for Payer: Mclaren Commercial |
$4,892.97
|
| Rate for Payer: Mclaren Medicaid |
$743.98
|
| Rate for Payer: Mclaren Medicare |
$1,388.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,457.42
|
| Rate for Payer: Meridian Medicaid |
$781.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,596.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,621.14
|
| Rate for Payer: Nomi Health Commercial |
$4,458.04
|
| Rate for Payer: PACE Medicare |
$1,318.62
|
| Rate for Payer: PACE SWMI |
$1,388.02
|
| Rate for Payer: PHP Commercial |
$1,526.82
|
| Rate for Payer: PHP Medicaid |
$743.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,388.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$743.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,533.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,763.58
|
| Rate for Payer: Priority Health Medicare |
$1,388.02
|
| Rate for Payer: Priority Health Narrow Network |
$3,811.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,388.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,784.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,388.02
|
| Rate for Payer: UHC Exchange |
$2,151.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,388.02
|
| Rate for Payer: UHCCP DNSP |
$1,388.02
|
| Rate for Payer: UHCCP Medicaid |
$743.98
|
| Rate for Payer: VA VA |
$1,388.02
|
|
|
HC IOFLUPANE I-123 PER STUDY
|
Facility
|
IP
|
$5,436.63
|
|
|
Service Code
|
HCPCS A9584
|
| Hospital Charge Code |
34300035
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,533.81 |
| Max. Negotiated Rate |
$5,436.63 |
| Rate for Payer: Aetna Commercial |
$4,892.97
|
| Rate for Payer: ASR ASR |
$5,273.53
|
| Rate for Payer: ASR Commercial |
$5,273.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,430.31
|
| Rate for Payer: BCN Commercial |
$4,215.02
|
| Rate for Payer: Cash Price |
$4,349.30
|
| Rate for Payer: Cofinity Commercial |
$5,110.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,349.30
|
| Rate for Payer: Healthscope Commercial |
$5,436.63
|
| Rate for Payer: Healthscope Whirlpool |
$5,273.53
|
| Rate for Payer: Mclaren Commercial |
$4,892.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,621.14
|
| Rate for Payer: Nomi Health Commercial |
$4,458.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,533.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,784.23
|
|
|
HC IOM EEG CAROTID ENDARTERECTOMY
|
Facility
|
OP
|
$1,297.89
|
|
|
Service Code
|
CPT 95955
|
| Hospital Charge Code |
74000014
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$519.16 |
| Max. Negotiated Rate |
$1,297.89 |
| Rate for Payer: Aetna Commercial |
$1,168.10
|
| Rate for Payer: Aetna Medicare |
$648.95
|
| Rate for Payer: ASR ASR |
$1,258.95
|
| Rate for Payer: ASR Commercial |
$1,258.95
|
| Rate for Payer: BCBS Complete |
$519.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.84
|
| Rate for Payer: BCN Commercial |
$1,006.25
|
| Rate for Payer: Cash Price |
$1,038.31
|
| Rate for Payer: Cofinity Commercial |
$1,220.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,038.31
|
| Rate for Payer: Healthscope Commercial |
$1,297.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,258.95
|
| Rate for Payer: Mclaren Commercial |
$1,168.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,103.21
|
| Rate for Payer: Nomi Health Commercial |
$1,064.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,137.21
|
| Rate for Payer: Priority Health Narrow Network |
$909.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,142.14
|
|
|
HC IOM EEG CAROTID ENDARTERECTOMY
|
Facility
|
IP
|
$1,297.89
|
|
|
Service Code
|
CPT 95955
|
| Hospital Charge Code |
74000014
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$843.63 |
| Max. Negotiated Rate |
$1,297.89 |
| Rate for Payer: Aetna Commercial |
$1,168.10
|
| Rate for Payer: ASR ASR |
$1,258.95
|
| Rate for Payer: ASR Commercial |
$1,258.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,057.65
|
| Rate for Payer: BCN Commercial |
$1,006.25
|
| Rate for Payer: Cash Price |
$1,038.31
|
| Rate for Payer: Cofinity Commercial |
$1,220.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,038.31
|
| Rate for Payer: Healthscope Commercial |
$1,297.89
|
| Rate for Payer: Healthscope Whirlpool |
$1,258.95
|
| Rate for Payer: Mclaren Commercial |
$1,168.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,103.21
|
| Rate for Payer: Nomi Health Commercial |
$1,064.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,142.14
|
|
|
HC IOM INTRAOPERATIVE MONITOR/15 MINUTES
|
Facility
|
IP
|
$187.07
|
|
|
Service Code
|
CPT 95940
|
| Hospital Charge Code |
74000017
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$187.07 |
| Rate for Payer: Aetna Commercial |
$168.36
|
| Rate for Payer: ASR ASR |
$181.46
|
| Rate for Payer: ASR Commercial |
$181.46
|
| Rate for Payer: BCBS Trust/PPO |
$152.44
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: Cash Price |
$149.66
|
| Rate for Payer: Cofinity Commercial |
$175.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.66
|
| Rate for Payer: Healthscope Commercial |
$187.07
|
| Rate for Payer: Healthscope Whirlpool |
$181.46
|
| Rate for Payer: Mclaren Commercial |
$168.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.01
|
| Rate for Payer: Nomi Health Commercial |
$153.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.62
|
|
|
HC IOM INTRAOPERATIVE MONITOR/15 MINUTES
|
Facility
|
OP
|
$187.07
|
|
|
Service Code
|
CPT 95940
|
| Hospital Charge Code |
74000017
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$74.83 |
| Max. Negotiated Rate |
$187.07 |
| Rate for Payer: Aetna Commercial |
$168.36
|
| Rate for Payer: Aetna Medicare |
$93.53
|
| Rate for Payer: ASR ASR |
$181.46
|
| Rate for Payer: ASR Commercial |
$181.46
|
| Rate for Payer: BCBS Complete |
$74.83
|
| Rate for Payer: BCBS Trust/PPO |
$153.19
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: Cash Price |
$149.66
|
| Rate for Payer: Cofinity Commercial |
$175.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.66
|
| Rate for Payer: Healthscope Commercial |
$187.07
|
| Rate for Payer: Healthscope Whirlpool |
$181.46
|
| Rate for Payer: Mclaren Commercial |
$168.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.01
|
| Rate for Payer: Nomi Health Commercial |
$153.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.91
|
| Rate for Payer: Priority Health Narrow Network |
$131.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.62
|
|
|
HC IOM STD PRASS PROBE
|
Facility
|
IP
|
$357.38
|
|
| Hospital Charge Code |
62200008
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$357.38 |
| Rate for Payer: Aetna Commercial |
$321.64
|
| Rate for Payer: ASR ASR |
$346.66
|
| Rate for Payer: ASR Commercial |
$346.66
|
| Rate for Payer: BCBS Trust/PPO |
$291.23
|
| Rate for Payer: BCN Commercial |
$277.08
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$335.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$357.38
|
| Rate for Payer: Healthscope Whirlpool |
$346.66
|
| Rate for Payer: Mclaren Commercial |
$321.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.49
|
|
