|
HC MED PHYSIC DOS EVAL RAD EXPS
|
Facility
|
IP
|
$269.27
|
|
|
Service Code
|
CPT 76145
|
| Hospital Charge Code |
32000333
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$201.95 |
| Max. Negotiated Rate |
$269.27 |
| Rate for Payer: Aetna Commercial |
$242.34
|
| Rate for Payer: ASR ASR |
$261.19
|
| Rate for Payer: BCBS Trust/PPO |
$221.12
|
| Rate for Payer: BCN Commercial |
$221.12
|
| Rate for Payer: Cash Price |
$215.42
|
| Rate for Payer: Cofinity Commercial |
$253.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.42
|
| Rate for Payer: Healthscope Commercial |
$261.19
|
| Rate for Payer: Healthscope Whirlpool |
$269.27
|
| Rate for Payer: Mclaren Commercial |
$242.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.88
|
| Rate for Payer: Nomi Health Commercial |
$220.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.96
|
|
|
HC MED PHYSIC DOS EVAL RAD EXPS
|
Facility
|
OP
|
$269.27
|
|
|
Service Code
|
CPT 76145
|
| Hospital Charge Code |
32000333
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$188.76 |
| Max. Negotiated Rate |
$576.32 |
| Rate for Payer: Aetna Commercial |
$242.34
|
| Rate for Payer: Aetna Medicare |
$371.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: ASR ASR |
$261.19
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$222.01
|
| Rate for Payer: BCN Commercial |
$222.01
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$215.42
|
| Rate for Payer: Cash Price |
$215.42
|
| Rate for Payer: Cofinity Commercial |
$253.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$261.19
|
| Rate for Payer: Healthscope Whirlpool |
$269.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$371.82
|
| Rate for Payer: Mclaren Commercial |
$242.34
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.88
|
| Rate for Payer: Nomi Health Commercial |
$220.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.95
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$409.00
|
| Rate for Payer: PHP Medicaid |
$199.30
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$235.93
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health Narrow Network |
$188.76
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$576.32
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP DNSP |
$371.82
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: VA VA |
$371.82
|
|
|
HC MED SURG ROOM & BOARD
|
Facility
|
IP
|
$3,423.98
|
|
| Hospital Charge Code |
11000001
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$2,567.99 |
| Max. Negotiated Rate |
$3,423.98 |
| Rate for Payer: Aetna Commercial |
$3,081.58
|
| Rate for Payer: ASR ASR |
$3,321.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,811.77
|
| Rate for Payer: BCN Commercial |
$2,811.77
|
| Rate for Payer: Cash Price |
$2,739.18
|
| Rate for Payer: Cofinity Commercial |
$3,218.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,739.18
|
| Rate for Payer: Healthscope Commercial |
$3,321.26
|
| Rate for Payer: Healthscope Whirlpool |
$3,423.98
|
| Rate for Payer: Mclaren Commercial |
$3,081.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,910.38
|
| Rate for Payer: Nomi Health Commercial |
$2,807.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,567.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,013.10
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.45 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$48.44
|
| Rate for Payer: Healthscope Whirlpool |
$49.94
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$44.95
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: ASR ASR |
$48.44
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$41.18
|
| Rate for Payer: BCN Commercial |
$41.18
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$48.44
|
| Rate for Payer: Healthscope Whirlpool |
$49.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.42
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.02
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
IP
|
$30,562.79
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$22,922.09 |
| Max. Negotiated Rate |
$30,562.79 |
| Rate for Payer: Aetna Commercial |
$27,506.51
|
| Rate for Payer: ASR ASR |
$29,645.91
|
| Rate for Payer: BCBS Trust/PPO |
$25,098.16
|
| Rate for Payer: BCN Commercial |
$25,098.16
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cofinity Commercial |
$28,729.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,450.23
|
| Rate for Payer: Healthscope Commercial |
$29,645.91
|
| Rate for Payer: Healthscope Whirlpool |
$30,562.79
|
| Rate for Payer: Mclaren Commercial |
$27,506.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,978.37
|
| Rate for Payer: Nomi Health Commercial |
$25,061.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,922.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,895.26
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
OP
|
$30,562.79
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,308.23 |
| Max. Negotiated Rate |
$30,562.79 |
| Rate for Payer: Aetna Commercial |
$27,506.51
|
| Rate for Payer: Aetna Medicare |
$11,308.23
|
| Rate for Payer: ASR ASR |
$29,645.91
|
| Rate for Payer: BCBS Complete |
$12,225.12
|
| Rate for Payer: BCBS Trust/PPO |
$25,199.02
|
| Rate for Payer: BCN Commercial |
$25,199.02
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cofinity Commercial |
$28,729.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,450.23
|
| Rate for Payer: Healthscope Commercial |
$29,645.91
|
| Rate for Payer: Healthscope Whirlpool |
$30,562.79
|
| Rate for Payer: Mclaren Commercial |
$27,506.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,450.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,978.37
|
| Rate for Payer: Nomi Health Commercial |
$25,061.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,922.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$26,779.12
|
| Rate for Payer: Priority Health Narrow Network |
$21,424.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,895.26
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
OP
|
$6,331.69
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,342.73 |
| Max. Negotiated Rate |
$6,331.69 |
| Rate for Payer: Aetna Commercial |
$5,698.52
|
| Rate for Payer: Aetna Medicare |
$2,342.73
|
| Rate for Payer: ASR ASR |
$6,141.74
|
| Rate for Payer: BCBS Complete |
$2,532.68
|
| Rate for Payer: BCBS Trust/PPO |
$5,220.48
|
| Rate for Payer: BCN Commercial |
$5,220.48
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cofinity Commercial |
$5,951.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,065.35
|
| Rate for Payer: Healthscope Commercial |
$6,141.74
|
| Rate for Payer: Healthscope Whirlpool |
$6,331.69
|
| Rate for Payer: Mclaren Commercial |
$5,698.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,065.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,381.94
|
| Rate for Payer: Nomi Health Commercial |
$5,191.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,748.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,547.83
|
| Rate for Payer: Priority Health Narrow Network |
$4,438.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,571.89
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
IP
|
$6,331.69
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,748.77 |
| Max. Negotiated Rate |
$6,331.69 |
| Rate for Payer: Aetna Commercial |
$5,698.52
|
| Rate for Payer: ASR ASR |
$6,141.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,199.58
|
| Rate for Payer: BCN Commercial |
$5,199.58
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cofinity Commercial |
$5,951.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,065.35
|
| Rate for Payer: Healthscope Commercial |
$6,141.74
|
| Rate for Payer: Healthscope Whirlpool |
$6,331.69
|
| Rate for Payer: Mclaren Commercial |
$5,698.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,381.94
|
| Rate for Payer: Nomi Health Commercial |
$5,191.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,748.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,571.89
|
|
|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
OP
|
$9,020.27
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,337.50 |
| Max. Negotiated Rate |
$9,020.27 |
| Rate for Payer: Aetna Commercial |
$8,118.24
|
| Rate for Payer: Aetna Medicare |
$3,337.50
|
| Rate for Payer: ASR ASR |
$8,749.66
|
| Rate for Payer: BCBS Complete |
$3,608.11
|
| Rate for Payer: BCBS Trust/PPO |
$7,437.21
|
| Rate for Payer: BCN Commercial |
$7,437.21
|
| Rate for Payer: Cash Price |
$7,216.22
|
| Rate for Payer: Cofinity Commercial |
$8,479.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.22
|
| Rate for Payer: Healthscope Commercial |
$8,749.66
|
| Rate for Payer: Healthscope Whirlpool |
$9,020.27
|
| Rate for Payer: Mclaren Commercial |
$8,118.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,216.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.23
|
| Rate for Payer: Nomi Health Commercial |
$7,396.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,765.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,903.56
|
| Rate for Payer: Priority Health Narrow Network |
$6,323.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,937.84
|
|
|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
IP
|
$9,020.27
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,765.20 |
| Max. Negotiated Rate |
$9,020.27 |
| Rate for Payer: Aetna Commercial |
$8,118.24
|
| Rate for Payer: ASR ASR |
$8,749.66
|
| Rate for Payer: BCBS Trust/PPO |
$7,407.45
|
| Rate for Payer: BCN Commercial |
$7,407.45
|
| Rate for Payer: Cash Price |
$7,216.22
|
| Rate for Payer: Cofinity Commercial |
$8,479.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.22
|
| Rate for Payer: Healthscope Commercial |
$8,749.66
|
| Rate for Payer: Healthscope Whirlpool |
$9,020.27
|
| Rate for Payer: Mclaren Commercial |
$8,118.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.23
|
| Rate for Payer: Nomi Health Commercial |
$7,396.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,765.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,937.84
|
|
|
HC MEDTRONIC ICD DUAL
|
Facility
|
IP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$20,136.42 |
| Max. Negotiated Rate |
$26,848.56 |
| Rate for Payer: Aetna Commercial |
$24,163.70
|
| Rate for Payer: ASR ASR |
$26,043.10
|
| Rate for Payer: BCBS Trust/PPO |
$22,048.04
|
| Rate for Payer: BCN Commercial |
$22,048.04
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Commercial |
$25,237.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$26,043.10
|
| Rate for Payer: Healthscope Whirlpool |
$26,848.56
|
| Rate for Payer: Mclaren Commercial |
$24,163.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Nomi Health Commercial |
$22,015.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,626.73
|
|
|
HC MEDTRONIC ICD DUAL
|
Facility
|
OP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,933.97 |
| Max. Negotiated Rate |
$26,848.56 |
| Rate for Payer: Aetna Commercial |
$24,163.70
|
| Rate for Payer: Aetna Medicare |
$9,933.97
|
| Rate for Payer: ASR ASR |
$26,043.10
|
| Rate for Payer: BCBS Complete |
$10,739.42
|
| Rate for Payer: BCBS Trust/PPO |
$22,136.64
|
| Rate for Payer: BCN Commercial |
$22,136.64
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Commercial |
$25,237.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$26,043.10
|
| Rate for Payer: Healthscope Whirlpool |
$26,848.56
|
| Rate for Payer: Mclaren Commercial |
$24,163.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,478.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Nomi Health Commercial |
$22,015.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23,524.71
|
| Rate for Payer: Priority Health Narrow Network |
$18,820.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23,626.73
|
|
|
HC MEDTRONIC ICD SINGLE
|
Facility
|
IP
|
$24,301.66
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18,226.24 |
| Max. Negotiated Rate |
$24,301.66 |
| Rate for Payer: Aetna Commercial |
$21,871.49
|
| Rate for Payer: ASR ASR |
$23,572.61
|
| Rate for Payer: BCBS Trust/PPO |
$19,956.52
|
| Rate for Payer: BCN Commercial |
$19,956.52
|
| Rate for Payer: Cash Price |
$19,441.33
|
| Rate for Payer: Cofinity Commercial |
$22,843.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,441.33
|
| Rate for Payer: Healthscope Commercial |
$23,572.61
|
| Rate for Payer: Healthscope Whirlpool |
$24,301.66
|
| Rate for Payer: Mclaren Commercial |
$21,871.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,656.41
|
| Rate for Payer: Nomi Health Commercial |
$19,927.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,226.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,385.46
|
|
|
HC MEDTRONIC ICD SINGLE
|
Facility
|
OP
|
$24,301.66
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,991.61 |
| Max. Negotiated Rate |
$24,301.66 |
| Rate for Payer: Aetna Commercial |
$21,871.49
|
| Rate for Payer: Aetna Medicare |
$8,991.61
|
| Rate for Payer: ASR ASR |
$23,572.61
|
| Rate for Payer: BCBS Complete |
$9,720.66
|
| Rate for Payer: BCBS Trust/PPO |
$20,036.72
|
| Rate for Payer: BCN Commercial |
$20,036.72
|
| Rate for Payer: Cash Price |
$19,441.33
|
| Rate for Payer: Cofinity Commercial |
$22,843.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,441.33
|
| Rate for Payer: Healthscope Commercial |
$23,572.61
|
| Rate for Payer: Healthscope Whirlpool |
$24,301.66
|
| Rate for Payer: Mclaren Commercial |
$21,871.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,441.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,656.41
|
| Rate for Payer: Nomi Health Commercial |
$19,927.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,226.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$21,293.11
|
| Rate for Payer: Priority Health Narrow Network |
$17,035.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,385.46
|
|
|
HC MEDTRONIC SINGLE PACEMAKER
|
Facility
|
IP
|
$13,480.45
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500008
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,110.34 |
| Max. Negotiated Rate |
$13,480.45 |
| Rate for Payer: Aetna Commercial |
$12,132.41
|
| Rate for Payer: ASR ASR |
$13,076.04
|
| Rate for Payer: BCBS Trust/PPO |
$11,070.15
|
| Rate for Payer: BCN Commercial |
$11,070.15
|
| Rate for Payer: Cash Price |
$10,784.36
|
| Rate for Payer: Cofinity Commercial |
$12,671.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,784.36
|
| Rate for Payer: Healthscope Commercial |
$13,076.04
|
| Rate for Payer: Healthscope Whirlpool |
$13,480.45
|
| Rate for Payer: Mclaren Commercial |
$12,132.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,458.38
|
| Rate for Payer: Nomi Health Commercial |
$11,053.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,110.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,862.80
|
|
|
HC MEDTRONIC SINGLE PACEMAKER
|
Facility
|
OP
|
$13,480.45
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500008
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,987.77 |
| Max. Negotiated Rate |
$13,480.45 |
| Rate for Payer: Aetna Commercial |
$12,132.41
|
| Rate for Payer: Aetna Medicare |
$4,987.77
|
| Rate for Payer: ASR ASR |
$13,076.04
|
| Rate for Payer: BCBS Complete |
$5,392.18
|
| Rate for Payer: BCBS Trust/PPO |
$11,114.63
|
| Rate for Payer: BCN Commercial |
$11,114.63
|
| Rate for Payer: Cash Price |
$10,784.36
|
| Rate for Payer: Cofinity Commercial |
$12,671.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,784.36
|
| Rate for Payer: Healthscope Commercial |
$13,076.04
|
| Rate for Payer: Healthscope Whirlpool |
$13,480.45
|
| Rate for Payer: Mclaren Commercial |
$12,132.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,784.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,458.38
|
| Rate for Payer: Nomi Health Commercial |
$11,053.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,110.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,811.57
|
| Rate for Payer: Priority Health Narrow Network |
$9,449.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,862.80
|
|
|
HC MEDTRONIC TACHY (ICD) LEAD
|
Facility
|
IP
|
$15,909.43
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,932.07 |
| Max. Negotiated Rate |
$15,909.43 |
| Rate for Payer: Aetna Commercial |
$14,318.49
|
| Rate for Payer: ASR ASR |
$15,432.15
|
| Rate for Payer: BCBS Trust/PPO |
$13,064.82
|
| Rate for Payer: BCN Commercial |
$13,064.82
|
| Rate for Payer: Cash Price |
$12,727.54
|
| Rate for Payer: Cofinity Commercial |
$14,954.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,727.54
|
| Rate for Payer: Healthscope Commercial |
$15,432.15
|
| Rate for Payer: Healthscope Whirlpool |
$15,909.43
|
| Rate for Payer: Mclaren Commercial |
$14,318.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,523.02
|
| Rate for Payer: Nomi Health Commercial |
$13,045.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,932.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,000.30
|
|
|
HC MEDTRONIC TACHY (ICD) LEAD
|
Facility
|
OP
|
$15,909.43
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,886.49 |
| Max. Negotiated Rate |
$15,909.43 |
| Rate for Payer: Aetna Commercial |
$14,318.49
|
| Rate for Payer: Aetna Medicare |
$5,886.49
|
| Rate for Payer: ASR ASR |
$15,432.15
|
| Rate for Payer: BCBS Complete |
$6,363.77
|
| Rate for Payer: BCBS Trust/PPO |
$13,117.33
|
| Rate for Payer: BCN Commercial |
$13,117.33
|
| Rate for Payer: Cash Price |
$12,727.54
|
| Rate for Payer: Cofinity Commercial |
$14,954.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,727.54
|
| Rate for Payer: Healthscope Commercial |
$15,432.15
|
| Rate for Payer: Healthscope Whirlpool |
$15,909.43
|
| Rate for Payer: Mclaren Commercial |
$14,318.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,727.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,523.02
|
| Rate for Payer: Nomi Health Commercial |
$13,045.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,932.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13,939.84
|
| Rate for Payer: Priority Health Narrow Network |
$11,152.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,000.30
|
|
|
HC MENACWY-TT VACCINE IM
|
Facility
|
OP
|
$191.02
|
|
|
Service Code
|
CPT 90619
|
| Hospital Charge Code |
63600210
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$70.68 |
| Max. Negotiated Rate |
$201.76 |
| Rate for Payer: Aetna Commercial |
$171.92
|
| Rate for Payer: Aetna Medicare |
$70.68
|
| Rate for Payer: ASR ASR |
$185.29
|
| Rate for Payer: BCBS Complete |
$76.41
|
| Rate for Payer: BCBS Trust/PPO |
$157.50
|
| Rate for Payer: BCN Commercial |
$157.50
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cofinity Commercial |
$179.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.82
|
| Rate for Payer: Healthscope Commercial |
$185.29
|
| Rate for Payer: Healthscope Whirlpool |
$191.02
|
| Rate for Payer: Mclaren Commercial |
$171.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.37
|
| Rate for Payer: Nomi Health Commercial |
$156.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$201.76
|
| Rate for Payer: Priority Health Narrow Network |
$161.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.10
|
|
|
HC MENACWY-TT VACCINE IM
|
Facility
|
IP
|
$191.02
|
|
|
Service Code
|
CPT 90619
|
| Hospital Charge Code |
63600210
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.26 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$171.92
|
| Rate for Payer: ASR ASR |
$185.29
|
| Rate for Payer: BCBS Trust/PPO |
$156.87
|
| Rate for Payer: BCN Commercial |
$156.87
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cofinity Commercial |
$179.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.82
|
| Rate for Payer: Healthscope Commercial |
$185.29
|
| Rate for Payer: Healthscope Whirlpool |
$191.02
|
| Rate for Payer: Mclaren Commercial |
$171.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.37
|
| Rate for Payer: Nomi Health Commercial |
$156.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.10
|
|
|
HC MENB-FHBP VACC 2/3 DOSE IM
|
Facility
|
OP
|
$537.45
|
|
|
Service Code
|
CPT 90621
|
| Hospital Charge Code |
63600187
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$198.86 |
| Max. Negotiated Rate |
$537.45 |
| Rate for Payer: Aetna Commercial |
$483.70
|
| Rate for Payer: Aetna Medicare |
$198.86
|
| Rate for Payer: ASR ASR |
$521.33
|
| Rate for Payer: BCBS Complete |
$214.98
|
| Rate for Payer: BCBS Trust/PPO |
$443.13
|
| Rate for Payer: BCN Commercial |
$443.13
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cofinity Commercial |
$505.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.96
|
| Rate for Payer: Healthscope Commercial |
$521.33
|
| Rate for Payer: Healthscope Whirlpool |
$537.45
|
| Rate for Payer: Mclaren Commercial |
$483.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.83
|
| Rate for Payer: Nomi Health Commercial |
$440.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.39
|
| Rate for Payer: Priority Health Narrow Network |
$205.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$472.96
|
|
|
HC MENB-FHBP VACC 2/3 DOSE IM
|
Facility
|
IP
|
$537.45
|
|
|
Service Code
|
CPT 90621
|
| Hospital Charge Code |
63600187
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$403.09 |
| Max. Negotiated Rate |
$537.45 |
| Rate for Payer: Aetna Commercial |
$483.70
|
| Rate for Payer: ASR ASR |
$521.33
|
| Rate for Payer: BCBS Trust/PPO |
$441.35
|
| Rate for Payer: BCN Commercial |
$441.35
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cofinity Commercial |
$505.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.96
|
| Rate for Payer: Healthscope Commercial |
$521.33
|
| Rate for Payer: Healthscope Whirlpool |
$537.45
|
| Rate for Payer: Mclaren Commercial |
$483.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.83
|
| Rate for Payer: Nomi Health Commercial |
$440.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$472.96
|
|
|
HC MENB RECOMB PROT W/OUT MEMBR VESIC VACC IM
|
Facility
|
IP
|
$268.42
|
|
|
Service Code
|
CPT 90620
|
| Hospital Charge Code |
63600122
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$201.31 |
| Max. Negotiated Rate |
$268.42 |
| Rate for Payer: Aetna Commercial |
$241.58
|
| Rate for Payer: ASR ASR |
$260.37
|
| Rate for Payer: BCBS Trust/PPO |
$220.43
|
| Rate for Payer: BCN Commercial |
$220.43
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cofinity Commercial |
$252.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.74
|
| Rate for Payer: Healthscope Commercial |
$260.37
|
| Rate for Payer: Healthscope Whirlpool |
$268.42
|
| Rate for Payer: Mclaren Commercial |
$241.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.16
|
| Rate for Payer: Nomi Health Commercial |
$220.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.21
|
|
|
HC MENB RECOMB PROT W/OUT MEMBR VESIC VACC IM
|
Facility
|
OP
|
$268.42
|
|
|
Service Code
|
CPT 90620
|
| Hospital Charge Code |
63600122
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$99.32 |
| Max. Negotiated Rate |
$270.18 |
| Rate for Payer: Aetna Commercial |
$241.58
|
| Rate for Payer: Aetna Medicare |
$99.32
|
| Rate for Payer: ASR ASR |
$260.37
|
| Rate for Payer: BCBS Complete |
$107.37
|
| Rate for Payer: BCBS Trust/PPO |
$221.31
|
| Rate for Payer: BCN Commercial |
$221.31
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cofinity Commercial |
$252.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.74
|
| Rate for Payer: Healthscope Commercial |
$260.37
|
| Rate for Payer: Healthscope Whirlpool |
$268.42
|
| Rate for Payer: Mclaren Commercial |
$241.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.16
|
| Rate for Payer: Nomi Health Commercial |
$220.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$270.18
|
| Rate for Payer: Priority Health Narrow Network |
$216.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.21
|
|
