|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
IP
|
$257.66
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$193.25 |
| Max. Negotiated Rate |
$257.66 |
| Rate for Payer: Aetna Commercial |
$231.89
|
| Rate for Payer: ASR ASR |
$249.93
|
| Rate for Payer: BCBS Trust/PPO |
$211.59
|
| Rate for Payer: BCN Commercial |
$211.59
|
| Rate for Payer: Cash Price |
$206.13
|
| Rate for Payer: Cofinity Commercial |
$242.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.13
|
| Rate for Payer: Healthscope Commercial |
$249.93
|
| Rate for Payer: Healthscope Whirlpool |
$257.66
|
| Rate for Payer: Mclaren Commercial |
$231.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.01
|
| Rate for Payer: Nomi Health Commercial |
$211.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.74
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
IP
|
$75.38
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$75.38 |
| Rate for Payer: Aetna Commercial |
$67.84
|
| Rate for Payer: ASR ASR |
$73.12
|
| Rate for Payer: BCBS Trust/PPO |
$61.90
|
| Rate for Payer: BCN Commercial |
$61.90
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cofinity Commercial |
$70.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.30
|
| Rate for Payer: Healthscope Commercial |
$73.12
|
| Rate for Payer: Healthscope Whirlpool |
$75.38
|
| Rate for Payer: Mclaren Commercial |
$67.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.07
|
| Rate for Payer: Nomi Health Commercial |
$61.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.33
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
OP
|
$75.38
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.89 |
| Max. Negotiated Rate |
$75.38 |
| Rate for Payer: Aetna Commercial |
$67.84
|
| Rate for Payer: Aetna Medicare |
$27.89
|
| Rate for Payer: ASR ASR |
$73.12
|
| Rate for Payer: BCBS Complete |
$30.15
|
| Rate for Payer: BCBS Trust/PPO |
$62.15
|
| Rate for Payer: BCN Commercial |
$62.15
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cofinity Commercial |
$70.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.30
|
| Rate for Payer: Healthscope Commercial |
$73.12
|
| Rate for Payer: Healthscope Whirlpool |
$75.38
|
| Rate for Payer: Mclaren Commercial |
$67.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.07
|
| Rate for Payer: Nomi Health Commercial |
$61.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.05
|
| Rate for Payer: Priority Health Narrow Network |
$52.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.33
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$53.06 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.57
|
| Rate for Payer: BCN Commercial |
$43.57
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$53.28 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$51.47
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$43.75
|
| Rate for Payer: BCN Commercial |
$43.75
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$51.47
|
| Rate for Payer: Healthscope Whirlpool |
$53.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53.28
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$42.62
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$53.28 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$25.73
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53.28
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$42.62
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$28.09
|
| Rate for Payer: ASR ASR |
$30.27
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$29.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$30.27
|
| Rate for Payer: Healthscope Whirlpool |
$31.21
|
| Rate for Payer: Mclaren Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.46
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$77.89 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$42.89
|
| Rate for Payer: BCN Commercial |
$42.89
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$50.46
|
| Rate for Payer: Healthscope Whirlpool |
$52.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$77.89
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$62.31
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.02 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.72
|
| Rate for Payer: BCN Commercial |
$42.72
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$50.46
|
| Rate for Payer: Healthscope Whirlpool |
$52.02
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$54.12
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.59 |
| Max. Negotiated Rate |
$54.12 |
| Rate for Payer: Aetna Commercial |
$48.71
|
| Rate for Payer: ASR ASR |
$52.50
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$44.44
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$50.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$52.50
|
| Rate for Payer: Healthscope Whirlpool |
$54.12
|
| Rate for Payer: Mclaren Commercial |
$48.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.63
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
OP
|
$54.12
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$54.12 |
| Rate for Payer: Aetna Commercial |
$48.71
|
| Rate for Payer: Aetna Medicare |
$20.02
|
| Rate for Payer: ASR ASR |
$52.50
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$44.62
|
| Rate for Payer: BCN Commercial |
$44.62
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$50.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$52.50
|
| Rate for Payer: Healthscope Whirlpool |
$54.12
|
| Rate for Payer: Mclaren Commercial |
$48.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.42
|
| Rate for Payer: Priority Health Narrow Network |
$37.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.63
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
IP
|
$237.85
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.39 |
| Max. Negotiated Rate |
$237.85 |
| Rate for Payer: Aetna Commercial |
$214.06
|
| Rate for Payer: ASR ASR |
$230.71
|
| Rate for Payer: BCBS Trust/PPO |
$195.32
|
| Rate for Payer: BCN Commercial |
$195.32
|
| Rate for Payer: Cash Price |
$190.28
|
| Rate for Payer: Cofinity Commercial |
$223.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.28
|
| Rate for Payer: Healthscope Commercial |
$230.71
|
| Rate for Payer: Healthscope Whirlpool |
$237.85
|
| Rate for Payer: Mclaren Commercial |
$214.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.17
|
| Rate for Payer: Nomi Health Commercial |
$195.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.31
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
OP
|
$237.85
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$237.85 |
| Rate for Payer: Aetna Commercial |
$214.06
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: ASR ASR |
$230.71
|
| Rate for Payer: BCBS Complete |
$95.14
|
| Rate for Payer: BCBS Trust/PPO |
$196.11
|
| Rate for Payer: BCN Commercial |
$196.11
|
| Rate for Payer: Cash Price |
$190.28
|
| Rate for Payer: Cofinity Commercial |
$223.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.28
|
| Rate for Payer: Healthscope Commercial |
$230.71
|
| Rate for Payer: Healthscope Whirlpool |
$237.85
|
| Rate for Payer: Mclaren Commercial |
$214.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.17
|
| Rate for Payer: Nomi Health Commercial |
$195.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$208.40
|
| Rate for Payer: Priority Health Narrow Network |
$166.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.31
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
IP
|
$154.49
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$154.49 |
| Rate for Payer: Aetna Commercial |
$139.04
|
| Rate for Payer: ASR ASR |
$149.86
|
| Rate for Payer: BCBS Trust/PPO |
$126.87
|
| Rate for Payer: BCN Commercial |
$126.87
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$145.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Healthscope Commercial |
$149.86
|
| Rate for Payer: Healthscope Whirlpool |
$154.49
|
| Rate for Payer: Mclaren Commercial |
$139.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: Nomi Health Commercial |
$126.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.95
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
OP
|
$154.49
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.16 |
| Max. Negotiated Rate |
$154.49 |
| Rate for Payer: Aetna Commercial |
$139.04
|
| Rate for Payer: Aetna Medicare |
$57.16
|
| Rate for Payer: ASR ASR |
$149.86
|
| Rate for Payer: BCBS Complete |
$61.80
|
| Rate for Payer: BCBS Trust/PPO |
$127.38
|
| Rate for Payer: BCN Commercial |
$127.38
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$145.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Healthscope Commercial |
$149.86
|
| Rate for Payer: Healthscope Whirlpool |
$154.49
|
| Rate for Payer: Mclaren Commercial |
$139.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: Nomi Health Commercial |
$126.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$135.36
|
| Rate for Payer: Priority Health Narrow Network |
$108.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.95
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
IP
|
$521.12
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$390.84 |
| Max. Negotiated Rate |
$521.12 |
| Rate for Payer: Aetna Commercial |
$469.01
|
| Rate for Payer: ASR ASR |
$505.49
|
| Rate for Payer: BCBS Trust/PPO |
$427.94
|
| Rate for Payer: BCN Commercial |
$427.94
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Cofinity Commercial |
$489.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.90
|
| Rate for Payer: Healthscope Commercial |
$505.49
|
| Rate for Payer: Healthscope Whirlpool |
$521.12
|
| Rate for Payer: Mclaren Commercial |
$469.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.95
|
| Rate for Payer: Nomi Health Commercial |
$427.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.59
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
OP
|
$521.12
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.81 |
| Max. Negotiated Rate |
$521.12 |
| Rate for Payer: Aetna Commercial |
$469.01
|
| Rate for Payer: Aetna Medicare |
$192.81
|
| Rate for Payer: ASR ASR |
$505.49
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS Trust/PPO |
$429.66
|
| Rate for Payer: BCN Commercial |
$429.66
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Cofinity Commercial |
$489.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.90
|
| Rate for Payer: Healthscope Commercial |
$505.49
|
| Rate for Payer: Healthscope Whirlpool |
$521.12
|
| Rate for Payer: Mclaren Commercial |
$469.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$416.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.95
|
| Rate for Payer: Nomi Health Commercial |
$427.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$456.61
|
| Rate for Payer: Priority Health Narrow Network |
$365.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$458.59
|
|
|
HC NEG PRES PEEL & PLACE DSG KIT LRG
|
Facility
|
IP
|
$405.03
|
|
| Hospital Charge Code |
27200404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$303.77 |
| Max. Negotiated Rate |
$405.03 |
| Rate for Payer: Aetna Commercial |
$364.53
|
| Rate for Payer: ASR ASR |
$392.88
|
| Rate for Payer: BCBS Trust/PPO |
$332.61
|
| Rate for Payer: BCN Commercial |
$332.61
|
| Rate for Payer: Cash Price |
$324.02
|
| Rate for Payer: Cofinity Commercial |
$380.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.02
|
| Rate for Payer: Healthscope Commercial |
$392.88
|
| Rate for Payer: Healthscope Whirlpool |
$405.03
|
| Rate for Payer: Mclaren Commercial |
$364.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.28
|
| Rate for Payer: Nomi Health Commercial |
$332.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$356.43
|
|
|
HC NEG PRES PEEL & PLACE DSG KIT LRG
|
Facility
|
OP
|
$405.03
|
|
| Hospital Charge Code |
27200404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.86 |
| Max. Negotiated Rate |
$405.03 |
| Rate for Payer: Aetna Commercial |
$364.53
|
| Rate for Payer: Aetna Medicare |
$149.86
|
| Rate for Payer: ASR ASR |
$392.88
|
| Rate for Payer: BCBS Complete |
$162.01
|
| Rate for Payer: BCBS Trust/PPO |
$333.95
|
| Rate for Payer: BCN Commercial |
$333.95
|
| Rate for Payer: Cash Price |
$324.02
|
| Rate for Payer: Cofinity Commercial |
$380.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$324.02
|
| Rate for Payer: Healthscope Commercial |
$392.88
|
| Rate for Payer: Healthscope Whirlpool |
$405.03
|
| Rate for Payer: Mclaren Commercial |
$364.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$324.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.28
|
| Rate for Payer: Nomi Health Commercial |
$332.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$354.89
|
| Rate for Payer: Priority Health Narrow Network |
$283.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$356.43
|
|
|
HC NEG PRES PEEL & PLACE DSG KIT MED
|
Facility
|
OP
|
$328.89
|
|
| Hospital Charge Code |
27200403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.69 |
| Max. Negotiated Rate |
$328.89 |
| Rate for Payer: Aetna Commercial |
$296.00
|
| Rate for Payer: Aetna Medicare |
$121.69
|
| Rate for Payer: ASR ASR |
$319.02
|
| Rate for Payer: BCBS Complete |
$131.56
|
| Rate for Payer: BCBS Trust/PPO |
$271.17
|
| Rate for Payer: BCN Commercial |
$271.17
|
| Rate for Payer: Cash Price |
$263.11
|
| Rate for Payer: Cofinity Commercial |
$309.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.11
|
| Rate for Payer: Healthscope Commercial |
$319.02
|
| Rate for Payer: Healthscope Whirlpool |
$328.89
|
| Rate for Payer: Mclaren Commercial |
$296.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$263.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.56
|
| Rate for Payer: Nomi Health Commercial |
$269.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$288.17
|
| Rate for Payer: Priority Health Narrow Network |
$230.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.42
|
|
|
HC NEG PRES PEEL & PLACE DSG KIT MED
|
Facility
|
IP
|
$328.89
|
|
| Hospital Charge Code |
27200403
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$246.67 |
| Max. Negotiated Rate |
$328.89 |
| Rate for Payer: Aetna Commercial |
$296.00
|
| Rate for Payer: ASR ASR |
$319.02
|
| Rate for Payer: BCBS Trust/PPO |
$270.08
|
| Rate for Payer: BCN Commercial |
$270.08
|
| Rate for Payer: Cash Price |
$263.11
|
| Rate for Payer: Cofinity Commercial |
$309.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.11
|
| Rate for Payer: Healthscope Commercial |
$319.02
|
| Rate for Payer: Healthscope Whirlpool |
$328.89
|
| Rate for Payer: Mclaren Commercial |
$296.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.56
|
| Rate for Payer: Nomi Health Commercial |
$269.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.42
|
|
|
HC NEG PRES PEEL & PLACE DSG KIT SML
|
Facility
|
OP
|
$266.16
|
|
| Hospital Charge Code |
27200402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.48 |
| Max. Negotiated Rate |
$266.16 |
| Rate for Payer: Aetna Commercial |
$239.54
|
| Rate for Payer: Aetna Medicare |
$98.48
|
| Rate for Payer: ASR ASR |
$258.18
|
| Rate for Payer: BCBS Complete |
$106.46
|
| Rate for Payer: BCBS Trust/PPO |
$219.45
|
| Rate for Payer: BCN Commercial |
$219.45
|
| Rate for Payer: Cash Price |
$212.93
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.93
|
| Rate for Payer: Healthscope Commercial |
$258.18
|
| Rate for Payer: Healthscope Whirlpool |
$266.16
|
| Rate for Payer: Mclaren Commercial |
$239.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.24
|
| Rate for Payer: Nomi Health Commercial |
$218.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$233.21
|
| Rate for Payer: Priority Health Narrow Network |
$186.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.22
|
|
|
HC NEG PRES PEEL & PLACE DSG KIT SML
|
Facility
|
IP
|
$266.16
|
|
| Hospital Charge Code |
27200402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.62 |
| Max. Negotiated Rate |
$266.16 |
| Rate for Payer: Aetna Commercial |
$239.54
|
| Rate for Payer: ASR ASR |
$258.18
|
| Rate for Payer: BCBS Trust/PPO |
$218.57
|
| Rate for Payer: BCN Commercial |
$218.57
|
| Rate for Payer: Cash Price |
$212.93
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.93
|
| Rate for Payer: Healthscope Commercial |
$258.18
|
| Rate for Payer: Healthscope Whirlpool |
$266.16
|
| Rate for Payer: Mclaren Commercial |
$239.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.24
|
| Rate for Payer: Nomi Health Commercial |
$218.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.22
|
|
|
HC NEG PRESSURE DERMATAC DRAPE
|
Facility
|
OP
|
$65.79
|
|
| Hospital Charge Code |
27200374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$65.79 |
| Rate for Payer: Aetna Commercial |
$59.21
|
| Rate for Payer: Aetna Medicare |
$24.34
|
| Rate for Payer: ASR ASR |
$63.82
|
| Rate for Payer: BCBS Complete |
$26.32
|
| Rate for Payer: BCBS Trust/PPO |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$61.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$63.82
|
| Rate for Payer: Healthscope Whirlpool |
$65.79
|
| Rate for Payer: Mclaren Commercial |
$59.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Nomi Health Commercial |
$53.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.65
|
| Rate for Payer: Priority Health Narrow Network |
$46.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.90
|
|
|
HC NEG PRESSURE DERMATAC DRAPE
|
Facility
|
IP
|
$65.79
|
|
| Hospital Charge Code |
27200374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.34 |
| Max. Negotiated Rate |
$65.79 |
| Rate for Payer: Aetna Commercial |
$59.21
|
| Rate for Payer: ASR ASR |
$63.82
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$54.03
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$61.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$63.82
|
| Rate for Payer: Healthscope Whirlpool |
$65.79
|
| Rate for Payer: Mclaren Commercial |
$59.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Nomi Health Commercial |
$53.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.90
|
|
