|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
OP
|
$16,081.87
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$16,081.87 |
| Rate for Payer: Aetna Commercial |
$14,473.68
|
| Rate for Payer: Aetna Medicare |
$9,778.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: ASR ASR |
$15,599.41
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$12,468.27
|
| Rate for Payer: BCN Commercial |
$12,468.27
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$12,865.50
|
| Rate for Payer: Cash Price |
$12,865.50
|
| Rate for Payer: Cofinity Commercial |
$15,116.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,865.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$16,081.87
|
| Rate for Payer: Healthscope Whirlpool |
$15,599.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,778.69
|
| Rate for Payer: Mclaren Commercial |
$14,473.68
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,669.59
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,756.56
|
| Rate for Payer: PHP Medicaid |
$5,348.94
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,257.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,758.08
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$7,806.46
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,152.05
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: VA VA |
$9,778.69
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
OP
|
$18,379.26
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$18,379.26 |
| Rate for Payer: Aetna Commercial |
$16,541.33
|
| Rate for Payer: Aetna Medicare |
$9,778.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: ASR ASR |
$17,827.88
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$14,249.44
|
| Rate for Payer: BCN Commercial |
$14,249.44
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$14,703.41
|
| Rate for Payer: Cash Price |
$14,703.41
|
| Rate for Payer: Cofinity Commercial |
$17,276.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,703.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$18,379.26
|
| Rate for Payer: Healthscope Whirlpool |
$17,827.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,778.69
|
| Rate for Payer: Mclaren Commercial |
$16,541.33
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,622.37
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,756.56
|
| Rate for Payer: PHP Medicaid |
$5,348.94
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,865.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,758.08
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$7,806.46
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,173.75
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: VA VA |
$9,778.69
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
IP
|
$18,379.26
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,865.48 |
| Max. Negotiated Rate |
$18,379.26 |
| Rate for Payer: Aetna Commercial |
$16,541.33
|
| Rate for Payer: ASR ASR |
$17,827.88
|
| Rate for Payer: BCBS Trust/PPO |
$14,249.44
|
| Rate for Payer: BCN Commercial |
$14,249.44
|
| Rate for Payer: Cash Price |
$14,703.41
|
| Rate for Payer: Cofinity Commercial |
$17,276.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,703.41
|
| Rate for Payer: Healthscope Commercial |
$18,379.26
|
| Rate for Payer: Healthscope Whirlpool |
$17,827.88
|
| Rate for Payer: Mclaren Commercial |
$16,541.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,622.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,865.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,173.75
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
OP
|
$10,408.41
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,775.31 |
| Max. Negotiated Rate |
$10,408.41 |
| Rate for Payer: Aetna Commercial |
$9,367.57
|
| Rate for Payer: ASR ASR |
$10,096.16
|
| Rate for Payer: BCBS Complete |
$4,163.36
|
| Rate for Payer: BCBS Trust/PPO |
$8,069.64
|
| Rate for Payer: BCN Commercial |
$8,069.64
|
| Rate for Payer: Cash Price |
$8,326.73
|
| Rate for Payer: Cash Price |
$8,326.73
|
| Rate for Payer: Cofinity Commercial |
$9,783.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,326.73
|
| Rate for Payer: Healthscope Commercial |
$10,408.41
|
| Rate for Payer: Healthscope Whirlpool |
$10,096.16
|
| Rate for Payer: Mclaren Commercial |
$9,367.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,847.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,285.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,719.14
|
| Rate for Payer: Priority Health Narrow Network |
$3,775.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,159.40
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
IP
|
$10,408.41
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,285.89 |
| Max. Negotiated Rate |
$10,408.41 |
| Rate for Payer: Aetna Commercial |
$9,367.57
|
| Rate for Payer: ASR ASR |
$10,096.16
|
| Rate for Payer: BCBS Trust/PPO |
$8,069.64
|
| Rate for Payer: BCN Commercial |
$8,069.64
|
| Rate for Payer: Cash Price |
$8,326.73
|
| Rate for Payer: Cofinity Commercial |
$9,783.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,326.73
|
| Rate for Payer: Healthscope Commercial |
$10,408.41
|
| Rate for Payer: Healthscope Whirlpool |
$10,096.16
|
| Rate for Payer: Mclaren Commercial |
$9,367.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,847.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,285.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,159.40
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
IP
|
$6,720.90
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,704.63 |
| Max. Negotiated Rate |
$6,720.90 |
| Rate for Payer: Aetna Commercial |
$6,048.81
|
| Rate for Payer: ASR ASR |
$6,519.27
|
| Rate for Payer: BCBS Trust/PPO |
$5,210.71
|
| Rate for Payer: BCN Commercial |
$5,210.71
|
| Rate for Payer: Cash Price |
$5,376.72
|
| Rate for Payer: Cofinity Commercial |
$6,317.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,376.72
|
| Rate for Payer: Healthscope Commercial |
$6,720.90
|
| Rate for Payer: Healthscope Whirlpool |
$6,519.27
|
| Rate for Payer: Mclaren Commercial |
$6,048.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,712.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,704.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,914.39
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
OP
|
$6,720.90
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,688.36 |
| Max. Negotiated Rate |
$6,720.90 |
| Rate for Payer: Aetna Commercial |
$6,048.81
|
| Rate for Payer: ASR ASR |
$6,519.27
|
| Rate for Payer: BCBS Complete |
$2,688.36
|
| Rate for Payer: BCBS Trust/PPO |
$5,210.71
|
| Rate for Payer: BCN Commercial |
$5,210.71
|
| Rate for Payer: Cash Price |
$5,376.72
|
| Rate for Payer: Cash Price |
$5,376.72
|
| Rate for Payer: Cofinity Commercial |
$6,317.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,376.72
|
| Rate for Payer: Healthscope Commercial |
$6,720.90
|
| Rate for Payer: Healthscope Whirlpool |
$6,519.27
|
| Rate for Payer: Mclaren Commercial |
$6,048.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,712.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,704.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,719.14
|
| Rate for Payer: Priority Health Narrow Network |
$3,775.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,914.39
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
IP
|
$24,183.90
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,928.73 |
| Max. Negotiated Rate |
$24,183.90 |
| Rate for Payer: Aetna Commercial |
$21,765.51
|
| Rate for Payer: ASR ASR |
$23,458.38
|
| Rate for Payer: BCBS Trust/PPO |
$18,749.78
|
| Rate for Payer: BCN Commercial |
$18,749.78
|
| Rate for Payer: Cash Price |
$19,347.12
|
| Rate for Payer: Cofinity Commercial |
$22,732.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,347.12
|
| Rate for Payer: Healthscope Commercial |
$24,183.90
|
| Rate for Payer: Healthscope Whirlpool |
$23,458.38
|
| Rate for Payer: Mclaren Commercial |
$21,765.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,556.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,928.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,281.83
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
OP
|
$24,183.90
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,230.54 |
| Max. Negotiated Rate |
$24,183.90 |
| Rate for Payer: Aetna Commercial |
$21,765.51
|
| Rate for Payer: Aetna Medicare |
$9,778.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: ASR ASR |
$23,458.38
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$18,749.78
|
| Rate for Payer: BCN Commercial |
$18,749.78
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$19,347.12
|
| Rate for Payer: Cash Price |
$19,347.12
|
| Rate for Payer: Cofinity Commercial |
$22,732.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,347.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$24,183.90
|
| Rate for Payer: Healthscope Whirlpool |
$23,458.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$9,778.69
|
| Rate for Payer: Mclaren Commercial |
$21,765.51
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,556.32
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,756.56
|
| Rate for Payer: PHP Medicaid |
$5,348.94
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,928.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,538.17
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$5,230.54
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,281.83
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: VA VA |
$9,778.69
|
|
|
HC STIZ MARKER
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT A9698
|
| Hospital Charge Code |
25500004
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$75.60
|
| Rate for Payer: ASR ASR |
$81.48
|
| Rate for Payer: BCBS Trust/PPO |
$65.13
|
| Rate for Payer: BCN Commercial |
$65.13
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$78.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.20
|
| Rate for Payer: Healthscope Commercial |
$84.00
|
| Rate for Payer: Healthscope Whirlpool |
$81.48
|
| Rate for Payer: Mclaren Commercial |
$75.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.92
|
|
|
HC STIZ MARKER
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT A9698
|
| Hospital Charge Code |
25500004
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$75.60
|
| Rate for Payer: ASR ASR |
$81.48
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS Trust/PPO |
$65.13
|
| Rate for Payer: BCN Commercial |
$65.13
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$78.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.20
|
| Rate for Payer: Healthscope Commercial |
$84.00
|
| Rate for Payer: Healthscope Whirlpool |
$81.48
|
| Rate for Payer: Mclaren Commercial |
$75.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.65
|
| Rate for Payer: Priority Health Narrow Network |
$51.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.92
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
IP
|
$27,540.00
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$19,278.00 |
| Max. Negotiated Rate |
$27,540.00 |
| Rate for Payer: Aetna Commercial |
$24,786.00
|
| Rate for Payer: ASR ASR |
$26,713.80
|
| Rate for Payer: BCBS Trust/PPO |
$21,351.76
|
| Rate for Payer: BCN Commercial |
$21,351.76
|
| Rate for Payer: Cash Price |
$22,032.00
|
| Rate for Payer: Cofinity Commercial |
$25,887.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,032.00
|
| Rate for Payer: Healthscope Commercial |
$27,540.00
|
| Rate for Payer: Healthscope Whirlpool |
$26,713.80
|
| Rate for Payer: Mclaren Commercial |
$24,786.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,409.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,278.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,235.20
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
OP
|
$27,540.00
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,016.00 |
| Max. Negotiated Rate |
$27,540.00 |
| Rate for Payer: Aetna Commercial |
$24,786.00
|
| Rate for Payer: ASR ASR |
$26,713.80
|
| Rate for Payer: BCBS Complete |
$11,016.00
|
| Rate for Payer: BCBS Trust/PPO |
$21,351.76
|
| Rate for Payer: BCN Commercial |
$21,351.76
|
| Rate for Payer: Cash Price |
$22,032.00
|
| Rate for Payer: Cofinity Commercial |
$25,887.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,032.00
|
| Rate for Payer: Healthscope Commercial |
$27,540.00
|
| Rate for Payer: Healthscope Whirlpool |
$26,713.80
|
| Rate for Payer: Mclaren Commercial |
$24,786.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,409.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,278.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,061.40
|
| Rate for Payer: Priority Health Narrow Network |
$19,553.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24,235.20
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
IP
|
$5,712.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,998.40 |
| Max. Negotiated Rate |
$5,712.00 |
| Rate for Payer: Aetna Commercial |
$5,140.80
|
| Rate for Payer: ASR ASR |
$5,540.64
|
| Rate for Payer: BCBS Trust/PPO |
$4,428.51
|
| Rate for Payer: BCN Commercial |
$4,428.51
|
| Rate for Payer: Cash Price |
$4,569.60
|
| Rate for Payer: Cofinity Commercial |
$5,369.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.60
|
| Rate for Payer: Healthscope Commercial |
$5,712.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,540.64
|
| Rate for Payer: Mclaren Commercial |
$5,140.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,855.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,998.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,026.56
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
OP
|
$5,712.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,284.80 |
| Max. Negotiated Rate |
$5,712.00 |
| Rate for Payer: Aetna Commercial |
$5,140.80
|
| Rate for Payer: ASR ASR |
$5,540.64
|
| Rate for Payer: BCBS Complete |
$2,284.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,428.51
|
| Rate for Payer: BCN Commercial |
$4,428.51
|
| Rate for Payer: Cash Price |
$4,569.60
|
| Rate for Payer: Cofinity Commercial |
$5,369.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.60
|
| Rate for Payer: Healthscope Commercial |
$5,712.00
|
| Rate for Payer: Healthscope Whirlpool |
$5,540.64
|
| Rate for Payer: Mclaren Commercial |
$5,140.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,855.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,998.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,197.92
|
| Rate for Payer: Priority Health Narrow Network |
$4,055.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,026.56
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
IP
|
$9,180.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,426.00 |
| Max. Negotiated Rate |
$9,180.00 |
| Rate for Payer: Aetna Commercial |
$8,262.00
|
| Rate for Payer: ASR ASR |
$8,904.60
|
| Rate for Payer: BCBS Trust/PPO |
$7,117.25
|
| Rate for Payer: BCN Commercial |
$7,117.25
|
| Rate for Payer: Cash Price |
$7,344.00
|
| Rate for Payer: Cofinity Commercial |
$8,629.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,344.00
|
| Rate for Payer: Healthscope Commercial |
$9,180.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,904.60
|
| Rate for Payer: Mclaren Commercial |
$8,262.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,803.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,426.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,078.40
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
OP
|
$9,180.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,672.00 |
| Max. Negotiated Rate |
$9,180.00 |
| Rate for Payer: Aetna Commercial |
$8,262.00
|
| Rate for Payer: ASR ASR |
$8,904.60
|
| Rate for Payer: BCBS Complete |
$3,672.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,117.25
|
| Rate for Payer: BCN Commercial |
$7,117.25
|
| Rate for Payer: Cash Price |
$7,344.00
|
| Rate for Payer: Cofinity Commercial |
$8,629.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,344.00
|
| Rate for Payer: Healthscope Commercial |
$9,180.00
|
| Rate for Payer: Healthscope Whirlpool |
$8,904.60
|
| Rate for Payer: Mclaren Commercial |
$8,262.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,803.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,426.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,353.80
|
| Rate for Payer: Priority Health Narrow Network |
$6,517.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,078.40
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
OP
|
$20,808.00
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,323.20 |
| Max. Negotiated Rate |
$20,808.00 |
| Rate for Payer: Aetna Commercial |
$18,727.20
|
| Rate for Payer: ASR ASR |
$20,183.76
|
| Rate for Payer: BCBS Complete |
$8,323.20
|
| Rate for Payer: BCBS Trust/PPO |
$16,132.44
|
| Rate for Payer: BCN Commercial |
$16,132.44
|
| Rate for Payer: Cash Price |
$16,646.40
|
| Rate for Payer: Cofinity Commercial |
$19,559.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,646.40
|
| Rate for Payer: Healthscope Commercial |
$20,808.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,183.76
|
| Rate for Payer: Mclaren Commercial |
$18,727.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17,686.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,565.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,935.28
|
| Rate for Payer: Priority Health Narrow Network |
$14,773.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,311.04
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
IP
|
$20,808.00
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14,565.60 |
| Max. Negotiated Rate |
$20,808.00 |
| Rate for Payer: Aetna Commercial |
$18,727.20
|
| Rate for Payer: ASR ASR |
$20,183.76
|
| Rate for Payer: BCBS Trust/PPO |
$16,132.44
|
| Rate for Payer: BCN Commercial |
$16,132.44
|
| Rate for Payer: Cash Price |
$16,646.40
|
| Rate for Payer: Cofinity Commercial |
$19,559.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,646.40
|
| Rate for Payer: Healthscope Commercial |
$20,808.00
|
| Rate for Payer: Healthscope Whirlpool |
$20,183.76
|
| Rate for Payer: Mclaren Commercial |
$18,727.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17,686.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,565.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,311.04
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
IP
|
$13,790.40
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,653.28 |
| Max. Negotiated Rate |
$13,790.40 |
| Rate for Payer: Aetna Commercial |
$12,411.36
|
| Rate for Payer: ASR ASR |
$13,376.69
|
| Rate for Payer: BCBS Trust/PPO |
$10,691.70
|
| Rate for Payer: BCN Commercial |
$10,691.70
|
| Rate for Payer: Cash Price |
$11,032.32
|
| Rate for Payer: Cofinity Commercial |
$12,962.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,032.32
|
| Rate for Payer: Healthscope Commercial |
$13,790.40
|
| Rate for Payer: Healthscope Whirlpool |
$13,376.69
|
| Rate for Payer: Mclaren Commercial |
$12,411.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,721.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,653.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,135.55
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
OP
|
$13,790.40
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,516.16 |
| Max. Negotiated Rate |
$13,790.40 |
| Rate for Payer: Aetna Commercial |
$12,411.36
|
| Rate for Payer: ASR ASR |
$13,376.69
|
| Rate for Payer: BCBS Complete |
$5,516.16
|
| Rate for Payer: BCBS Trust/PPO |
$10,691.70
|
| Rate for Payer: BCN Commercial |
$10,691.70
|
| Rate for Payer: Cash Price |
$11,032.32
|
| Rate for Payer: Cofinity Commercial |
$12,962.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,032.32
|
| Rate for Payer: Healthscope Commercial |
$13,790.40
|
| Rate for Payer: Healthscope Whirlpool |
$13,376.69
|
| Rate for Payer: Mclaren Commercial |
$12,411.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,721.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,653.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,549.26
|
| Rate for Payer: Priority Health Narrow Network |
$9,791.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,135.55
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
OP
|
$7,038.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,815.20 |
| Max. Negotiated Rate |
$7,038.00 |
| Rate for Payer: Aetna Commercial |
$6,334.20
|
| Rate for Payer: ASR ASR |
$6,826.86
|
| Rate for Payer: BCBS Complete |
$2,815.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,456.56
|
| Rate for Payer: BCN Commercial |
$5,456.56
|
| Rate for Payer: Cash Price |
$5,630.40
|
| Rate for Payer: Cofinity Commercial |
$6,615.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,630.40
|
| Rate for Payer: Healthscope Commercial |
$7,038.00
|
| Rate for Payer: Healthscope Whirlpool |
$6,826.86
|
| Rate for Payer: Mclaren Commercial |
$6,334.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,982.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,926.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,404.58
|
| Rate for Payer: Priority Health Narrow Network |
$4,996.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,193.44
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
IP
|
$7,038.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,926.60 |
| Max. Negotiated Rate |
$7,038.00 |
| Rate for Payer: Aetna Commercial |
$6,334.20
|
| Rate for Payer: ASR ASR |
$6,826.86
|
| Rate for Payer: BCBS Trust/PPO |
$5,456.56
|
| Rate for Payer: BCN Commercial |
$5,456.56
|
| Rate for Payer: Cash Price |
$5,630.40
|
| Rate for Payer: Cofinity Commercial |
$6,615.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,630.40
|
| Rate for Payer: Healthscope Commercial |
$7,038.00
|
| Rate for Payer: Healthscope Whirlpool |
$6,826.86
|
| Rate for Payer: Mclaren Commercial |
$6,334.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,982.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,926.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,193.44
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,004.63
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,201.85 |
| Max. Negotiated Rate |
$8,004.63 |
| Rate for Payer: Aetna Commercial |
$7,204.17
|
| Rate for Payer: ASR ASR |
$7,764.49
|
| Rate for Payer: BCBS Complete |
$3,201.85
|
| Rate for Payer: BCBS Trust/PPO |
$6,205.99
|
| Rate for Payer: BCN Commercial |
$6,205.99
|
| Rate for Payer: Cash Price |
$6,403.70
|
| Rate for Payer: Cofinity Commercial |
$7,524.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,403.70
|
| Rate for Payer: Healthscope Commercial |
$8,004.63
|
| Rate for Payer: Healthscope Whirlpool |
$7,764.49
|
| Rate for Payer: Mclaren Commercial |
$7,204.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,803.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,603.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,284.21
|
| Rate for Payer: Priority Health Narrow Network |
$5,683.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,044.07
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,004.63
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,603.24 |
| Max. Negotiated Rate |
$8,004.63 |
| Rate for Payer: Aetna Commercial |
$7,204.17
|
| Rate for Payer: ASR ASR |
$7,764.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,205.99
|
| Rate for Payer: BCN Commercial |
$6,205.99
|
| Rate for Payer: Cash Price |
$6,403.70
|
| Rate for Payer: Cofinity Commercial |
$7,524.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,403.70
|
| Rate for Payer: Healthscope Commercial |
$8,004.63
|
| Rate for Payer: Healthscope Whirlpool |
$7,764.49
|
| Rate for Payer: Mclaren Commercial |
$7,204.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,803.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,603.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,044.07
|
|
