|
HC OXYGENATOR NX EAST/WEST
|
Facility
|
IP
|
$1,279.69
|
|
| Hospital Charge Code |
27000649
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$959.77 |
| Max. Negotiated Rate |
$1,279.69 |
| Rate for Payer: Aetna Commercial |
$1,151.72
|
| Rate for Payer: ASR ASR |
$1,241.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,050.88
|
| Rate for Payer: BCN Commercial |
$1,050.88
|
| Rate for Payer: Cash Price |
$1,023.75
|
| Rate for Payer: Cofinity Commercial |
$1,202.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,023.75
|
| Rate for Payer: Healthscope Commercial |
$1,241.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,279.69
|
| Rate for Payer: Mclaren Commercial |
$1,151.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,087.74
|
| Rate for Payer: Nomi Health Commercial |
$1,049.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$959.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,126.13
|
|
|
HC OXYGENATOR QUADROX
|
Facility
|
OP
|
$3,940.52
|
|
| Hospital Charge Code |
27000652
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,457.99 |
| Max. Negotiated Rate |
$3,940.52 |
| Rate for Payer: Aetna Commercial |
$3,546.47
|
| Rate for Payer: Aetna Medicare |
$1,457.99
|
| Rate for Payer: ASR ASR |
$3,822.30
|
| Rate for Payer: BCBS Complete |
$1,576.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,248.96
|
| Rate for Payer: BCN Commercial |
$3,248.96
|
| Rate for Payer: Cash Price |
$3,152.42
|
| Rate for Payer: Cofinity Commercial |
$3,704.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,152.42
|
| Rate for Payer: Healthscope Commercial |
$3,822.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,940.52
|
| Rate for Payer: Mclaren Commercial |
$3,546.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,152.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,349.44
|
| Rate for Payer: Nomi Health Commercial |
$3,231.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,955.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,452.68
|
| Rate for Payer: Priority Health Narrow Network |
$2,762.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,467.66
|
|
|
HC OXYGENATOR QUADROX
|
Facility
|
IP
|
$3,940.52
|
|
| Hospital Charge Code |
27000652
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,955.39 |
| Max. Negotiated Rate |
$3,940.52 |
| Rate for Payer: Aetna Commercial |
$3,546.47
|
| Rate for Payer: ASR ASR |
$3,822.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,235.96
|
| Rate for Payer: BCN Commercial |
$3,235.96
|
| Rate for Payer: Cash Price |
$3,152.42
|
| Rate for Payer: Cofinity Commercial |
$3,704.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,152.42
|
| Rate for Payer: Healthscope Commercial |
$3,822.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,940.52
|
| Rate for Payer: Mclaren Commercial |
$3,546.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,349.44
|
| Rate for Payer: Nomi Health Commercial |
$3,231.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,955.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,467.66
|
|
|
HC OXYTOCIN CHALLENGE TEST
|
Facility
|
OP
|
$818.25
|
|
|
Service Code
|
CPT 59020
|
| Hospital Charge Code |
92000003
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$818.25 |
| Rate for Payer: Aetna Commercial |
$736.42
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$793.70
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$674.65
|
| Rate for Payer: BCN Commercial |
$674.65
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cofinity Commercial |
$769.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$793.70
|
| Rate for Payer: Healthscope Whirlpool |
$818.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$736.42
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.51
|
| Rate for Payer: Nomi Health Commercial |
$670.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$613.69
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$272.38
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$217.90
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$720.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$312.23
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC OXYTOCIN CHALLENGE TEST
|
Facility
|
IP
|
$818.25
|
|
|
Service Code
|
CPT 59020
|
| Hospital Charge Code |
92000003
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$613.69 |
| Max. Negotiated Rate |
$818.25 |
| Rate for Payer: Aetna Commercial |
$736.42
|
| Rate for Payer: ASR ASR |
$793.70
|
| Rate for Payer: BCBS Trust/PPO |
$671.95
|
| Rate for Payer: BCN Commercial |
$671.95
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cofinity Commercial |
$769.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.60
|
| Rate for Payer: Healthscope Commercial |
$793.70
|
| Rate for Payer: Healthscope Whirlpool |
$818.25
|
| Rate for Payer: Mclaren Commercial |
$736.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.51
|
| Rate for Payer: Nomi Health Commercial |
$670.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$613.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$720.06
|
|
|
HC OYSTER IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200053
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC OYSTER IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200053
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC PACEMAKER AVEIR LEADLESS DUAL CHAMBER
|
Facility
|
OP
|
$87,549.66
|
|
|
Service Code
|
HCPCS C1605
|
| Hospital Charge Code |
27500014
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$32,393.37 |
| Max. Negotiated Rate |
$87,549.66 |
| Rate for Payer: Aetna Commercial |
$78,794.69
|
| Rate for Payer: Aetna Medicare |
$32,393.37
|
| Rate for Payer: ASR ASR |
$84,923.17
|
| Rate for Payer: BCBS Complete |
$35,019.86
|
| Rate for Payer: BCBS Trust/PPO |
$72,184.69
|
| Rate for Payer: BCN Commercial |
$72,184.69
|
| Rate for Payer: Cash Price |
$70,039.73
|
| Rate for Payer: Cofinity Commercial |
$82,296.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70,039.73
|
| Rate for Payer: Healthscope Commercial |
$84,923.17
|
| Rate for Payer: Healthscope Whirlpool |
$87,549.66
|
| Rate for Payer: Mclaren Commercial |
$78,794.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70,039.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,417.21
|
| Rate for Payer: Nomi Health Commercial |
$71,790.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65,662.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$76,711.01
|
| Rate for Payer: Priority Health Narrow Network |
$61,372.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77,043.70
|
|
|
HC PACEMAKER AVEIR LEADLESS DUAL CHAMBER
|
Facility
|
IP
|
$87,549.66
|
|
|
Service Code
|
HCPCS C1605
|
| Hospital Charge Code |
27500014
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$65,662.24 |
| Max. Negotiated Rate |
$87,549.66 |
| Rate for Payer: Aetna Commercial |
$78,794.69
|
| Rate for Payer: ASR ASR |
$84,923.17
|
| Rate for Payer: BCBS Trust/PPO |
$71,895.78
|
| Rate for Payer: BCN Commercial |
$71,895.78
|
| Rate for Payer: Cash Price |
$70,039.73
|
| Rate for Payer: Cofinity Commercial |
$82,296.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70,039.73
|
| Rate for Payer: Healthscope Commercial |
$84,923.17
|
| Rate for Payer: Healthscope Whirlpool |
$87,549.66
|
| Rate for Payer: Mclaren Commercial |
$78,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,417.21
|
| Rate for Payer: Nomi Health Commercial |
$71,790.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65,662.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77,043.70
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
OP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,942.24 |
| Max. Negotiated Rate |
$7,952.00 |
| Rate for Payer: Aetna Commercial |
$7,156.80
|
| Rate for Payer: Aetna Medicare |
$2,942.24
|
| Rate for Payer: ASR ASR |
$7,713.44
|
| Rate for Payer: BCBS Complete |
$3,180.80
|
| Rate for Payer: BCBS Trust/PPO |
$6,556.42
|
| Rate for Payer: BCN Commercial |
$6,556.42
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Commercial |
$7,474.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,713.44
|
| Rate for Payer: Healthscope Whirlpool |
$7,952.00
|
| Rate for Payer: Mclaren Commercial |
$7,156.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,361.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,759.20
|
| Rate for Payer: Nomi Health Commercial |
$6,520.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,964.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,967.54
|
| Rate for Payer: Priority Health Narrow Network |
$5,574.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,997.76
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
IP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,964.00 |
| Max. Negotiated Rate |
$7,952.00 |
| Rate for Payer: Aetna Commercial |
$7,156.80
|
| Rate for Payer: ASR ASR |
$7,713.44
|
| Rate for Payer: BCBS Trust/PPO |
$6,530.18
|
| Rate for Payer: BCN Commercial |
$6,530.18
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Commercial |
$7,474.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,713.44
|
| Rate for Payer: Healthscope Whirlpool |
$7,952.00
|
| Rate for Payer: Mclaren Commercial |
$7,156.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,759.20
|
| Rate for Payer: Nomi Health Commercial |
$6,520.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,964.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,997.76
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
IP
|
$9,233.04
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,924.78 |
| Max. Negotiated Rate |
$9,233.04 |
| Rate for Payer: Aetna Commercial |
$8,309.74
|
| Rate for Payer: ASR ASR |
$8,956.05
|
| Rate for Payer: BCBS Trust/PPO |
$7,582.17
|
| Rate for Payer: BCN Commercial |
$7,582.17
|
| Rate for Payer: Cash Price |
$7,386.43
|
| Rate for Payer: Cofinity Commercial |
$8,679.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,386.43
|
| Rate for Payer: Healthscope Commercial |
$8,956.05
|
| Rate for Payer: Healthscope Whirlpool |
$9,233.04
|
| Rate for Payer: Mclaren Commercial |
$8,309.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,848.08
|
| Rate for Payer: Nomi Health Commercial |
$7,571.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,924.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,125.08
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
OP
|
$9,233.04
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,416.22 |
| Max. Negotiated Rate |
$9,233.04 |
| Rate for Payer: Aetna Commercial |
$8,309.74
|
| Rate for Payer: Aetna Medicare |
$3,416.22
|
| Rate for Payer: ASR ASR |
$8,956.05
|
| Rate for Payer: BCBS Complete |
$3,693.22
|
| Rate for Payer: BCBS Trust/PPO |
$7,612.64
|
| Rate for Payer: BCN Commercial |
$7,612.64
|
| Rate for Payer: Cash Price |
$7,386.43
|
| Rate for Payer: Cofinity Commercial |
$8,679.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,386.43
|
| Rate for Payer: Healthscope Commercial |
$8,956.05
|
| Rate for Payer: Healthscope Whirlpool |
$9,233.04
|
| Rate for Payer: Mclaren Commercial |
$8,309.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,386.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,848.08
|
| Rate for Payer: Nomi Health Commercial |
$7,571.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,924.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,089.99
|
| Rate for Payer: Priority Health Narrow Network |
$6,472.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,125.08
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
IP
|
$20,314.40
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,235.80 |
| Max. Negotiated Rate |
$20,314.40 |
| Rate for Payer: Aetna Commercial |
$18,282.96
|
| Rate for Payer: ASR ASR |
$19,704.97
|
| Rate for Payer: BCBS Trust/PPO |
$16,682.19
|
| Rate for Payer: BCN Commercial |
$16,682.19
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cofinity Commercial |
$19,095.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,251.52
|
| Rate for Payer: Healthscope Commercial |
$19,704.97
|
| Rate for Payer: Healthscope Whirlpool |
$20,314.40
|
| Rate for Payer: Mclaren Commercial |
$18,282.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,267.24
|
| Rate for Payer: Nomi Health Commercial |
$16,657.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,235.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,876.67
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
OP
|
$20,314.40
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,446.74 |
| Max. Negotiated Rate |
$20,314.40 |
| Rate for Payer: Aetna Commercial |
$18,282.96
|
| Rate for Payer: Aetna Medicare |
$10,414.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,018.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,018.01
|
| Rate for Payer: ASR ASR |
$19,704.97
|
| Rate for Payer: BCBS Complete |
$5,719.59
|
| Rate for Payer: BCBS MAPPO |
$10,414.41
|
| Rate for Payer: BCBS Trust/PPO |
$16,749.22
|
| Rate for Payer: BCN Commercial |
$16,749.22
|
| Rate for Payer: BCN Medicare Advantage |
$10,414.41
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cofinity Commercial |
$19,095.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,251.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,414.41
|
| Rate for Payer: Healthscope Commercial |
$19,704.97
|
| Rate for Payer: Healthscope Whirlpool |
$20,314.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$10,414.41
|
| Rate for Payer: Mclaren Commercial |
$18,282.96
|
| Rate for Payer: Mclaren Medicaid |
$10,414.41
|
| Rate for Payer: Mclaren Medicare |
$10,414.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,935.13
|
| Rate for Payer: Meridian Medicaid |
$5,719.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,976.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,455.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,267.24
|
| Rate for Payer: Nomi Health Commercial |
$16,657.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,235.80
|
| Rate for Payer: PACE Medicare |
$9,893.69
|
| Rate for Payer: PACE SWMI |
$10,414.41
|
| Rate for Payer: PHP Commercial |
$11,455.85
|
| Rate for Payer: PHP Medicaid |
$5,582.12
|
| Rate for Payer: PHP Medicare Advantage |
$10,414.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,446.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,799.48
|
| Rate for Payer: Priority Health Medicare |
$10,414.41
|
| Rate for Payer: Priority Health Narrow Network |
$14,240.39
|
| Rate for Payer: Railroad Medicare Medicare |
$10,414.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,876.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,414.41
|
| Rate for Payer: UHC Exchange |
$16,142.34
|
| Rate for Payer: UHC Medicaid |
$5,446.74
|
| Rate for Payer: UHCCP DNSP |
$10,414.41
|
| Rate for Payer: UHCCP Medicaid |
$5,446.74
|
| Rate for Payer: VA VA |
$10,414.41
|
|
|
HC PACEMAKER LEAD
|
Facility
|
IP
|
$1,988.20
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.15 |
| Max. Negotiated Rate |
$1,988.20 |
| Rate for Payer: Aetna Commercial |
$1,789.38
|
| Rate for Payer: ASR ASR |
$1,928.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.71
|
| Rate for Payer: BCN Commercial |
$1,632.71
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Commercial |
$1,868.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Healthscope Commercial |
$1,928.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,988.20
|
| Rate for Payer: Mclaren Commercial |
$1,789.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Nomi Health Commercial |
$1,630.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,749.62
|
|
|
HC PACEMAKER LEAD
|
Facility
|
OP
|
$1,988.20
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$735.63 |
| Max. Negotiated Rate |
$1,988.20 |
| Rate for Payer: Aetna Commercial |
$1,789.38
|
| Rate for Payer: Aetna Medicare |
$735.63
|
| Rate for Payer: ASR ASR |
$1,928.55
|
| Rate for Payer: BCBS Complete |
$795.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.27
|
| Rate for Payer: BCN Commercial |
$1,639.27
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Commercial |
$1,868.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Healthscope Commercial |
$1,928.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,988.20
|
| Rate for Payer: Mclaren Commercial |
$1,789.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,590.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Nomi Health Commercial |
$1,630.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,742.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,393.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,749.62
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
IP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$8,916.75 |
| Max. Negotiated Rate |
$11,889.00 |
| Rate for Payer: Aetna Commercial |
$10,700.10
|
| Rate for Payer: ASR ASR |
$11,532.33
|
| Rate for Payer: BCBS Trust/PPO |
$9,763.25
|
| Rate for Payer: BCN Commercial |
$9,763.25
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Commercial |
$11,175.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$11,532.33
|
| Rate for Payer: Healthscope Whirlpool |
$11,889.00
|
| Rate for Payer: Mclaren Commercial |
$10,700.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,105.65
|
| Rate for Payer: Nomi Health Commercial |
$9,748.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,916.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,462.32
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
OP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,398.93 |
| Max. Negotiated Rate |
$11,889.00 |
| Rate for Payer: Aetna Commercial |
$10,700.10
|
| Rate for Payer: Aetna Medicare |
$4,398.93
|
| Rate for Payer: ASR ASR |
$11,532.33
|
| Rate for Payer: BCBS Complete |
$4,755.60
|
| Rate for Payer: BCBS Trust/PPO |
$9,802.48
|
| Rate for Payer: BCN Commercial |
$9,802.48
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Commercial |
$11,175.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$11,532.33
|
| Rate for Payer: Healthscope Whirlpool |
$11,889.00
|
| Rate for Payer: Mclaren Commercial |
$10,700.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,511.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,105.65
|
| Rate for Payer: Nomi Health Commercial |
$9,748.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,916.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,417.14
|
| Rate for Payer: Priority Health Narrow Network |
$8,334.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,462.32
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
OP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,094.90 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Aetna Commercial |
$12,393.00
|
| Rate for Payer: Aetna Medicare |
$5,094.90
|
| Rate for Payer: ASR ASR |
$13,356.90
|
| Rate for Payer: BCBS Complete |
$5,508.00
|
| Rate for Payer: BCBS Trust/PPO |
$11,353.36
|
| Rate for Payer: BCN Commercial |
$11,353.36
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Commercial |
$12,943.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$13,356.90
|
| Rate for Payer: Healthscope Whirlpool |
$13,770.00
|
| Rate for Payer: Mclaren Commercial |
$12,393.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,016.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: Nomi Health Commercial |
$11,291.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,327.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12,065.27
|
| Rate for Payer: Priority Health Narrow Network |
$9,652.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,117.60
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
IP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,327.50 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Aetna Commercial |
$12,393.00
|
| Rate for Payer: ASR ASR |
$13,356.90
|
| Rate for Payer: BCBS Trust/PPO |
$11,307.92
|
| Rate for Payer: BCN Commercial |
$11,307.92
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Commercial |
$12,943.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$13,356.90
|
| Rate for Payer: Healthscope Whirlpool |
$13,770.00
|
| Rate for Payer: Mclaren Commercial |
$12,393.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: Nomi Health Commercial |
$11,291.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,327.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,117.60
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 15
|
Facility
|
OP
|
$15,812.50
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500015
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,850.62 |
| Max. Negotiated Rate |
$15,812.50 |
| Rate for Payer: Aetna Commercial |
$14,231.25
|
| Rate for Payer: Aetna Medicare |
$5,850.62
|
| Rate for Payer: ASR ASR |
$15,338.12
|
| Rate for Payer: BCBS Complete |
$6,325.00
|
| Rate for Payer: BCBS Trust/PPO |
$13,037.41
|
| Rate for Payer: BCN Commercial |
$13,037.41
|
| Rate for Payer: Cash Price |
$12,650.00
|
| Rate for Payer: Cofinity Commercial |
$14,863.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,650.00
|
| Rate for Payer: Healthscope Commercial |
$15,338.12
|
| Rate for Payer: Healthscope Whirlpool |
$15,812.50
|
| Rate for Payer: Mclaren Commercial |
$14,231.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,650.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,440.62
|
| Rate for Payer: Nomi Health Commercial |
$12,966.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,859.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13,854.91
|
| Rate for Payer: Priority Health Narrow Network |
$11,084.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,915.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 15
|
Facility
|
IP
|
$15,812.50
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500015
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,859.38 |
| Max. Negotiated Rate |
$15,812.50 |
| Rate for Payer: Aetna Commercial |
$14,231.25
|
| Rate for Payer: ASR ASR |
$15,338.12
|
| Rate for Payer: BCBS Trust/PPO |
$12,985.23
|
| Rate for Payer: BCN Commercial |
$12,985.23
|
| Rate for Payer: Cash Price |
$12,650.00
|
| Rate for Payer: Cofinity Commercial |
$14,863.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,650.00
|
| Rate for Payer: Healthscope Commercial |
$15,338.12
|
| Rate for Payer: Healthscope Whirlpool |
$15,812.50
|
| Rate for Payer: Mclaren Commercial |
$14,231.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,440.62
|
| Rate for Payer: Nomi Health Commercial |
$12,966.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,859.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13,915.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
IP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,647.36 |
| Max. Negotiated Rate |
$16,863.15 |
| Rate for Payer: Aetna Commercial |
$15,176.83
|
| Rate for Payer: ASR ASR |
$16,357.26
|
| Rate for Payer: BCBS Trust/PPO |
$13,848.02
|
| Rate for Payer: BCN Commercial |
$13,848.02
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Commercial |
$15,851.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$16,357.26
|
| Rate for Payer: Healthscope Whirlpool |
$16,863.15
|
| Rate for Payer: Mclaren Commercial |
$15,176.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: Nomi Health Commercial |
$13,827.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,647.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,839.57
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
OP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,239.37 |
| Max. Negotiated Rate |
$16,863.15 |
| Rate for Payer: Aetna Commercial |
$15,176.83
|
| Rate for Payer: Aetna Medicare |
$6,239.37
|
| Rate for Payer: ASR ASR |
$16,357.26
|
| Rate for Payer: BCBS Complete |
$6,745.26
|
| Rate for Payer: BCBS Trust/PPO |
$13,903.67
|
| Rate for Payer: BCN Commercial |
$13,903.67
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Commercial |
$15,851.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$16,357.26
|
| Rate for Payer: Healthscope Whirlpool |
$16,863.15
|
| Rate for Payer: Mclaren Commercial |
$15,176.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,490.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: Nomi Health Commercial |
$13,827.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,647.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$14,775.49
|
| Rate for Payer: Priority Health Narrow Network |
$11,821.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,839.57
|
|
