|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
IP
|
$19,347.05
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,575.58 |
| Max. Negotiated Rate |
$19,347.05 |
| Rate for Payer: Aetna Commercial |
$17,412.35
|
| Rate for Payer: ASR ASR |
$18,766.64
|
| Rate for Payer: ASR Commercial |
$18,766.64
|
| Rate for Payer: BCBS Trust/PPO |
$15,765.91
|
| Rate for Payer: BCN Commercial |
$14,999.77
|
| Rate for Payer: Cash Price |
$15,477.64
|
| Rate for Payer: Cofinity Commercial |
$18,186.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,477.64
|
| Rate for Payer: Healthscope Commercial |
$19,347.05
|
| Rate for Payer: Healthscope Whirlpool |
$18,766.64
|
| Rate for Payer: Mclaren Commercial |
$17,412.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,444.99
|
| Rate for Payer: Nomi Health Commercial |
$15,864.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,575.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,025.40
|
|
|
HC PACEMAKER LEAD
|
Facility
|
IP
|
$1,949.22
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,266.99 |
| Max. Negotiated Rate |
$1,949.22 |
| Rate for Payer: Aetna Commercial |
$1,754.30
|
| Rate for Payer: ASR ASR |
$1,890.74
|
| Rate for Payer: ASR Commercial |
$1,890.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.42
|
| Rate for Payer: BCN Commercial |
$1,511.23
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,832.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Healthscope Commercial |
$1,949.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,890.74
|
| Rate for Payer: Mclaren Commercial |
$1,754.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,715.31
|
|
|
HC PACEMAKER LEAD
|
Facility
|
OP
|
$1,949.22
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$779.69 |
| Max. Negotiated Rate |
$1,949.22 |
| Rate for Payer: Aetna Commercial |
$1,754.30
|
| Rate for Payer: Aetna Medicare |
$974.61
|
| Rate for Payer: ASR ASR |
$1,890.74
|
| Rate for Payer: ASR Commercial |
$1,890.74
|
| Rate for Payer: BCBS Complete |
$779.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.22
|
| Rate for Payer: BCN Commercial |
$1,511.23
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,832.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Healthscope Commercial |
$1,949.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,890.74
|
| Rate for Payer: Mclaren Commercial |
$1,754.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,707.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,366.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,715.31
|
|
|
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 |
$4,755.60 |
| Max. Negotiated Rate |
$11,889.00 |
| Rate for Payer: Aetna Commercial |
$10,700.10
|
| Rate for Payer: Aetna Medicare |
$5,944.50
|
| Rate for Payer: ASR ASR |
$11,532.33
|
| Rate for Payer: ASR Commercial |
$11,532.33
|
| Rate for Payer: BCBS Complete |
$4,755.60
|
| Rate for Payer: BCBS Trust/PPO |
$9,735.90
|
| Rate for Payer: BCN Commercial |
$9,217.54
|
| 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 |
$11,889.00
|
| Rate for Payer: Healthscope Whirlpool |
$11,532.33
|
| 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: Priority Health Cigna Priority Health |
$7,727.85
|
| Rate for Payer: 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 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 |
$7,727.85 |
| 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: ASR Commercial |
$11,532.33
|
| Rate for Payer: BCBS Trust/PPO |
$9,688.35
|
| Rate for Payer: BCN Commercial |
$9,217.54
|
| 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 |
$11,889.00
|
| Rate for Payer: Healthscope Whirlpool |
$11,532.33
|
| 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: Priority Health Cigna Priority Health |
$7,727.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,462.32
|
|
|
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 |
$8,950.50 |
| 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: ASR Commercial |
$13,356.90
|
| Rate for Payer: BCBS Trust/PPO |
$11,221.17
|
| Rate for Payer: BCN Commercial |
$10,675.88
|
| 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 |
$13,770.00
|
| Rate for Payer: Healthscope Whirlpool |
$13,356.90
|
| 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: Priority Health Cigna Priority Health |
$8,950.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,117.60
|
|
|
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 |
$5,508.00 |
| Max. Negotiated Rate |
$13,770.00 |
| Rate for Payer: Aetna Commercial |
$12,393.00
|
| Rate for Payer: Aetna Medicare |
$6,885.00
|
| Rate for Payer: ASR ASR |
$13,356.90
|
| Rate for Payer: ASR Commercial |
$13,356.90
|
| Rate for Payer: BCBS Complete |
$5,508.00
|
| Rate for Payer: BCBS Trust/PPO |
$11,276.25
|
| Rate for Payer: BCN Commercial |
$10,675.88
|
| 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 |
$13,770.00
|
| Rate for Payer: Healthscope Whirlpool |
$13,356.90
|
| 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: Priority Health Cigna Priority Health |
$8,950.50
|
| Rate for Payer: 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 16
|
Facility
|
IP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,961.05 |
| 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: ASR Commercial |
$16,357.26
|
| Rate for Payer: BCBS Trust/PPO |
$13,741.78
|
| Rate for Payer: BCN Commercial |
$13,074.00
|
| 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 |
$16,863.15
|
| Rate for Payer: Healthscope Whirlpool |
$16,357.26
|
| 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: Priority Health Cigna Priority Health |
$10,961.05
|
| 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 |
$6,745.26 |
| Max. Negotiated Rate |
$16,863.15 |
| Rate for Payer: Aetna Commercial |
$15,176.83
|
| Rate for Payer: Aetna Medicare |
$8,431.58
|
| Rate for Payer: ASR ASR |
$16,357.26
|
| Rate for Payer: ASR Commercial |
$16,357.26
|
| Rate for Payer: BCBS Complete |
$6,745.26
|
| Rate for Payer: BCBS Trust/PPO |
$13,809.23
|
| Rate for Payer: BCN Commercial |
$13,074.00
|
| 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 |
$16,863.15
|
| Rate for Payer: Healthscope Whirlpool |
$16,357.26
|
| 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: Priority Health Cigna Priority Health |
$10,961.05
|
| Rate for Payer: 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
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
IP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,107.95 |
| Max. Negotiated Rate |
$6,319.92 |
| Rate for Payer: Aetna Commercial |
$5,687.93
|
| Rate for Payer: ASR ASR |
$6,130.32
|
| Rate for Payer: ASR Commercial |
$6,130.32
|
| Rate for Payer: BCBS Trust/PPO |
$5,150.10
|
| Rate for Payer: BCN Commercial |
$4,899.83
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Commercial |
$5,940.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$6,319.92
|
| Rate for Payer: Healthscope Whirlpool |
$6,130.32
|
| Rate for Payer: Mclaren Commercial |
$5,687.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: Nomi Health Commercial |
$5,182.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,107.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,561.53
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
OP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,527.97 |
| Max. Negotiated Rate |
$6,319.92 |
| Rate for Payer: Aetna Commercial |
$5,687.93
|
| Rate for Payer: Aetna Medicare |
$3,159.96
|
| Rate for Payer: ASR ASR |
$6,130.32
|
| Rate for Payer: ASR Commercial |
$6,130.32
|
| Rate for Payer: BCBS Complete |
$2,527.97
|
| Rate for Payer: BCBS Trust/PPO |
$5,175.38
|
| Rate for Payer: BCN Commercial |
$4,899.83
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Commercial |
$5,940.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$6,319.92
|
| Rate for Payer: Healthscope Whirlpool |
$6,130.32
|
| Rate for Payer: Mclaren Commercial |
$5,687.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: Nomi Health Commercial |
$5,182.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,107.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,537.51
|
| Rate for Payer: Priority Health Narrow Network |
$4,430.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,561.53
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
OP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,326.02 |
| Max. Negotiated Rate |
$8,315.04 |
| Rate for Payer: Aetna Commercial |
$7,483.54
|
| Rate for Payer: Aetna Medicare |
$4,157.52
|
| Rate for Payer: ASR ASR |
$8,065.59
|
| Rate for Payer: ASR Commercial |
$8,065.59
|
| Rate for Payer: BCBS Complete |
$3,326.02
|
| Rate for Payer: BCBS Trust/PPO |
$6,809.19
|
| Rate for Payer: BCN Commercial |
$6,446.65
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Commercial |
$7,816.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Healthscope Commercial |
$8,315.04
|
| Rate for Payer: Healthscope Whirlpool |
$8,065.59
|
| Rate for Payer: Mclaren Commercial |
$7,483.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: Nomi Health Commercial |
$6,818.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,404.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,285.64
|
| Rate for Payer: Priority Health Narrow Network |
$5,828.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,317.24
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
IP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,404.78 |
| Max. Negotiated Rate |
$8,315.04 |
| Rate for Payer: Aetna Commercial |
$7,483.54
|
| Rate for Payer: ASR ASR |
$8,065.59
|
| Rate for Payer: ASR Commercial |
$8,065.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,775.93
|
| Rate for Payer: BCN Commercial |
$6,446.65
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Commercial |
$7,816.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Healthscope Commercial |
$8,315.04
|
| Rate for Payer: Healthscope Whirlpool |
$8,065.59
|
| Rate for Payer: Mclaren Commercial |
$7,483.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: Nomi Health Commercial |
$6,818.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,404.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,317.24
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
IP
|
$114.69
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$114.69 |
| Rate for Payer: Aetna Commercial |
$103.22
|
| Rate for Payer: ASR ASR |
$111.25
|
| Rate for Payer: ASR Commercial |
$111.25
|
| Rate for Payer: BCBS Trust/PPO |
$93.46
|
| Rate for Payer: BCN Commercial |
$88.92
|
| Rate for Payer: Cash Price |
$91.75
|
| Rate for Payer: Cofinity Commercial |
$107.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$114.69
|
| Rate for Payer: Healthscope Whirlpool |
$111.25
|
| Rate for Payer: Mclaren Commercial |
$103.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.49
|
| Rate for Payer: Nomi Health Commercial |
$94.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.93
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
OP
|
$114.69
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.88 |
| Max. Negotiated Rate |
$114.69 |
| Rate for Payer: Aetna Commercial |
$103.22
|
| Rate for Payer: Aetna Medicare |
$57.34
|
| Rate for Payer: ASR ASR |
$111.25
|
| Rate for Payer: ASR Commercial |
$111.25
|
| Rate for Payer: BCBS Complete |
$45.88
|
| Rate for Payer: BCBS Trust/PPO |
$93.92
|
| Rate for Payer: BCN Commercial |
$88.92
|
| Rate for Payer: Cash Price |
$91.75
|
| Rate for Payer: Cofinity Commercial |
$107.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$114.69
|
| Rate for Payer: Healthscope Whirlpool |
$111.25
|
| Rate for Payer: Mclaren Commercial |
$103.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.49
|
| Rate for Payer: Nomi Health Commercial |
$94.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.49
|
| Rate for Payer: Priority Health Narrow Network |
$80.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.93
|
|
|
HC PACER POCKET REVISION
|
Facility
|
IP
|
$2,755.73
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,791.22 |
| Max. Negotiated Rate |
$2,755.73 |
| Rate for Payer: Aetna Commercial |
$2,480.16
|
| Rate for Payer: ASR ASR |
$2,673.06
|
| Rate for Payer: ASR Commercial |
$2,673.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.64
|
| Rate for Payer: BCN Commercial |
$2,136.52
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,590.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Healthscope Commercial |
$2,755.73
|
| Rate for Payer: Healthscope Whirlpool |
$2,673.06
|
| Rate for Payer: Mclaren Commercial |
$2,480.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$2,259.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,425.04
|
|
|
HC PACER POCKET REVISION
|
Facility
|
OP
|
$2,755.73
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$2,765.22 |
| Rate for Payer: Aetna Commercial |
$2,480.16
|
| Rate for Payer: Aetna Medicare |
$1,784.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: ASR ASR |
$2,673.06
|
| Rate for Payer: ASR Commercial |
$2,673.06
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,256.67
|
| Rate for Payer: BCN Commercial |
$2,136.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,590.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$2,755.73
|
| Rate for Payer: Healthscope Whirlpool |
$2,673.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,784.01
|
| Rate for Payer: Mclaren Commercial |
$2,480.16
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$2,259.70
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$1,962.41
|
| Rate for Payer: PHP Medicaid |
$956.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,414.57
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,931.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,425.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$2,765.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP DNSP |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: VA VA |
$1,784.01
|
|
|
HC PACK CCS BRONSON FX XC BASE
|
Facility
|
OP
|
$765.00
|
|
| Hospital Charge Code |
27000682
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$306.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Aetna Commercial |
$688.50
|
| Rate for Payer: Aetna Medicare |
$382.50
|
| Rate for Payer: ASR ASR |
$742.05
|
| Rate for Payer: ASR Commercial |
$742.05
|
| Rate for Payer: BCBS Complete |
$306.00
|
| Rate for Payer: BCBS Trust/PPO |
$626.46
|
| Rate for Payer: BCN Commercial |
$593.10
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$719.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$765.00
|
| Rate for Payer: Healthscope Whirlpool |
$742.05
|
| Rate for Payer: Mclaren Commercial |
$688.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.25
|
| Rate for Payer: Nomi Health Commercial |
$627.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$670.29
|
| Rate for Payer: Priority Health Narrow Network |
$536.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$673.20
|
|
|
HC PACK CCS BRONSON FX XC BASE
|
Facility
|
IP
|
$765.00
|
|
| Hospital Charge Code |
27000682
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$497.25 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Aetna Commercial |
$688.50
|
| Rate for Payer: ASR ASR |
$742.05
|
| Rate for Payer: ASR Commercial |
$742.05
|
| Rate for Payer: BCBS Trust/PPO |
$623.40
|
| Rate for Payer: BCN Commercial |
$593.10
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$719.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$765.00
|
| Rate for Payer: Healthscope Whirlpool |
$742.05
|
| Rate for Payer: Mclaren Commercial |
$688.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.25
|
| Rate for Payer: Nomi Health Commercial |
$627.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$673.20
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
OP
|
$825.28
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.14 |
| Max. Negotiated Rate |
$825.28 |
| Rate for Payer: Aetna Commercial |
$742.75
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.88
|
| Rate for Payer: ASR ASR |
$800.52
|
| Rate for Payer: ASR Commercial |
$800.52
|
| Rate for Payer: BCBS Complete |
$99.90
|
| Rate for Payer: BCBS MAPPO |
$177.50
|
| Rate for Payer: BCBS Trust/PPO |
$675.82
|
| Rate for Payer: BCN Commercial |
$639.84
|
| Rate for Payer: BCN Medicare Advantage |
$177.50
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$775.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.50
|
| Rate for Payer: Healthscope Commercial |
$825.28
|
| Rate for Payer: Healthscope Whirlpool |
$800.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.50
|
| Rate for Payer: Mclaren Commercial |
$742.75
|
| Rate for Payer: Mclaren Medicaid |
$95.14
|
| Rate for Payer: Mclaren Medicare |
$177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.38
|
| Rate for Payer: Meridian Medicaid |
$99.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$676.73
|
| Rate for Payer: PACE Medicare |
$168.62
|
| Rate for Payer: PACE SWMI |
$177.50
|
| Rate for Payer: PHP Commercial |
$195.25
|
| Rate for Payer: PHP Medicaid |
$95.14
|
| Rate for Payer: PHP Medicare Advantage |
$177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.11
|
| Rate for Payer: Priority Health Medicare |
$177.50
|
| Rate for Payer: Priority Health Narrow Network |
$578.52
|
| Rate for Payer: Railroad Medicare Medicare |
$177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.50
|
| Rate for Payer: UHC Exchange |
$275.12
|
| Rate for Payer: UHC Medicare Advantage |
$177.50
|
| Rate for Payer: UHCCP DNSP |
$177.50
|
| Rate for Payer: UHCCP Medicaid |
$95.14
|
| Rate for Payer: VA VA |
$177.50
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
IP
|
$825.28
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$536.43 |
| Max. Negotiated Rate |
$825.28 |
| Rate for Payer: Aetna Commercial |
$742.75
|
| Rate for Payer: ASR ASR |
$800.52
|
| Rate for Payer: ASR Commercial |
$800.52
|
| Rate for Payer: BCBS Trust/PPO |
$672.52
|
| Rate for Payer: BCN Commercial |
$639.84
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$775.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Healthscope Commercial |
$825.28
|
| Rate for Payer: Healthscope Whirlpool |
$800.52
|
| Rate for Payer: Mclaren Commercial |
$742.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$676.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.25
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
OP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$133.72 |
| Max. Negotiated Rate |
$1,257.09 |
| Rate for Payer: Aetna Commercial |
$1,131.38
|
| Rate for Payer: Aetna Medicare |
$249.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.85
|
| Rate for Payer: ASR ASR |
$1,219.38
|
| Rate for Payer: ASR Commercial |
$1,219.38
|
| Rate for Payer: BCBS Complete |
$140.41
|
| Rate for Payer: BCBS MAPPO |
$249.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,029.43
|
| Rate for Payer: BCN Commercial |
$974.62
|
| Rate for Payer: BCN Medicare Advantage |
$249.48
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,181.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.48
|
| Rate for Payer: Healthscope Commercial |
$1,257.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,219.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$249.48
|
| Rate for Payer: Mclaren Commercial |
$1,131.38
|
| Rate for Payer: Mclaren Medicaid |
$133.72
|
| Rate for Payer: Mclaren Medicare |
$249.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.95
|
| Rate for Payer: Meridian Medicaid |
$140.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$1,030.81
|
| Rate for Payer: PACE Medicare |
$237.01
|
| Rate for Payer: PACE SWMI |
$249.48
|
| Rate for Payer: PHP Commercial |
$274.43
|
| Rate for Payer: PHP Medicaid |
$133.72
|
| Rate for Payer: PHP Medicare Advantage |
$249.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.46
|
| Rate for Payer: Priority Health Medicare |
$249.48
|
| Rate for Payer: Priority Health Narrow Network |
$881.22
|
| Rate for Payer: Railroad Medicare Medicare |
$249.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,106.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.48
|
| Rate for Payer: UHC Exchange |
$386.69
|
| Rate for Payer: UHC Medicare Advantage |
$249.48
|
| Rate for Payer: UHCCP DNSP |
$249.48
|
| Rate for Payer: UHCCP Medicaid |
$133.72
|
| Rate for Payer: VA VA |
$249.48
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
IP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$817.11 |
| Max. Negotiated Rate |
$1,257.09 |
| Rate for Payer: Aetna Commercial |
$1,131.38
|
| Rate for Payer: ASR ASR |
$1,219.38
|
| Rate for Payer: ASR Commercial |
$1,219.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.40
|
| Rate for Payer: BCN Commercial |
$974.62
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,181.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Healthscope Commercial |
$1,257.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,219.38
|
| Rate for Payer: Mclaren Commercial |
$1,131.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$1,030.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,106.24
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
OP
|
$97.92
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.17 |
| Max. Negotiated Rate |
$97.92 |
| Rate for Payer: Aetna Commercial |
$88.13
|
| Rate for Payer: Aetna Medicare |
$48.96
|
| Rate for Payer: ASR ASR |
$94.98
|
| Rate for Payer: ASR Commercial |
$94.98
|
| Rate for Payer: BCBS Complete |
$39.17
|
| Rate for Payer: BCBS Trust/PPO |
$80.19
|
| Rate for Payer: BCN Commercial |
$75.92
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$92.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$97.92
|
| Rate for Payer: Healthscope Whirlpool |
$94.98
|
| Rate for Payer: Mclaren Commercial |
$88.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: Nomi Health Commercial |
$80.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.80
|
| Rate for Payer: Priority Health Narrow Network |
$68.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.17
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
IP
|
$97.92
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.65 |
| Max. Negotiated Rate |
$97.92 |
| Rate for Payer: Aetna Commercial |
$88.13
|
| Rate for Payer: ASR ASR |
$94.98
|
| Rate for Payer: ASR Commercial |
$94.98
|
| Rate for Payer: BCBS Trust/PPO |
$79.80
|
| Rate for Payer: BCN Commercial |
$75.92
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$92.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$97.92
|
| Rate for Payer: Healthscope Whirlpool |
$94.98
|
| Rate for Payer: Mclaren Commercial |
$88.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: Nomi Health Commercial |
$80.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.17
|
|
