|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$280.14 |
| Max. Negotiated Rate |
$400.20 |
| Rate for Payer: Aetna Commercial |
$360.18
|
| Rate for Payer: ASR ASR |
$388.19
|
| Rate for Payer: BCBS Trust/PPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$310.28
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$376.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$400.20
|
| Rate for Payer: Healthscope Whirlpool |
$388.19
|
| Rate for Payer: Mclaren Commercial |
$360.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$352.18
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
OP
|
$15.94
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$15.94 |
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: ASR ASR |
$15.46
|
| Rate for Payer: BCBS Complete |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$12.36
|
| Rate for Payer: BCN Commercial |
$12.36
|
| Rate for Payer: Cash Price |
$12.75
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$15.94
|
| Rate for Payer: Healthscope Whirlpool |
$15.46
|
| Rate for Payer: Mclaren Commercial |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.51
|
| Rate for Payer: Priority Health Narrow Network |
$11.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.03
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$15.94
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$15.94 |
| Rate for Payer: Aetna Commercial |
$14.35
|
| Rate for Payer: ASR ASR |
$15.46
|
| Rate for Payer: BCBS Trust/PPO |
$12.36
|
| Rate for Payer: BCN Commercial |
$12.36
|
| Rate for Payer: Cash Price |
$12.75
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$15.94
|
| Rate for Payer: Healthscope Whirlpool |
$15.46
|
| Rate for Payer: Mclaren Commercial |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.03
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$52.53
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$52.53 |
| Rate for Payer: Aetna Commercial |
$47.28
|
| Rate for Payer: ASR ASR |
$50.95
|
| Rate for Payer: BCBS Complete |
$21.01
|
| Rate for Payer: BCBS Trust/PPO |
$40.73
|
| Rate for Payer: BCN Commercial |
$40.73
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cofinity Commercial |
$49.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.02
|
| Rate for Payer: Healthscope Commercial |
$52.53
|
| Rate for Payer: Healthscope Whirlpool |
$50.95
|
| Rate for Payer: Mclaren Commercial |
$47.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.80
|
| Rate for Payer: Priority Health Narrow Network |
$37.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.23
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$52.53
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.77 |
| Max. Negotiated Rate |
$52.53 |
| Rate for Payer: Aetna Commercial |
$47.28
|
| Rate for Payer: ASR ASR |
$50.95
|
| Rate for Payer: BCBS Trust/PPO |
$40.73
|
| Rate for Payer: BCN Commercial |
$40.73
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cofinity Commercial |
$49.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.02
|
| Rate for Payer: Healthscope Commercial |
$52.53
|
| Rate for Payer: Healthscope Whirlpool |
$50.95
|
| Rate for Payer: Mclaren Commercial |
$47.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.23
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$41.25
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.88 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Aetna Commercial |
$37.12
|
| Rate for Payer: ASR ASR |
$40.01
|
| Rate for Payer: BCBS Trust/PPO |
$31.98
|
| Rate for Payer: BCN Commercial |
$31.98
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cofinity Commercial |
$38.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.00
|
| Rate for Payer: Healthscope Commercial |
$41.25
|
| Rate for Payer: Healthscope Whirlpool |
$40.01
|
| Rate for Payer: Mclaren Commercial |
$37.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.30
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$41.25
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Aetna Commercial |
$37.12
|
| Rate for Payer: ASR ASR |
$40.01
|
| Rate for Payer: BCBS Complete |
$16.50
|
| Rate for Payer: BCBS Trust/PPO |
$31.98
|
| Rate for Payer: BCN Commercial |
$31.98
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cofinity Commercial |
$38.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.00
|
| Rate for Payer: Healthscope Commercial |
$41.25
|
| Rate for Payer: Healthscope Whirlpool |
$40.01
|
| Rate for Payer: Mclaren Commercial |
$37.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.54
|
| Rate for Payer: Priority Health Narrow Network |
$29.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.30
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$49,783.83
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34,848.68 |
| Max. Negotiated Rate |
$49,783.83 |
| Rate for Payer: Aetna Commercial |
$44,805.45
|
| Rate for Payer: ASR ASR |
$48,290.32
|
| Rate for Payer: BCBS Trust/PPO |
$38,597.40
|
| Rate for Payer: BCN Commercial |
$38,597.40
|
| Rate for Payer: Cash Price |
$39,827.06
|
| Rate for Payer: Cofinity Commercial |
$46,796.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39,827.06
|
| Rate for Payer: Healthscope Commercial |
$49,783.83
|
| Rate for Payer: Healthscope Whirlpool |
$48,290.32
|
| Rate for Payer: Mclaren Commercial |
$44,805.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42,316.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34,848.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43,809.77
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$49,783.83
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,765.55 |
| Max. Negotiated Rate |
$49,783.83 |
| Rate for Payer: Aetna Commercial |
$44,805.45
|
| Rate for Payer: Aetna Medicare |
$16,024.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,030.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,030.98
|
| Rate for Payer: ASR ASR |
$48,290.32
|
| Rate for Payer: BCBS Complete |
$9,204.63
|
| Rate for Payer: BCBS MAPPO |
$16,024.78
|
| Rate for Payer: BCBS Trust/PPO |
$38,597.40
|
| Rate for Payer: BCN Commercial |
$38,597.40
|
| Rate for Payer: BCN Medicare Advantage |
$16,024.78
|
| Rate for Payer: Cash Price |
$39,827.06
|
| Rate for Payer: Cash Price |
$39,827.06
|
| Rate for Payer: Cofinity Commercial |
$46,796.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39,827.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,024.78
|
| Rate for Payer: Healthscope Commercial |
$49,783.83
|
| Rate for Payer: Healthscope Whirlpool |
$48,290.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,024.78
|
| Rate for Payer: Mclaren Commercial |
$44,805.45
|
| Rate for Payer: Mclaren Medicaid |
$8,765.55
|
| Rate for Payer: Mclaren Medicare |
$16,024.78
|
| Rate for Payer: Meridian Medicaid |
$9,204.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,826.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,428.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42,316.26
|
| Rate for Payer: PACE Medicare |
$15,223.54
|
| Rate for Payer: PACE SWMI |
$16,024.78
|
| Rate for Payer: PHP Commercial |
$17,627.26
|
| Rate for Payer: PHP Medicaid |
$8,765.55
|
| Rate for Payer: PHP Medicare Advantage |
$16,024.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,765.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34,848.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45,303.29
|
| Rate for Payer: Priority Health Medicare |
$16,024.78
|
| Rate for Payer: Priority Health Narrow Network |
$35,346.52
|
| Rate for Payer: Railroad Medicare Medicare |
$16,024.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43,809.77
|
| Rate for Payer: UHC Medicare Advantage |
$16,505.52
|
| Rate for Payer: VA VA |
$16,024.78
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$41.00 |
| Rate for Payer: Aetna Commercial |
$36.90
|
| Rate for Payer: ASR ASR |
$39.77
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$31.79
|
| Rate for Payer: BCN Commercial |
$31.79
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$38.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.80
|
| Rate for Payer: Healthscope Commercial |
$41.00
|
| Rate for Payer: Healthscope Whirlpool |
$39.77
|
| Rate for Payer: Mclaren Commercial |
$36.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.31
|
| Rate for Payer: Priority Health Narrow Network |
$29.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.08
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.70 |
| Max. Negotiated Rate |
$41.00 |
| Rate for Payer: Aetna Commercial |
$36.90
|
| Rate for Payer: ASR ASR |
$39.77
|
| Rate for Payer: BCBS Trust/PPO |
$31.79
|
| Rate for Payer: BCN Commercial |
$31.79
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$38.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.80
|
| Rate for Payer: Healthscope Commercial |
$41.00
|
| Rate for Payer: Healthscope Whirlpool |
$39.77
|
| Rate for Payer: Mclaren Commercial |
$36.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.08
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$200.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.34 |
| Max. Negotiated Rate |
$200.84 |
| Rate for Payer: Aetna Commercial |
$180.76
|
| Rate for Payer: ASR ASR |
$194.81
|
| Rate for Payer: BCBS Complete |
$80.34
|
| Rate for Payer: BCBS Trust/PPO |
$155.71
|
| Rate for Payer: BCN Commercial |
$155.71
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cofinity Commercial |
$188.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.67
|
| Rate for Payer: Healthscope Commercial |
$200.84
|
| Rate for Payer: Healthscope Whirlpool |
$194.81
|
| Rate for Payer: Mclaren Commercial |
$180.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.76
|
| Rate for Payer: Priority Health Narrow Network |
$142.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.74
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$200.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.59 |
| Max. Negotiated Rate |
$200.84 |
| Rate for Payer: Aetna Commercial |
$180.76
|
| Rate for Payer: ASR ASR |
$194.81
|
| Rate for Payer: BCBS Trust/PPO |
$155.71
|
| Rate for Payer: BCN Commercial |
$155.71
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cofinity Commercial |
$188.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.67
|
| Rate for Payer: Healthscope Commercial |
$200.84
|
| Rate for Payer: Healthscope Whirlpool |
$194.81
|
| Rate for Payer: Mclaren Commercial |
$180.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.74
|
|
|
HC Z ACCULINK CAROTID STENT
|
Facility
|
OP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,711.73 |
| Max. Negotiated Rate |
$6,779.33 |
| Rate for Payer: Aetna Commercial |
$6,101.40
|
| Rate for Payer: ASR ASR |
$6,575.95
|
| Rate for Payer: BCBS Complete |
$2,711.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,256.01
|
| Rate for Payer: BCN Commercial |
$5,256.01
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Commercial |
$6,372.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,779.33
|
| Rate for Payer: Healthscope Whirlpool |
$6,575.95
|
| Rate for Payer: Mclaren Commercial |
$6,101.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,762.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,745.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,169.19
|
| Rate for Payer: Priority Health Narrow Network |
$4,813.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,965.81
|
|
|
HC Z ACCULINK CAROTID STENT
|
Facility
|
IP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,745.53 |
| Max. Negotiated Rate |
$6,779.33 |
| Rate for Payer: Aetna Commercial |
$6,101.40
|
| Rate for Payer: ASR ASR |
$6,575.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,256.01
|
| Rate for Payer: BCN Commercial |
$5,256.01
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Commercial |
$6,372.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,779.33
|
| Rate for Payer: Healthscope Whirlpool |
$6,575.95
|
| Rate for Payer: Mclaren Commercial |
$6,101.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,762.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,745.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,965.81
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,241.28
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,368.90 |
| Max. Negotiated Rate |
$6,241.28 |
| Rate for Payer: Aetna Commercial |
$5,617.15
|
| Rate for Payer: ASR ASR |
$6,054.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,838.86
|
| Rate for Payer: BCN Commercial |
$4,838.86
|
| Rate for Payer: Cash Price |
$4,993.02
|
| Rate for Payer: Cofinity Commercial |
$5,866.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,993.02
|
| Rate for Payer: Healthscope Commercial |
$6,241.28
|
| Rate for Payer: Healthscope Whirlpool |
$6,054.04
|
| Rate for Payer: Mclaren Commercial |
$5,617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,305.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,368.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,492.33
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,241.28
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,496.51 |
| Max. Negotiated Rate |
$6,241.28 |
| Rate for Payer: Aetna Commercial |
$5,617.15
|
| Rate for Payer: ASR ASR |
$6,054.04
|
| Rate for Payer: BCBS Complete |
$2,496.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,838.86
|
| Rate for Payer: BCN Commercial |
$4,838.86
|
| Rate for Payer: Cash Price |
$4,993.02
|
| Rate for Payer: Cofinity Commercial |
$5,866.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,993.02
|
| Rate for Payer: Healthscope Commercial |
$6,241.28
|
| Rate for Payer: Healthscope Whirlpool |
$6,054.04
|
| Rate for Payer: Mclaren Commercial |
$5,617.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,305.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,368.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,679.56
|
| Rate for Payer: Priority Health Narrow Network |
$4,431.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,492.33
|
|
