|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$429.05 |
| Rate for Payer: Aetna Commercial |
$386.14
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$416.18
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$332.64
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$429.05
|
| Rate for Payer: Healthscope Whirlpool |
$416.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$386.14
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$377.64
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$302.11
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.56
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$300.34 |
| Max. Negotiated Rate |
$429.05 |
| Rate for Payer: Aetna Commercial |
$386.14
|
| Rate for Payer: ASR ASR |
$416.18
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$332.64
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$403.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$429.05
|
| Rate for Payer: Healthscope Whirlpool |
$416.18
|
| Rate for Payer: Mclaren Commercial |
$386.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.56
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$679.12
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$227.98 |
| Max. Negotiated Rate |
$679.12 |
| Rate for Payer: Aetna Commercial |
$611.21
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$658.75
|
| Rate for Payer: BCBS Complete |
$239.40
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$526.52
|
| Rate for Payer: BCN Commercial |
$526.52
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cofinity Commercial |
$638.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$679.12
|
| Rate for Payer: Healthscope Whirlpool |
$658.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$611.21
|
| Rate for Payer: Mclaren Medicaid |
$227.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Medicaid |
$239.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$577.25
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$227.98
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.00
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$482.18
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$597.63
|
| Rate for Payer: UHC Medicare Advantage |
$429.28
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$679.12
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$475.38 |
| Max. Negotiated Rate |
$679.12 |
| Rate for Payer: Aetna Commercial |
$611.21
|
| Rate for Payer: ASR ASR |
$658.75
|
| Rate for Payer: BCBS Trust/PPO |
$526.52
|
| Rate for Payer: BCN Commercial |
$526.52
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cofinity Commercial |
$638.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.30
|
| Rate for Payer: Healthscope Commercial |
$679.12
|
| Rate for Payer: Healthscope Whirlpool |
$658.75
|
| Rate for Payer: Mclaren Commercial |
$611.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$577.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$597.63
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$610.48
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$610.48 |
| Rate for Payer: Aetna Commercial |
$549.43
|
| Rate for Payer: Aetna Medicare |
$416.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: ASR ASR |
$592.17
|
| Rate for Payer: BCBS Complete |
$239.40
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$473.31
|
| Rate for Payer: BCN Commercial |
$473.31
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cofinity Commercial |
$573.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$610.48
|
| Rate for Payer: Healthscope Whirlpool |
$592.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$416.78
|
| Rate for Payer: Mclaren Commercial |
$549.43
|
| Rate for Payer: Mclaren Medicaid |
$227.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Medicaid |
$239.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.91
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$458.46
|
| Rate for Payer: PHP Medicaid |
$227.98
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.22
|
| Rate for Payer: UHC Medicare Advantage |
$429.28
|
| Rate for Payer: VA VA |
$416.78
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$610.48
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$427.34 |
| Max. Negotiated Rate |
$610.48 |
| Rate for Payer: Aetna Commercial |
$549.43
|
| Rate for Payer: ASR ASR |
$592.17
|
| Rate for Payer: BCBS Trust/PPO |
$473.31
|
| Rate for Payer: BCN Commercial |
$473.31
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cofinity Commercial |
$573.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.38
|
| Rate for Payer: Healthscope Commercial |
$610.48
|
| Rate for Payer: Healthscope Whirlpool |
$592.17
|
| Rate for Payer: Mclaren Commercial |
$549.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$537.22
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.93 |
| Max. Negotiated Rate |
$108.12 |
| Rate for Payer: Aetna Commercial |
$97.31
|
| Rate for Payer: Aetna Medicare |
$65.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.11
|
| Rate for Payer: ASR ASR |
$104.88
|
| Rate for Payer: BCBS Complete |
$37.73
|
| Rate for Payer: BCBS MAPPO |
$65.69
|
| Rate for Payer: BCBS Trust/PPO |
$83.83
|
| Rate for Payer: BCN Commercial |
$83.83
|
| Rate for Payer: BCN Medicare Advantage |
$65.69
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$101.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$108.12
|
| Rate for Payer: Healthscope Whirlpool |
$104.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$65.69
|
| Rate for Payer: Mclaren Commercial |
$97.31
|
| Rate for Payer: Mclaren Medicaid |
$35.93
|
| Rate for Payer: Mclaren Medicare |
$65.69
|
| Rate for Payer: Meridian Medicaid |
$37.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PACE Medicare |
$62.41
|
| Rate for Payer: PACE SWMI |
$65.69
|
| Rate for Payer: PHP Commercial |
$72.26
|
| Rate for Payer: PHP Medicaid |
$35.93
|
| Rate for Payer: PHP Medicare Advantage |
$65.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.96
|
| Rate for Payer: Priority Health Medicare |
$65.69
|
| Rate for Payer: Priority Health Narrow Network |
$39.17
|
| Rate for Payer: Railroad Medicare Medicare |
$65.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.15
|
| Rate for Payer: UHC Medicare Advantage |
$67.66
|
| Rate for Payer: VA VA |
$65.69
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.68 |
| Max. Negotiated Rate |
$108.12 |
| Rate for Payer: Aetna Commercial |
$97.31
|
| Rate for Payer: ASR ASR |
$104.88
|
| Rate for Payer: BCBS Trust/PPO |
$83.83
|
| Rate for Payer: BCN Commercial |
$83.83
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$101.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$108.12
|
| Rate for Payer: Healthscope Whirlpool |
$104.88
|
| Rate for Payer: Mclaren Commercial |
$97.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.15
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$116.60
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.62 |
| Max. Negotiated Rate |
$116.60 |
| Rate for Payer: Aetna Commercial |
$104.94
|
| Rate for Payer: ASR ASR |
$113.10
|
| Rate for Payer: BCBS Trust/PPO |
$90.40
|
| Rate for Payer: BCN Commercial |
$90.40
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$109.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.28
|
| Rate for Payer: Healthscope Commercial |
$116.60
|
| Rate for Payer: Healthscope Whirlpool |
$113.10
|
| Rate for Payer: Mclaren Commercial |
$104.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.61
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$116.60
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.58 |
| Max. Negotiated Rate |
$116.60 |
| Rate for Payer: Aetna Commercial |
$104.94
|
| Rate for Payer: Aetna Medicare |
$73.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.71
|
| Rate for Payer: ASR ASR |
$113.10
|
| Rate for Payer: BCBS Complete |
$42.14
|
| Rate for Payer: BCBS MAPPO |
$73.37
|
| Rate for Payer: BCBS Trust/PPO |
$90.40
|
| Rate for Payer: BCN Commercial |
$90.40
|
| Rate for Payer: BCN Medicare Advantage |
$73.37
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$109.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.37
|
| Rate for Payer: Healthscope Commercial |
$116.60
|
| Rate for Payer: Healthscope Whirlpool |
$113.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$73.37
|
| Rate for Payer: Mclaren Commercial |
$104.94
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Mclaren Medicare |
$73.37
|
| Rate for Payer: Meridian Medicaid |
$42.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.11
|
| Rate for Payer: PACE Medicare |
$69.70
|
| Rate for Payer: PACE SWMI |
$73.37
|
| Rate for Payer: PHP Commercial |
$80.71
|
| Rate for Payer: PHP Medicaid |
$40.13
|
| Rate for Payer: PHP Medicare Advantage |
$73.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.48
|
| Rate for Payer: Priority Health Medicare |
$73.37
|
| Rate for Payer: Priority Health Narrow Network |
$35.58
|
| Rate for Payer: Railroad Medicare Medicare |
$73.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$102.61
|
| Rate for Payer: UHC Medicare Advantage |
$75.57
|
| Rate for Payer: VA VA |
$73.37
|
|
|
HC Z BALLOON CATHETER
|
Facility
|
OP
|
$1,522.88
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$609.15 |
| Max. Negotiated Rate |
$1,522.88 |
| Rate for Payer: Aetna Commercial |
$1,370.59
|
| Rate for Payer: ASR ASR |
$1,477.19
|
| Rate for Payer: BCBS Complete |
$609.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.69
|
| Rate for Payer: BCN Commercial |
$1,180.69
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Cofinity Commercial |
$1,431.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.30
|
| Rate for Payer: Healthscope Commercial |
$1,522.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,477.19
|
| Rate for Payer: Mclaren Commercial |
$1,370.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,294.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,385.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,340.13
|
|
|
HC Z BALLOON CATHETER
|
Facility
|
IP
|
$1,522.88
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,066.02 |
| Max. Negotiated Rate |
$1,522.88 |
| Rate for Payer: Aetna Commercial |
$1,370.59
|
| Rate for Payer: ASR ASR |
$1,477.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.69
|
| Rate for Payer: BCN Commercial |
$1,180.69
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Cofinity Commercial |
$1,431.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.30
|
| Rate for Payer: Healthscope Commercial |
$1,522.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,477.19
|
| Rate for Payer: Mclaren Commercial |
$1,370.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,294.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,340.13
|
|
|
HC Z CORDIS BALLOON STENT
|
Facility
|
OP
|
$5,380.54
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,152.22 |
| Max. Negotiated Rate |
$5,380.54 |
| Rate for Payer: Aetna Commercial |
$4,842.49
|
| Rate for Payer: ASR ASR |
$5,219.12
|
| Rate for Payer: BCBS Complete |
$2,152.22
|
| Rate for Payer: BCBS Trust/PPO |
$4,171.53
|
| Rate for Payer: BCN Commercial |
$4,171.53
|
| Rate for Payer: Cash Price |
$4,304.43
|
| Rate for Payer: Cofinity Commercial |
$5,057.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,304.43
|
| Rate for Payer: Healthscope Commercial |
$5,380.54
|
| Rate for Payer: Healthscope Whirlpool |
$5,219.12
|
| Rate for Payer: Mclaren Commercial |
$4,842.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,573.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,896.29
|
| Rate for Payer: Priority Health Narrow Network |
$3,820.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,734.88
|
|
|
HC Z CORDIS BALLOON STENT
|
Facility
|
IP
|
$5,380.54
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,766.38 |
| Max. Negotiated Rate |
$5,380.54 |
| Rate for Payer: Aetna Commercial |
$4,842.49
|
| Rate for Payer: ASR ASR |
$5,219.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,171.53
|
| Rate for Payer: BCN Commercial |
$4,171.53
|
| Rate for Payer: Cash Price |
$4,304.43
|
| Rate for Payer: Cofinity Commercial |
$5,057.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,304.43
|
| Rate for Payer: Healthscope Commercial |
$5,380.54
|
| Rate for Payer: Healthscope Whirlpool |
$5,219.12
|
| Rate for Payer: Mclaren Commercial |
$4,842.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,573.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,734.88
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,017.54
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,812.28 |
| Max. Negotiated Rate |
$4,017.54 |
| Rate for Payer: Aetna Commercial |
$3,615.79
|
| Rate for Payer: ASR ASR |
$3,897.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,114.80
|
| Rate for Payer: BCN Commercial |
$3,114.80
|
| Rate for Payer: Cash Price |
$3,214.03
|
| Rate for Payer: Cofinity Commercial |
$3,776.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,214.03
|
| Rate for Payer: Healthscope Commercial |
$4,017.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,897.01
|
| Rate for Payer: Mclaren Commercial |
$3,615.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,812.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,535.44
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,017.54
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,607.02 |
| Max. Negotiated Rate |
$4,017.54 |
| Rate for Payer: Aetna Commercial |
$3,615.79
|
| Rate for Payer: ASR ASR |
$3,897.01
|
| Rate for Payer: BCBS Complete |
$1,607.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,114.80
|
| Rate for Payer: BCN Commercial |
$3,114.80
|
| Rate for Payer: Cash Price |
$3,214.03
|
| Rate for Payer: Cofinity Commercial |
$3,776.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,214.03
|
| Rate for Payer: Healthscope Commercial |
$4,017.54
|
| Rate for Payer: Healthscope Whirlpool |
$3,897.01
|
| Rate for Payer: Mclaren Commercial |
$3,615.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,812.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,655.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,852.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,535.44
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,541.41
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,278.99 |
| Max. Negotiated Rate |
$7,541.41 |
| Rate for Payer: Aetna Commercial |
$6,787.27
|
| Rate for Payer: ASR ASR |
$7,315.17
|
| Rate for Payer: BCBS Trust/PPO |
$5,846.86
|
| Rate for Payer: BCN Commercial |
$5,846.86
|
| Rate for Payer: Cash Price |
$6,033.13
|
| Rate for Payer: Cofinity Commercial |
$7,088.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,033.13
|
| Rate for Payer: Healthscope Commercial |
$7,541.41
|
| Rate for Payer: Healthscope Whirlpool |
$7,315.17
|
| Rate for Payer: Mclaren Commercial |
$6,787.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,410.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,278.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,636.44
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,541.41
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,016.56 |
| Max. Negotiated Rate |
$7,541.41 |
| Rate for Payer: Aetna Commercial |
$6,787.27
|
| Rate for Payer: ASR ASR |
$7,315.17
|
| Rate for Payer: BCBS Complete |
$3,016.56
|
| Rate for Payer: BCBS Trust/PPO |
$5,846.86
|
| Rate for Payer: BCN Commercial |
$5,846.86
|
| Rate for Payer: Cash Price |
$6,033.13
|
| Rate for Payer: Cofinity Commercial |
$7,088.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,033.13
|
| Rate for Payer: Healthscope Commercial |
$7,541.41
|
| Rate for Payer: Healthscope Whirlpool |
$7,315.17
|
| Rate for Payer: Mclaren Commercial |
$6,787.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,410.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,278.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,862.68
|
| Rate for Payer: Priority Health Narrow Network |
$5,354.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,636.44
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,185.41
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,529.79 |
| Max. Negotiated Rate |
$2,185.41 |
| Rate for Payer: Aetna Commercial |
$1,966.87
|
| Rate for Payer: ASR ASR |
$2,119.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.35
|
| Rate for Payer: BCN Commercial |
$1,694.35
|
| Rate for Payer: Cash Price |
$1,748.33
|
| Rate for Payer: Cofinity Commercial |
$2,054.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,748.33
|
| Rate for Payer: Healthscope Commercial |
$2,185.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,119.85
|
| Rate for Payer: Mclaren Commercial |
$1,966.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,857.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,529.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,923.16
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,185.41
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$874.16 |
| Max. Negotiated Rate |
$2,185.41 |
| Rate for Payer: Aetna Commercial |
$1,966.87
|
| Rate for Payer: ASR ASR |
$2,119.85
|
| Rate for Payer: BCBS Complete |
$874.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.35
|
| Rate for Payer: BCN Commercial |
$1,694.35
|
| Rate for Payer: Cash Price |
$1,748.33
|
| Rate for Payer: Cofinity Commercial |
$2,054.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,748.33
|
| Rate for Payer: Healthscope Commercial |
$2,185.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,119.85
|
| Rate for Payer: Mclaren Commercial |
$1,966.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,857.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,529.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,988.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,551.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,923.16
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$60,748.42
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$42,523.89 |
| Max. Negotiated Rate |
$60,748.42 |
| Rate for Payer: Aetna Commercial |
$54,673.58
|
| Rate for Payer: ASR ASR |
$58,925.97
|
| Rate for Payer: BCBS Trust/PPO |
$47,098.25
|
| Rate for Payer: BCN Commercial |
$47,098.25
|
| Rate for Payer: Cash Price |
$48,598.74
|
| Rate for Payer: Cofinity Commercial |
$57,103.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,598.74
|
| Rate for Payer: Healthscope Commercial |
$60,748.42
|
| Rate for Payer: Healthscope Whirlpool |
$58,925.97
|
| Rate for Payer: Mclaren Commercial |
$54,673.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51,636.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42,523.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53,458.61
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$60,748.42
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$35,815.69 |
| Max. Negotiated Rate |
$81,845.73 |
| Rate for Payer: Aetna Commercial |
$54,673.58
|
| Rate for Payer: Aetna Medicare |
$65,476.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81,845.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81,845.73
|
| Rate for Payer: ASR ASR |
$58,925.97
|
| Rate for Payer: BCBS Complete |
$37,609.75
|
| Rate for Payer: BCBS MAPPO |
$65,476.58
|
| Rate for Payer: BCBS Trust/PPO |
$47,098.25
|
| Rate for Payer: BCN Commercial |
$47,098.25
|
| Rate for Payer: BCN Medicare Advantage |
$65,476.58
|
| Rate for Payer: Cash Price |
$48,598.74
|
| Rate for Payer: Cash Price |
$48,598.74
|
| Rate for Payer: Cofinity Commercial |
$57,103.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,598.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65,476.58
|
| Rate for Payer: Healthscope Commercial |
$60,748.42
|
| Rate for Payer: Healthscope Whirlpool |
$58,925.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$65,476.58
|
| Rate for Payer: Mclaren Commercial |
$54,673.58
|
| Rate for Payer: Mclaren Medicaid |
$35,815.69
|
| Rate for Payer: Mclaren Medicare |
$65,476.58
|
| Rate for Payer: Meridian Medicaid |
$37,609.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68,750.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75,298.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51,636.16
|
| Rate for Payer: PACE Medicare |
$62,202.75
|
| Rate for Payer: PACE SWMI |
$65,476.58
|
| Rate for Payer: PHP Commercial |
$72,024.24
|
| Rate for Payer: PHP Medicaid |
$35,815.69
|
| Rate for Payer: PHP Medicare Advantage |
$65,476.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$35,815.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42,523.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,281.06
|
| Rate for Payer: Priority Health Medicare |
$65,476.58
|
| Rate for Payer: Priority Health Narrow Network |
$43,131.38
|
| Rate for Payer: Railroad Medicare Medicare |
$65,476.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53,458.61
|
| Rate for Payer: UHC Medicare Advantage |
$67,440.88
|
| Rate for Payer: VA VA |
$65,476.58
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,500.87
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$600.35 |
| Max. Negotiated Rate |
$1,500.87 |
| Rate for Payer: Aetna Commercial |
$1,350.78
|
| Rate for Payer: ASR ASR |
$1,455.84
|
| Rate for Payer: BCBS Complete |
$600.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,163.62
|
| Rate for Payer: BCN Commercial |
$1,163.62
|
| Rate for Payer: Cash Price |
$1,200.70
|
| Rate for Payer: Cofinity Commercial |
$1,410.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.70
|
| Rate for Payer: Healthscope Commercial |
$1,500.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,455.84
|
| Rate for Payer: Mclaren Commercial |
$1,350.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,065.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,320.77
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,500.87
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.61 |
| Max. Negotiated Rate |
$1,500.87 |
| Rate for Payer: Aetna Commercial |
$1,350.78
|
| Rate for Payer: ASR ASR |
$1,455.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,163.62
|
| Rate for Payer: BCN Commercial |
$1,163.62
|
| Rate for Payer: Cash Price |
$1,200.70
|
| Rate for Payer: Cofinity Commercial |
$1,410.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.70
|
| Rate for Payer: Healthscope Commercial |
$1,500.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,455.84
|
| Rate for Payer: Mclaren Commercial |
$1,350.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,320.77
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,199.35
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$479.74 |
| Max. Negotiated Rate |
$1,199.35 |
| Rate for Payer: Aetna Commercial |
$1,079.42
|
| Rate for Payer: ASR ASR |
$1,163.37
|
| Rate for Payer: BCBS Complete |
$479.74
|
| Rate for Payer: BCBS Trust/PPO |
$929.86
|
| Rate for Payer: BCN Commercial |
$929.86
|
| Rate for Payer: Cash Price |
$959.48
|
| Rate for Payer: Cofinity Commercial |
$1,127.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.48
|
| Rate for Payer: Healthscope Commercial |
$1,199.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,163.37
|
| Rate for Payer: Mclaren Commercial |
$1,079.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,019.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$839.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,091.41
|
| Rate for Payer: Priority Health Narrow Network |
$851.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,055.43
|
|
