|
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC
|
Facility
|
IP
|
$347,946.02
|
|
|
Service Code
|
MS-DRG 001
|
| Min. Negotiated Rate |
$219,553.02 |
| Max. Negotiated Rate |
$347,946.02 |
| Rate for Payer: Aetna Medicare |
$231,108.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288,885.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288,885.55
|
| Rate for Payer: BCBS MAPPO |
$231,108.44
|
| Rate for Payer: BCN Medicare Advantage |
$231,108.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231,108.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$231,108.44
|
| Rate for Payer: Mclaren Medicare |
$231,108.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$242,663.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265,774.71
|
| Rate for Payer: PACE Medicare |
$219,553.02
|
| Rate for Payer: PACE SWMI |
$231,108.44
|
| Rate for Payer: PHP Commercial |
$254,219.28
|
| Rate for Payer: PHP Medicare Advantage |
$231,108.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$347,946.02
|
| Rate for Payer: Priority Health Medicare |
$231,108.44
|
| Rate for Payer: Priority Health Narrow Network |
$278,356.82
|
| Rate for Payer: Railroad Medicare Medicare |
$231,108.44
|
| Rate for Payer: UHC Medicare Advantage |
$238,041.69
|
| Rate for Payer: VA VA |
$231,108.44
|
|
|
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$157,214.24
|
|
|
Service Code
|
MS-DRG 002
|
| Min. Negotiated Rate |
$100,077.12 |
| Max. Negotiated Rate |
$157,214.24 |
| Rate for Payer: Aetna Medicare |
$105,344.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131,680.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131,680.42
|
| Rate for Payer: BCBS MAPPO |
$105,344.34
|
| Rate for Payer: BCN Medicare Advantage |
$105,344.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105,344.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$105,344.34
|
| Rate for Payer: Mclaren Medicare |
$105,344.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110,611.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121,145.99
|
| Rate for Payer: PACE Medicare |
$100,077.12
|
| Rate for Payer: PACE SWMI |
$105,344.34
|
| Rate for Payer: PHP Commercial |
$115,878.77
|
| Rate for Payer: PHP Medicare Advantage |
$105,344.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157,214.24
|
| Rate for Payer: Priority Health Medicare |
$105,344.34
|
| Rate for Payer: Priority Health Narrow Network |
$125,771.39
|
| Rate for Payer: Railroad Medicare Medicare |
$105,344.34
|
| Rate for Payer: UHC Medicare Advantage |
$108,504.67
|
| Rate for Payer: VA VA |
$105,344.34
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.82
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$26.82 |
| Rate for Payer: Aetna Commercial |
$24.14
|
| Rate for Payer: ASR ASR |
$26.02
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$20.79
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$26.82
|
| Rate for Payer: Healthscope Whirlpool |
$26.02
|
| Rate for Payer: Mclaren Commercial |
$24.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.60
|
|
|
HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$26.54
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10176
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.58 |
| Max. Negotiated Rate |
$26.54 |
| Rate for Payer: Aetna Commercial |
$23.89
|
| Rate for Payer: Aetna Commercial |
$20.84
|
| Rate for Payer: Aetna Commercial |
$24.84
|
| Rate for Payer: ASR ASR |
$22.47
|
| Rate for Payer: ASR ASR |
$25.74
|
| Rate for Payer: ASR ASR |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$21.40
|
| Rate for Payer: BCBS Trust/PPO |
$20.58
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$17.96
|
| Rate for Payer: BCN Commercial |
$20.58
|
| Rate for Payer: BCN Commercial |
$21.40
|
| Rate for Payer: Cash Price |
$21.23
|
| Rate for Payer: Cash Price |
$18.53
|
| Rate for Payer: Cash Price |
$22.08
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Cofinity Commercial |
$25.94
|
| Rate for Payer: Cofinity Commercial |
$24.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.08
|
| Rate for Payer: Healthscope Commercial |
$27.60
|
| Rate for Payer: Healthscope Commercial |
$26.54
|
| Rate for Payer: Healthscope Commercial |
$23.16
|
| Rate for Payer: Healthscope Whirlpool |
$22.47
|
| Rate for Payer: Healthscope Whirlpool |
$26.77
|
| Rate for Payer: Healthscope Whirlpool |
$25.74
|
| Rate for Payer: Mclaren Commercial |
$24.84
|
| Rate for Payer: Mclaren Commercial |
$20.84
|
| Rate for Payer: Mclaren Commercial |
$23.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.38
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV
|
Facility
|
IP
|
$99.69
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
15846
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$69.78 |
| Max. Negotiated Rate |
$99.69 |
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Commercial |
$93.30
|
| Rate for Payer: Aetna Commercial |
$64.03
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$100.56
|
| Rate for Payer: ASR ASR |
$69.01
|
| Rate for Payer: BCBS Trust/PPO |
$55.15
|
| Rate for Payer: BCBS Trust/PPO |
$80.38
|
| Rate for Payer: BCBS Trust/PPO |
$77.29
|
| Rate for Payer: BCN Commercial |
$77.29
|
| Rate for Payer: BCN Commercial |
$80.38
|
| Rate for Payer: BCN Commercial |
$55.15
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cash Price |
$82.94
|
| Rate for Payer: Cash Price |
$56.92
|
| Rate for Payer: Cofinity Commercial |
$66.87
|
| Rate for Payer: Cofinity Commercial |
$97.45
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Healthscope Commercial |
$99.69
|
| Rate for Payer: Healthscope Commercial |
$71.14
|
| Rate for Payer: Healthscope Commercial |
$103.67
|
| Rate for Payer: Healthscope Whirlpool |
$69.01
|
| Rate for Payer: Healthscope Whirlpool |
$100.56
|
| Rate for Payer: Healthscope Whirlpool |
$96.70
|
| Rate for Payer: Mclaren Commercial |
$64.03
|
| Rate for Payer: Mclaren Commercial |
$93.30
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
|
|
HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) INFUSION CUSTOM
|
Facility
|
IP
|
$71.14
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$49.80 |
| Max. Negotiated Rate |
$71.14 |
| Rate for Payer: Aetna Commercial |
$64.03
|
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$69.01
|
| Rate for Payer: BCBS Trust/PPO |
$77.29
|
| Rate for Payer: BCBS Trust/PPO |
$55.15
|
| Rate for Payer: BCN Commercial |
$77.29
|
| Rate for Payer: BCN Commercial |
$55.15
|
| Rate for Payer: Cash Price |
$56.92
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cofinity Commercial |
$66.87
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.91
|
| Rate for Payer: Healthscope Commercial |
$99.69
|
| Rate for Payer: Healthscope Commercial |
$71.14
|
| Rate for Payer: Healthscope Whirlpool |
$96.70
|
| Rate for Payer: Healthscope Whirlpool |
$69.01
|
| Rate for Payer: Mclaren Commercial |
$64.03
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION (IV BOLUS)
|
Facility
|
IP
|
$18.30
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
164900
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.81 |
| Max. Negotiated Rate |
$18.30 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: ASR ASR |
$17.75
|
| Rate for Payer: BCBS Trust/PPO |
$14.19
|
| Rate for Payer: BCN Commercial |
$14.19
|
| Rate for Payer: Cash Price |
$14.64
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.64
|
| Rate for Payer: Healthscope Commercial |
$18.30
|
| Rate for Payer: Healthscope Whirlpool |
$17.75
|
| Rate for Payer: Mclaren Commercial |
$16.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.10
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$22.18
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.53 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna Commercial |
$19.96
|
| Rate for Payer: Aetna Commercial |
$11.29
|
| Rate for Payer: Aetna Commercial |
$14.29
|
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna Commercial |
$15.19
|
| Rate for Payer: Aetna Commercial |
$18.52
|
| Rate for Payer: Aetna Commercial |
$15.41
|
| Rate for Payer: ASR ASR |
$15.40
|
| Rate for Payer: ASR ASR |
$16.37
|
| Rate for Payer: ASR ASR |
$17.75
|
| Rate for Payer: ASR ASR |
$12.16
|
| Rate for Payer: ASR ASR |
$19.96
|
| Rate for Payer: ASR ASR |
$16.61
|
| Rate for Payer: ASR ASR |
$21.51
|
| Rate for Payer: BCBS Trust/PPO |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$14.19
|
| Rate for Payer: BCBS Trust/PPO |
$17.20
|
| Rate for Payer: BCBS Trust/PPO |
$12.31
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$15.96
|
| Rate for Payer: BCN Commercial |
$13.27
|
| Rate for Payer: BCN Commercial |
$17.20
|
| Rate for Payer: BCN Commercial |
$9.72
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Commercial |
$15.96
|
| Rate for Payer: BCN Commercial |
$14.19
|
| Rate for Payer: BCN Commercial |
$12.31
|
| Rate for Payer: Cash Price |
$12.70
|
| Rate for Payer: Cash Price |
$17.75
|
| Rate for Payer: Cash Price |
$14.64
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$19.35
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$16.09
|
| Rate for Payer: Cofinity Commercial |
$11.79
|
| Rate for Payer: Cofinity Commercial |
$20.85
|
| Rate for Payer: Cofinity Commercial |
$15.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Healthscope Commercial |
$20.58
|
| Rate for Payer: Healthscope Commercial |
$12.54
|
| Rate for Payer: Healthscope Commercial |
$15.88
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$18.30
|
| Rate for Payer: Healthscope Commercial |
$22.18
|
| Rate for Payer: Healthscope Whirlpool |
$16.37
|
| Rate for Payer: Healthscope Whirlpool |
$19.96
|
| Rate for Payer: Healthscope Whirlpool |
$17.75
|
| Rate for Payer: Healthscope Whirlpool |
$21.51
|
| Rate for Payer: Healthscope Whirlpool |
$12.16
|
| Rate for Payer: Healthscope Whirlpool |
$15.40
|
| Rate for Payer: Healthscope Whirlpool |
$16.61
|
| Rate for Payer: Mclaren Commercial |
$15.19
|
| Rate for Payer: Mclaren Commercial |
$18.52
|
| Rate for Payer: Mclaren Commercial |
$19.96
|
| Rate for Payer: Mclaren Commercial |
$14.29
|
| Rate for Payer: Mclaren Commercial |
$11.29
|
| Rate for Payer: Mclaren Commercial |
$16.47
|
| Rate for Payer: Mclaren Commercial |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.52
|
|
|
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$13.22
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
10181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$13.22 |
| Rate for Payer: Aetna Commercial |
$11.90
|
| Rate for Payer: ASR ASR |
$12.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$10.25
|
| Rate for Payer: Cash Price |
$10.58
|
| Rate for Payer: Cofinity Commercial |
$12.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.58
|
| Rate for Payer: Healthscope Commercial |
$13.22
|
| Rate for Payer: Healthscope Whirlpool |
$12.82
|
| Rate for Payer: Mclaren Commercial |
$11.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.63
|
|
|
HEPARIN (PORCINE) IN D5W 25,000 UNIT/250 ML (UNITS/HR)
|
Facility
|
IP
|
$99.69
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
164950
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$69.78 |
| Max. Negotiated Rate |
$99.69 |
| Rate for Payer: Aetna Commercial |
$89.72
|
| Rate for Payer: Aetna Commercial |
$64.03
|
| Rate for Payer: Aetna Commercial |
$86.95
|
| Rate for Payer: ASR ASR |
$96.70
|
| Rate for Payer: ASR ASR |
$93.71
|
| Rate for Payer: ASR ASR |
$69.01
|
| Rate for Payer: BCBS Trust/PPO |
$77.29
|
| Rate for Payer: BCBS Trust/PPO |
$55.15
|
| Rate for Payer: BCBS Trust/PPO |
$74.90
|
| Rate for Payer: BCN Commercial |
$74.90
|
| Rate for Payer: BCN Commercial |
$77.29
|
| Rate for Payer: BCN Commercial |
$55.15
|
| Rate for Payer: Cash Price |
$77.29
|
| Rate for Payer: Cash Price |
$56.92
|
| Rate for Payer: Cash Price |
$79.75
|
| Rate for Payer: Cofinity Commercial |
$93.71
|
| Rate for Payer: Cofinity Commercial |
$90.81
|
| Rate for Payer: Cofinity Commercial |
$66.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.29
|
| Rate for Payer: Healthscope Commercial |
$96.61
|
| Rate for Payer: Healthscope Commercial |
$99.69
|
| Rate for Payer: Healthscope Commercial |
$71.14
|
| Rate for Payer: Healthscope Whirlpool |
$93.71
|
| Rate for Payer: Healthscope Whirlpool |
$69.01
|
| Rate for Payer: Healthscope Whirlpool |
$96.70
|
| Rate for Payer: Mclaren Commercial |
$86.95
|
| Rate for Payer: Mclaren Commercial |
$89.72
|
| Rate for Payer: Mclaren Commercial |
$64.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.73
|
|
|
HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$10.25
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
116327
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$10.25 |
| Rate for Payer: Aetna Commercial |
$9.22
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Commercial |
$11.70
|
| Rate for Payer: ASR ASR |
$10.67
|
| Rate for Payer: ASR ASR |
$9.94
|
| Rate for Payer: ASR ASR |
$12.61
|
| Rate for Payer: BCBS Trust/PPO |
$7.95
|
| Rate for Payer: BCBS Trust/PPO |
$8.53
|
| Rate for Payer: BCBS Trust/PPO |
$10.08
|
| Rate for Payer: BCN Commercial |
$8.53
|
| Rate for Payer: BCN Commercial |
$10.08
|
| Rate for Payer: BCN Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$8.20
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$10.34
|
| Rate for Payer: Cofinity Commercial |
$12.22
|
| Rate for Payer: Cofinity Commercial |
$9.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$10.25
|
| Rate for Payer: Healthscope Commercial |
$11.00
|
| Rate for Payer: Healthscope Whirlpool |
$10.67
|
| Rate for Payer: Healthscope Whirlpool |
$9.94
|
| Rate for Payer: Healthscope Whirlpool |
$12.61
|
| Rate for Payer: Mclaren Commercial |
$11.70
|
| Rate for Payer: Mclaren Commercial |
$9.22
|
| Rate for Payer: Mclaren Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.02
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$495.26
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$346.68 |
| Max. Negotiated Rate |
$495.26 |
| Rate for Payer: Aetna Commercial |
$445.73
|
| Rate for Payer: ASR ASR |
$480.40
|
| Rate for Payer: BCBS Trust/PPO |
$383.98
|
| Rate for Payer: BCN Commercial |
$383.98
|
| Rate for Payer: Cash Price |
$396.21
|
| Rate for Payer: Cofinity Commercial |
$465.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.21
|
| Rate for Payer: Healthscope Commercial |
$495.26
|
| Rate for Payer: Healthscope Whirlpool |
$480.40
|
| Rate for Payer: Mclaren Commercial |
$445.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.83
|
|
|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SYRINGE
|
Facility
|
IP
|
$495.26
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116867
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$346.68 |
| Max. Negotiated Rate |
$495.26 |
| Rate for Payer: Aetna Commercial |
$445.73
|
| Rate for Payer: ASR ASR |
$480.40
|
| Rate for Payer: BCBS Trust/PPO |
$383.98
|
| Rate for Payer: BCN Commercial |
$383.98
|
| Rate for Payer: Cash Price |
$396.21
|
| Rate for Payer: Cofinity Commercial |
$465.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.21
|
| Rate for Payer: Healthscope Commercial |
$495.26
|
| Rate for Payer: Healthscope Whirlpool |
$480.40
|
| Rate for Payer: Mclaren Commercial |
$445.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.83
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$21,951.26
|
|
|
Service Code
|
MS-DRG 421
|
| Min. Negotiated Rate |
$15,347.34 |
| Max. Negotiated Rate |
$21,951.26 |
| Rate for Payer: Aetna Medicare |
$16,155.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,193.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,193.86
|
| Rate for Payer: BCBS MAPPO |
$16,155.09
|
| Rate for Payer: BCN Medicare Advantage |
$16,155.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,155.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,155.09
|
| Rate for Payer: Mclaren Medicare |
$16,155.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,962.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,578.35
|
| Rate for Payer: PACE Medicare |
$15,347.34
|
| Rate for Payer: PACE SWMI |
$16,155.09
|
| Rate for Payer: PHP Commercial |
$17,770.60
|
| Rate for Payer: PHP Medicare Advantage |
$16,155.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,951.26
|
| Rate for Payer: Priority Health Medicare |
$16,155.09
|
| Rate for Payer: Priority Health Narrow Network |
$17,561.01
|
| Rate for Payer: Railroad Medicare Medicare |
$16,155.09
|
| Rate for Payer: UHC Medicare Advantage |
$16,639.74
|
| Rate for Payer: VA VA |
$16,155.09
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$41,098.27
|
|
|
Service Code
|
MS-DRG 420
|
| Min. Negotiated Rate |
$27,341.17 |
| Max. Negotiated Rate |
$41,098.27 |
| Rate for Payer: Aetna Medicare |
$28,780.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,975.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,975.22
|
| Rate for Payer: BCBS MAPPO |
$28,780.18
|
| Rate for Payer: BCN Medicare Advantage |
$28,780.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,780.18
|
| Rate for Payer: Humana Choice PPO Medicare |
$28,780.18
|
| Rate for Payer: Mclaren Medicare |
$28,780.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30,219.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33,097.21
|
| Rate for Payer: PACE Medicare |
$27,341.17
|
| Rate for Payer: PACE SWMI |
$28,780.18
|
| Rate for Payer: PHP Commercial |
$31,658.20
|
| Rate for Payer: PHP Medicare Advantage |
$28,780.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41,098.27
|
| Rate for Payer: Priority Health Medicare |
$28,780.18
|
| Rate for Payer: Priority Health Narrow Network |
$32,878.62
|
| Rate for Payer: Railroad Medicare Medicare |
$28,780.18
|
| Rate for Payer: UHC Medicare Advantage |
$29,643.59
|
| Rate for Payer: VA VA |
$28,780.18
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,117.24
|
|
|
Service Code
|
MS-DRG 422
|
| Min. Negotiated Rate |
$12,945.66 |
| Max. Negotiated Rate |
$18,117.24 |
| Rate for Payer: Aetna Medicare |
$13,627.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,033.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,033.76
|
| Rate for Payer: BCBS MAPPO |
$13,627.01
|
| Rate for Payer: BCN Medicare Advantage |
$13,627.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,627.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,627.01
|
| Rate for Payer: Mclaren Medicare |
$13,627.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,308.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,671.06
|
| Rate for Payer: PACE Medicare |
$12,945.66
|
| Rate for Payer: PACE SWMI |
$13,627.01
|
| Rate for Payer: PHP Commercial |
$14,989.71
|
| Rate for Payer: PHP Medicare Advantage |
$13,627.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,117.24
|
| Rate for Payer: Priority Health Medicare |
$13,627.01
|
| Rate for Payer: Priority Health Narrow Network |
$14,493.79
|
| Rate for Payer: Railroad Medicare Medicare |
$13,627.01
|
| Rate for Payer: UHC Medicare Advantage |
$14,035.82
|
| Rate for Payer: VA VA |
$13,627.01
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$22,056.55
|
|
|
Service Code
|
MS-DRG 354
|
| Min. Negotiated Rate |
$15,413.28 |
| Max. Negotiated Rate |
$22,056.55 |
| Rate for Payer: Aetna Medicare |
$16,224.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,280.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,280.64
|
| Rate for Payer: BCBS MAPPO |
$16,224.51
|
| Rate for Payer: BCN Medicare Advantage |
$16,224.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,224.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$16,224.51
|
| Rate for Payer: Mclaren Medicare |
$16,224.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,035.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,658.19
|
| Rate for Payer: PACE Medicare |
$15,413.28
|
| Rate for Payer: PACE SWMI |
$16,224.51
|
| Rate for Payer: PHP Commercial |
$17,846.96
|
| Rate for Payer: PHP Medicare Advantage |
$16,224.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,056.55
|
| Rate for Payer: Priority Health Medicare |
$16,224.51
|
| Rate for Payer: Priority Health Narrow Network |
$17,645.24
|
| Rate for Payer: Railroad Medicare Medicare |
$16,224.51
|
| Rate for Payer: UHC Medicare Advantage |
$16,711.25
|
| Rate for Payer: VA VA |
$16,224.51
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$37,548.01
|
|
|
Service Code
|
MS-DRG 353
|
| Min. Negotiated Rate |
$25,117.27 |
| Max. Negotiated Rate |
$37,548.01 |
| Rate for Payer: Aetna Medicare |
$26,439.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33,049.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33,049.04
|
| Rate for Payer: BCBS MAPPO |
$26,439.23
|
| Rate for Payer: BCN Medicare Advantage |
$26,439.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,439.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,439.23
|
| Rate for Payer: Mclaren Medicare |
$26,439.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,761.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,405.11
|
| Rate for Payer: PACE Medicare |
$25,117.27
|
| Rate for Payer: PACE SWMI |
$26,439.23
|
| Rate for Payer: PHP Commercial |
$29,083.15
|
| Rate for Payer: PHP Medicare Advantage |
$26,439.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,548.01
|
| Rate for Payer: Priority Health Medicare |
$26,439.23
|
| Rate for Payer: Priority Health Narrow Network |
$30,038.41
|
| Rate for Payer: Railroad Medicare Medicare |
$26,439.23
|
| Rate for Payer: UHC Medicare Advantage |
$27,232.41
|
| Rate for Payer: VA VA |
$26,439.23
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$17,495.78
|
|
|
Service Code
|
MS-DRG 355
|
| Min. Negotiated Rate |
$12,556.39 |
| Max. Negotiated Rate |
$17,495.78 |
| Rate for Payer: Aetna Medicare |
$13,217.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,521.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,521.56
|
| Rate for Payer: BCBS MAPPO |
$13,217.25
|
| Rate for Payer: BCN Medicare Advantage |
$13,217.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,217.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,217.25
|
| Rate for Payer: Mclaren Medicare |
$13,217.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,878.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,199.84
|
| Rate for Payer: PACE Medicare |
$12,556.39
|
| Rate for Payer: PACE SWMI |
$13,217.25
|
| Rate for Payer: PHP Commercial |
$14,538.98
|
| Rate for Payer: PHP Medicare Advantage |
$13,217.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,495.78
|
| Rate for Payer: Priority Health Medicare |
$13,217.25
|
| Rate for Payer: Priority Health Narrow Network |
$13,996.62
|
| Rate for Payer: Railroad Medicare Medicare |
$13,217.25
|
| Rate for Payer: UHC Medicare Advantage |
$13,613.77
|
| Rate for Payer: VA VA |
$13,217.25
|
|
|
HH CATHETER LEG STRAP BARD
|
Facility
|
OP
|
$12.47
|
|
|
Service Code
|
HCPCS A4334
|
| Hospital Charge Code |
27000598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.99 |
| Max. Negotiated Rate |
$12.47 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: ASR ASR |
$12.10
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$9.67
|
| Rate for Payer: BCN Commercial |
$9.67
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.47
|
| Rate for Payer: Healthscope Whirlpool |
$12.10
|
| Rate for Payer: Mclaren Commercial |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.35
|
| Rate for Payer: Priority Health Narrow Network |
$8.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.97
|
|
|
HH CATHETER LEG STRAP BARD
|
Facility
|
IP
|
$12.47
|
|
|
Service Code
|
HCPCS A4334
|
| Hospital Charge Code |
27000598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$12.47 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: ASR ASR |
$12.10
|
| Rate for Payer: BCBS Trust/PPO |
$9.67
|
| Rate for Payer: BCN Commercial |
$9.67
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.47
|
| Rate for Payer: Healthscope Whirlpool |
$12.10
|
| Rate for Payer: Mclaren Commercial |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.97
|
|
|
HH DRSG MEPILEX AG FOAM 4X4 EA
|
Facility
|
OP
|
$27.16
|
|
|
Service Code
|
HCPCS A6209
|
| Hospital Charge Code |
62300044
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$27.16 |
| Rate for Payer: Aetna Commercial |
$24.44
|
| Rate for Payer: ASR ASR |
$26.35
|
| Rate for Payer: BCBS Complete |
$10.86
|
| Rate for Payer: BCBS Trust/PPO |
$21.06
|
| Rate for Payer: BCN Commercial |
$21.06
|
| Rate for Payer: Cash Price |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$25.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$27.16
|
| Rate for Payer: Healthscope Whirlpool |
$26.35
|
| Rate for Payer: Mclaren Commercial |
$24.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.72
|
| Rate for Payer: Priority Health Narrow Network |
$19.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.90
|
|
|
HH DRSG MEPILEX AG FOAM 4X4 EA
|
Facility
|
IP
|
$27.16
|
|
|
Service Code
|
HCPCS A6209
|
| Hospital Charge Code |
62300044
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$27.16 |
| Rate for Payer: Aetna Commercial |
$24.44
|
| Rate for Payer: ASR ASR |
$26.35
|
| Rate for Payer: BCBS Trust/PPO |
$21.06
|
| Rate for Payer: BCN Commercial |
$21.06
|
| Rate for Payer: Cash Price |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$25.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$27.16
|
| Rate for Payer: Healthscope Whirlpool |
$26.35
|
| Rate for Payer: Mclaren Commercial |
$24.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.90
|
|
|
HH DRSG MEPILEX BORDER 4X4 EA
|
Facility
|
IP
|
$9.78
|
|
|
Service Code
|
HCPCS A6212
|
| Hospital Charge Code |
62300017
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$9.78 |
| Rate for Payer: Aetna Commercial |
$8.80
|
| Rate for Payer: ASR ASR |
$9.49
|
| Rate for Payer: BCBS Trust/PPO |
$7.58
|
| Rate for Payer: BCN Commercial |
$7.58
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Cofinity Commercial |
$9.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$9.78
|
| Rate for Payer: Healthscope Whirlpool |
$9.49
|
| Rate for Payer: Mclaren Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.61
|
|
|
HH DRSG MEPILEX BORDER 4X4 EA
|
Facility
|
OP
|
$9.78
|
|
|
Service Code
|
HCPCS A6212
|
| Hospital Charge Code |
62300017
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$9.78 |
| Rate for Payer: Aetna Commercial |
$8.80
|
| Rate for Payer: ASR ASR |
$9.49
|
| Rate for Payer: BCBS Complete |
$3.91
|
| Rate for Payer: BCBS Trust/PPO |
$7.58
|
| Rate for Payer: BCN Commercial |
$7.58
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Cofinity Commercial |
$9.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$9.78
|
| Rate for Payer: Healthscope Whirlpool |
$9.49
|
| Rate for Payer: Mclaren Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.90
|
| Rate for Payer: Priority Health Narrow Network |
$6.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.61
|
|
