|
HC REPLACEMENT COMPLETE TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$3,292.89
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
36100135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,140.38 |
| Max. Negotiated Rate |
$3,292.89 |
| Rate for Payer: Aetna Commercial |
$2,963.60
|
| Rate for Payer: ASR ASR |
$3,194.10
|
| Rate for Payer: ASR Commercial |
$3,194.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.38
|
| Rate for Payer: BCN Commercial |
$2,552.98
|
| Rate for Payer: Cash Price |
$2,634.31
|
| Rate for Payer: Cofinity Commercial |
$3,095.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.31
|
| Rate for Payer: Healthscope Commercial |
$3,292.89
|
| Rate for Payer: Healthscope Whirlpool |
$3,194.10
|
| Rate for Payer: Mclaren Commercial |
$2,963.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.96
|
| Rate for Payer: Nomi Health Commercial |
$2,700.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,897.74
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
IP
|
$1,970.18
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.62 |
| Max. Negotiated Rate |
$1,970.18 |
| Rate for Payer: Aetna Commercial |
$1,773.16
|
| Rate for Payer: ASR ASR |
$1,911.07
|
| Rate for Payer: ASR Commercial |
$1,911.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,605.50
|
| Rate for Payer: BCN Commercial |
$1,527.48
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cofinity Commercial |
$1,851.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.14
|
| Rate for Payer: Healthscope Commercial |
$1,970.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,911.07
|
| Rate for Payer: Mclaren Commercial |
$1,773.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,674.65
|
| Rate for Payer: Nomi Health Commercial |
$1,615.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,733.76
|
|
|
HC REPLACEMENT OF PICC W IMAGING
|
Facility
|
OP
|
$1,970.18
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
36100138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,359.15 |
| Rate for Payer: Aetna Commercial |
$1,773.16
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$1,911.07
|
| Rate for Payer: ASR Commercial |
$1,911.07
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,613.38
|
| Rate for Payer: BCN Commercial |
$1,527.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cash Price |
$1,576.14
|
| Rate for Payer: Cofinity Commercial |
$1,851.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,970.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,911.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$1,773.16
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,674.65
|
| Rate for Payer: Nomi Health Commercial |
$1,615.55
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.27
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,733.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
OP
|
$1,064.33
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$324.69 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna Commercial |
$957.90
|
| Rate for Payer: Aetna Medicare |
$605.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: ASR ASR |
$1,032.40
|
| Rate for Payer: ASR Commercial |
$1,032.40
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$871.58
|
| Rate for Payer: BCN Commercial |
$825.18
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$1,000.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$1,064.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,032.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$605.76
|
| Rate for Payer: Mclaren Commercial |
$957.90
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: Nomi Health Commercial |
$872.75
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$666.34
|
| Rate for Payer: PHP Medicaid |
$324.69
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$691.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$932.57
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$746.10
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$936.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$938.93
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP DNSP |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: VA VA |
$605.76
|
|
|
HC REPLACEMENT OF PICC WO IMAGING
|
Facility
|
IP
|
$1,064.33
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
36100563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$691.81 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna Commercial |
$957.90
|
| Rate for Payer: ASR ASR |
$1,032.40
|
| Rate for Payer: ASR Commercial |
$1,032.40
|
| Rate for Payer: BCBS Trust/PPO |
$867.32
|
| Rate for Payer: BCN Commercial |
$825.18
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$1,000.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Healthscope Commercial |
$1,064.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,032.40
|
| Rate for Payer: Mclaren Commercial |
$957.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: Nomi Health Commercial |
$872.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$691.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$936.61
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
IP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,243.79 |
| Max. Negotiated Rate |
$21,913.52 |
| Rate for Payer: Aetna Commercial |
$19,722.17
|
| Rate for Payer: ASR ASR |
$21,256.11
|
| Rate for Payer: ASR Commercial |
$21,256.11
|
| Rate for Payer: BCBS Trust/PPO |
$17,857.33
|
| Rate for Payer: BCN Commercial |
$16,989.55
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$20,598.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Healthscope Commercial |
$21,913.52
|
| Rate for Payer: Healthscope Whirlpool |
$21,256.11
|
| Rate for Payer: Mclaren Commercial |
$19,722.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: Nomi Health Commercial |
$17,969.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,283.90
|
|
|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
OP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,243.79 |
| Max. Negotiated Rate |
$48,690.60 |
| Rate for Payer: Aetna Commercial |
$19,722.17
|
| Rate for Payer: Aetna Medicare |
$31,413.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,266.61
|
| Rate for Payer: ASR ASR |
$21,256.11
|
| Rate for Payer: ASR Commercial |
$21,256.11
|
| Rate for Payer: BCBS Complete |
$17,679.40
|
| Rate for Payer: BCBS MAPPO |
$31,413.29
|
| Rate for Payer: BCBS Trust/PPO |
$17,944.98
|
| Rate for Payer: BCN Commercial |
$16,989.55
|
| Rate for Payer: BCN Medicare Advantage |
$31,413.29
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$20,598.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,413.29
|
| Rate for Payer: Healthscope Commercial |
$21,913.52
|
| Rate for Payer: Healthscope Whirlpool |
$21,256.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$31,413.29
|
| Rate for Payer: Mclaren Commercial |
$19,722.17
|
| Rate for Payer: Mclaren Medicaid |
$16,837.52
|
| Rate for Payer: Mclaren Medicare |
$31,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,983.95
|
| Rate for Payer: Meridian Medicaid |
$17,679.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,125.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: Nomi Health Commercial |
$17,969.09
|
| Rate for Payer: PACE Medicare |
$29,842.63
|
| Rate for Payer: PACE SWMI |
$31,413.29
|
| Rate for Payer: PHP Commercial |
$34,554.62
|
| Rate for Payer: PHP Medicaid |
$16,837.52
|
| Rate for Payer: PHP Medicare Advantage |
$31,413.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,837.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,200.63
|
| Rate for Payer: Priority Health Medicare |
$31,413.29
|
| Rate for Payer: Priority Health Narrow Network |
$15,361.38
|
| Rate for Payer: Railroad Medicare Medicare |
$31,413.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19,283.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,413.29
|
| Rate for Payer: UHC Exchange |
$48,690.60
|
| Rate for Payer: UHC Medicare Advantage |
$31,413.29
|
| Rate for Payer: UHCCP DNSP |
$31,413.29
|
| Rate for Payer: UHCCP Medicaid |
$16,837.52
|
| Rate for Payer: VA VA |
$31,413.29
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
OP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,015.45 |
| Max. Negotiated Rate |
$28,962.59 |
| Rate for Payer: Aetna Commercial |
$16,632.36
|
| Rate for Payer: Aetna Medicare |
$18,685.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,356.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,356.92
|
| Rate for Payer: ASR ASR |
$17,925.99
|
| Rate for Payer: ASR Commercial |
$17,925.99
|
| Rate for Payer: BCBS Complete |
$10,516.22
|
| Rate for Payer: BCBS MAPPO |
$18,685.54
|
| Rate for Payer: BCBS Trust/PPO |
$15,133.60
|
| Rate for Payer: BCN Commercial |
$14,327.85
|
| Rate for Payer: BCN Medicare Advantage |
$18,685.54
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$17,371.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,685.54
|
| Rate for Payer: Healthscope Commercial |
$18,480.40
|
| Rate for Payer: Healthscope Whirlpool |
$17,925.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,685.54
|
| Rate for Payer: Mclaren Commercial |
$16,632.36
|
| Rate for Payer: Mclaren Medicaid |
$10,015.45
|
| Rate for Payer: Mclaren Medicare |
$18,685.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,619.82
|
| Rate for Payer: Meridian Medicaid |
$10,516.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,488.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: Nomi Health Commercial |
$15,153.93
|
| Rate for Payer: PACE Medicare |
$17,751.26
|
| Rate for Payer: PACE SWMI |
$18,685.54
|
| Rate for Payer: PHP Commercial |
$20,554.09
|
| Rate for Payer: PHP Medicaid |
$10,015.45
|
| Rate for Payer: PHP Medicare Advantage |
$18,685.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,015.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,192.53
|
| Rate for Payer: Priority Health Medicare |
$18,685.54
|
| Rate for Payer: Priority Health Narrow Network |
$12,954.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,685.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,262.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,685.54
|
| Rate for Payer: UHC Exchange |
$28,962.59
|
| Rate for Payer: UHC Medicare Advantage |
$18,685.54
|
| Rate for Payer: UHCCP DNSP |
$18,685.54
|
| Rate for Payer: UHCCP Medicaid |
$10,015.45
|
| Rate for Payer: VA VA |
$18,685.54
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
IP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,012.26 |
| Max. Negotiated Rate |
$18,480.40 |
| Rate for Payer: Aetna Commercial |
$16,632.36
|
| Rate for Payer: ASR ASR |
$17,925.99
|
| Rate for Payer: ASR Commercial |
$17,925.99
|
| Rate for Payer: BCBS Trust/PPO |
$15,059.68
|
| Rate for Payer: BCN Commercial |
$14,327.85
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$17,371.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Healthscope Commercial |
$18,480.40
|
| Rate for Payer: Healthscope Whirlpool |
$17,925.99
|
| Rate for Payer: Mclaren Commercial |
$16,632.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: Nomi Health Commercial |
$15,153.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,262.75
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
OP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,622.93 |
| Max. Negotiated Rate |
$34,088.11 |
| Rate for Payer: Aetna Commercial |
$16,093.29
|
| Rate for Payer: Aetna Medicare |
$21,992.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,490.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,490.41
|
| Rate for Payer: ASR ASR |
$17,344.99
|
| Rate for Payer: ASR Commercial |
$17,344.99
|
| Rate for Payer: BCBS Complete |
$12,377.28
|
| Rate for Payer: BCBS MAPPO |
$21,992.33
|
| Rate for Payer: BCBS Trust/PPO |
$14,643.10
|
| Rate for Payer: BCN Commercial |
$13,863.47
|
| Rate for Payer: BCN Medicare Advantage |
$21,992.33
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$16,808.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,992.33
|
| Rate for Payer: Healthscope Commercial |
$17,881.43
|
| Rate for Payer: Healthscope Whirlpool |
$17,344.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,992.33
|
| Rate for Payer: Mclaren Commercial |
$16,093.29
|
| Rate for Payer: Mclaren Medicaid |
$11,787.89
|
| Rate for Payer: Mclaren Medicare |
$21,992.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,091.95
|
| Rate for Payer: Meridian Medicaid |
$12,377.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,291.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: Nomi Health Commercial |
$14,662.77
|
| Rate for Payer: PACE Medicare |
$20,892.71
|
| Rate for Payer: PACE SWMI |
$21,992.33
|
| Rate for Payer: PHP Commercial |
$24,191.56
|
| Rate for Payer: PHP Medicaid |
$11,787.89
|
| Rate for Payer: PHP Medicare Advantage |
$21,992.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,787.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,667.71
|
| Rate for Payer: Priority Health Medicare |
$21,992.33
|
| Rate for Payer: Priority Health Narrow Network |
$12,534.88
|
| Rate for Payer: Railroad Medicare Medicare |
$21,992.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,735.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,992.33
|
| Rate for Payer: UHC Exchange |
$34,088.11
|
| Rate for Payer: UHC Medicare Advantage |
$21,992.33
|
| Rate for Payer: UHCCP DNSP |
$21,992.33
|
| Rate for Payer: UHCCP Medicaid |
$11,787.89
|
| Rate for Payer: VA VA |
$21,992.33
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
IP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,622.93 |
| Max. Negotiated Rate |
$17,881.43 |
| Rate for Payer: Aetna Commercial |
$16,093.29
|
| Rate for Payer: ASR ASR |
$17,344.99
|
| Rate for Payer: ASR Commercial |
$17,344.99
|
| Rate for Payer: BCBS Trust/PPO |
$14,571.58
|
| Rate for Payer: BCN Commercial |
$13,863.47
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$16,808.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Healthscope Commercial |
$17,881.43
|
| Rate for Payer: Healthscope Whirlpool |
$17,344.99
|
| Rate for Payer: Mclaren Commercial |
$16,093.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: Nomi Health Commercial |
$14,662.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,735.66
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
IP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,917.70 |
| Max. Negotiated Rate |
$12,181.07 |
| Rate for Payer: Aetna Commercial |
$10,962.96
|
| Rate for Payer: ASR ASR |
$11,815.64
|
| Rate for Payer: ASR Commercial |
$11,815.64
|
| Rate for Payer: BCBS Trust/PPO |
$9,926.35
|
| Rate for Payer: BCN Commercial |
$9,443.98
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$11,450.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Healthscope Commercial |
$12,181.07
|
| Rate for Payer: Healthscope Whirlpool |
$11,815.64
|
| Rate for Payer: Mclaren Commercial |
$10,962.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: Nomi Health Commercial |
$9,988.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,719.34
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
OP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,346.23 |
| Max. Negotiated Rate |
$12,568.39 |
| Rate for Payer: Aetna Commercial |
$10,962.96
|
| Rate for Payer: Aetna Medicare |
$8,108.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,135.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,135.80
|
| Rate for Payer: ASR ASR |
$11,815.64
|
| Rate for Payer: ASR Commercial |
$11,815.64
|
| Rate for Payer: BCBS Complete |
$4,563.54
|
| Rate for Payer: BCBS MAPPO |
$8,108.64
|
| Rate for Payer: BCBS Trust/PPO |
$9,975.08
|
| Rate for Payer: BCN Commercial |
$9,443.98
|
| Rate for Payer: BCN Medicare Advantage |
$8,108.64
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$11,450.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,108.64
|
| Rate for Payer: Healthscope Commercial |
$12,181.07
|
| Rate for Payer: Healthscope Whirlpool |
$11,815.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$8,108.64
|
| Rate for Payer: Mclaren Commercial |
$10,962.96
|
| Rate for Payer: Mclaren Medicaid |
$4,346.23
|
| Rate for Payer: Mclaren Medicare |
$8,108.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,514.07
|
| Rate for Payer: Meridian Medicaid |
$4,563.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,324.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: Nomi Health Commercial |
$9,988.48
|
| Rate for Payer: PACE Medicare |
$7,703.21
|
| Rate for Payer: PACE SWMI |
$8,108.64
|
| Rate for Payer: PHP Commercial |
$8,919.50
|
| Rate for Payer: PHP Medicaid |
$4,346.23
|
| Rate for Payer: PHP Medicare Advantage |
$8,108.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,346.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,673.05
|
| Rate for Payer: Priority Health Medicare |
$8,108.64
|
| Rate for Payer: Priority Health Narrow Network |
$8,538.93
|
| Rate for Payer: Railroad Medicare Medicare |
$8,108.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,719.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,108.64
|
| Rate for Payer: UHC Exchange |
$12,568.39
|
| Rate for Payer: UHC Medicare Advantage |
$8,108.64
|
| Rate for Payer: UHCCP DNSP |
$8,108.64
|
| Rate for Payer: UHCCP Medicaid |
$4,346.23
|
| Rate for Payer: VA VA |
$8,108.64
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
IP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$23,550.14 |
| Max. Negotiated Rate |
$36,230.98 |
| Rate for Payer: Aetna Commercial |
$32,607.88
|
| Rate for Payer: ASR ASR |
$35,144.05
|
| Rate for Payer: ASR Commercial |
$35,144.05
|
| Rate for Payer: BCBS Trust/PPO |
$29,524.63
|
| Rate for Payer: BCN Commercial |
$28,089.88
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$34,057.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Healthscope Commercial |
$36,230.98
|
| Rate for Payer: Healthscope Whirlpool |
$35,144.05
|
| Rate for Payer: Mclaren Commercial |
$32,607.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: Nomi Health Commercial |
$29,709.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31,883.26
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
OP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,787.89 |
| Max. Negotiated Rate |
$36,230.98 |
| Rate for Payer: Aetna Commercial |
$32,607.88
|
| Rate for Payer: Aetna Medicare |
$21,992.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,490.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,490.41
|
| Rate for Payer: ASR ASR |
$35,144.05
|
| Rate for Payer: ASR Commercial |
$35,144.05
|
| Rate for Payer: BCBS Complete |
$12,377.28
|
| Rate for Payer: BCBS MAPPO |
$21,992.33
|
| Rate for Payer: BCBS Trust/PPO |
$29,669.55
|
| Rate for Payer: BCN Commercial |
$28,089.88
|
| Rate for Payer: BCN Medicare Advantage |
$21,992.33
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$34,057.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,992.33
|
| Rate for Payer: Healthscope Commercial |
$36,230.98
|
| Rate for Payer: Healthscope Whirlpool |
$35,144.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$21,992.33
|
| Rate for Payer: Mclaren Commercial |
$32,607.88
|
| Rate for Payer: Mclaren Medicaid |
$11,787.89
|
| Rate for Payer: Mclaren Medicare |
$21,992.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,091.95
|
| Rate for Payer: Meridian Medicaid |
$12,377.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,291.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: Nomi Health Commercial |
$29,709.40
|
| Rate for Payer: PACE Medicare |
$20,892.71
|
| Rate for Payer: PACE SWMI |
$21,992.33
|
| Rate for Payer: PHP Commercial |
$24,191.56
|
| Rate for Payer: PHP Medicaid |
$11,787.89
|
| Rate for Payer: PHP Medicare Advantage |
$21,992.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,787.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31,745.58
|
| Rate for Payer: Priority Health Medicare |
$21,992.33
|
| Rate for Payer: Priority Health Narrow Network |
$25,397.92
|
| Rate for Payer: Railroad Medicare Medicare |
$21,992.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31,883.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,992.33
|
| Rate for Payer: UHC Exchange |
$34,088.11
|
| Rate for Payer: UHC Medicare Advantage |
$21,992.33
|
| Rate for Payer: UHCCP DNSP |
$21,992.33
|
| Rate for Payer: UHCCP Medicaid |
$11,787.89
|
| Rate for Payer: VA VA |
$21,992.33
|
|
|
HC REPOSITION CVAC
|
Facility
|
IP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,630.73 |
| Max. Negotiated Rate |
$2,508.82 |
| Rate for Payer: Aetna Commercial |
$2,257.94
|
| Rate for Payer: ASR ASR |
$2,433.56
|
| Rate for Payer: ASR Commercial |
$2,433.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,044.44
|
| Rate for Payer: BCN Commercial |
$1,945.09
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$2,358.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Healthscope Commercial |
$2,508.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,433.56
|
| Rate for Payer: Mclaren Commercial |
$2,257.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: Nomi Health Commercial |
$2,057.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,207.76
|
|
|
HC REPOSITION CVAC
|
Facility
|
OP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$815.81 |
| Max. Negotiated Rate |
$2,508.82 |
| Rate for Payer: Aetna Commercial |
$2,257.94
|
| Rate for Payer: Aetna Medicare |
$1,522.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: ASR ASR |
$2,433.56
|
| Rate for Payer: ASR Commercial |
$2,433.56
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,054.47
|
| Rate for Payer: BCN Commercial |
$1,945.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$2,358.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$2,508.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,433.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,522.03
|
| Rate for Payer: Mclaren Commercial |
$2,257.94
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: Nomi Health Commercial |
$2,057.23
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,674.23
|
| Rate for Payer: PHP Medicaid |
$815.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,198.23
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,758.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,207.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$2,359.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP DNSP |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: VA VA |
$1,522.03
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$4,779.98 |
| Rate for Payer: Aetna Commercial |
$2,647.47
|
| Rate for Payer: Aetna Medicare |
$3,083.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: ASR ASR |
$2,853.38
|
| Rate for Payer: ASR Commercial |
$2,853.38
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,408.90
|
| Rate for Payer: BCN Commercial |
$2,280.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,765.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,941.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,853.38
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,083.86
|
| Rate for Payer: Mclaren Commercial |
$2,647.47
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: Nomi Health Commercial |
$2,412.14
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,392.25
|
| Rate for Payer: PHP Medicaid |
$1,652.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,577.46
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,062.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,588.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$4,779.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP DNSP |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,912.06 |
| Max. Negotiated Rate |
$2,941.63 |
| Rate for Payer: Aetna Commercial |
$2,647.47
|
| Rate for Payer: ASR ASR |
$2,853.38
|
| Rate for Payer: ASR Commercial |
$2,853.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,397.13
|
| Rate for Payer: BCN Commercial |
$2,280.65
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,765.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Healthscope Commercial |
$2,941.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,853.38
|
| Rate for Payer: Mclaren Commercial |
$2,647.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: Nomi Health Commercial |
$2,412.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,588.63
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$53.55
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Complete |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$87.70
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.84
|
| Rate for Payer: Priority Health Narrow Network |
$75.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.62 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: ASR ASR |
$103.89
|
| Rate for Payer: ASR Commercial |
$103.89
|
| Rate for Payer: BCBS Trust/PPO |
$87.28
|
| Rate for Payer: BCN Commercial |
$83.03
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Healthscope Whirlpool |
$103.89
|
| Rate for Payer: Mclaren Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.25
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.81
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.81
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
