|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
OP
|
$97.10
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$63.12 |
| Max. Negotiated Rate |
$259.04 |
| Rate for Payer: Aetna Commercial |
$87.39
|
| Rate for Payer: Aetna Medicare |
$167.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: ASR ASR |
$94.19
|
| Rate for Payer: ASR Commercial |
$94.19
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCBS Trust/PPO |
$79.52
|
| Rate for Payer: BCN Commercial |
$75.28
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$91.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$97.10
|
| Rate for Payer: Healthscope Whirlpool |
$94.19
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.12
|
| Rate for Payer: Mclaren Commercial |
$87.39
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.53
|
| Rate for Payer: Nomi Health Commercial |
$79.62
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$183.83
|
| Rate for Payer: PHP Medicaid |
$89.58
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.08
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health Narrow Network |
$68.07
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Exchange |
$259.04
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP DNSP |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$89.58
|
| Rate for Payer: VA VA |
$167.12
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
IP
|
$97.10
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$63.12 |
| Max. Negotiated Rate |
$97.10 |
| Rate for Payer: Aetna Commercial |
$87.39
|
| Rate for Payer: ASR ASR |
$94.19
|
| Rate for Payer: ASR Commercial |
$94.19
|
| Rate for Payer: BCBS Trust/PPO |
$79.13
|
| Rate for Payer: BCN Commercial |
$75.28
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$91.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Healthscope Commercial |
$97.10
|
| Rate for Payer: Healthscope Whirlpool |
$94.19
|
| Rate for Payer: Mclaren Commercial |
$87.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.53
|
| Rate for Payer: Nomi Health Commercial |
$79.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.45
|
|
|
HC SPORE CHECK
|
Facility
|
IP
|
$23.26
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.12 |
| Max. Negotiated Rate |
$23.26 |
| Rate for Payer: Aetna Commercial |
$20.93
|
| Rate for Payer: ASR ASR |
$22.56
|
| Rate for Payer: ASR Commercial |
$22.56
|
| Rate for Payer: BCBS Trust/PPO |
$18.95
|
| Rate for Payer: BCN Commercial |
$18.03
|
| Rate for Payer: Cash Price |
$18.61
|
| Rate for Payer: Cofinity Commercial |
$21.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.61
|
| Rate for Payer: Healthscope Commercial |
$23.26
|
| Rate for Payer: Healthscope Whirlpool |
$22.56
|
| Rate for Payer: Mclaren Commercial |
$20.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.77
|
| Rate for Payer: Nomi Health Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.47
|
|
|
HC SPORE CHECK
|
Facility
|
OP
|
$23.26
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$23.26 |
| Rate for Payer: Aetna Commercial |
$20.93
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: ASR ASR |
$22.56
|
| Rate for Payer: ASR Commercial |
$22.56
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$19.05
|
| Rate for Payer: BCN Commercial |
$18.03
|
| Rate for Payer: Cash Price |
$18.61
|
| Rate for Payer: Cofinity Commercial |
$21.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.61
|
| Rate for Payer: Healthscope Commercial |
$23.26
|
| Rate for Payer: Healthscope Whirlpool |
$22.56
|
| Rate for Payer: Mclaren Commercial |
$20.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.77
|
| Rate for Payer: Nomi Health Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.38
|
| Rate for Payer: Priority Health Narrow Network |
$16.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.47
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
OP
|
$4,707.35
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$4,236.61
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,566.13
|
| Rate for Payer: ASR Commercial |
$4,566.13
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,854.85
|
| Rate for Payer: BCN Commercial |
$3,649.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cofinity Commercial |
$4,424.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,707.35
|
| Rate for Payer: Healthscope Whirlpool |
$4,566.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,236.61
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,001.25
|
| Rate for Payer: Nomi Health Commercial |
$3,860.03
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,059.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,124.58
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,299.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,142.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
IP
|
$4,707.35
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,059.78 |
| Max. Negotiated Rate |
$4,707.35 |
| Rate for Payer: Aetna Commercial |
$4,236.61
|
| Rate for Payer: ASR ASR |
$4,566.13
|
| Rate for Payer: ASR Commercial |
$4,566.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,836.02
|
| Rate for Payer: BCN Commercial |
$3,649.61
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cofinity Commercial |
$4,424.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.88
|
| Rate for Payer: Healthscope Commercial |
$4,707.35
|
| Rate for Payer: Healthscope Whirlpool |
$4,566.13
|
| Rate for Payer: Mclaren Commercial |
$4,236.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,001.25
|
| Rate for Payer: Nomi Health Commercial |
$3,860.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,059.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,142.47
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
IP
|
$3,767.45
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,448.84 |
| Max. Negotiated Rate |
$3,767.45 |
| Rate for Payer: Aetna Commercial |
$3,390.70
|
| Rate for Payer: ASR ASR |
$3,654.43
|
| Rate for Payer: ASR Commercial |
$3,654.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,070.10
|
| Rate for Payer: BCN Commercial |
$2,920.90
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cofinity Commercial |
$3,541.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.96
|
| Rate for Payer: Healthscope Commercial |
$3,767.45
|
| Rate for Payer: Healthscope Whirlpool |
$3,654.43
|
| Rate for Payer: Mclaren Commercial |
$3,390.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: Nomi Health Commercial |
$3,089.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.36
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
OP
|
$3,767.45
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,433.59 |
| Max. Negotiated Rate |
$4,145.63 |
| Rate for Payer: Aetna Commercial |
$3,390.70
|
| Rate for Payer: Aetna Medicare |
$2,674.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: ASR ASR |
$3,654.43
|
| Rate for Payer: ASR Commercial |
$3,654.43
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,085.16
|
| Rate for Payer: BCN Commercial |
$2,920.90
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cofinity Commercial |
$3,541.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$3,767.45
|
| Rate for Payer: Healthscope Whirlpool |
$3,654.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,674.60
|
| Rate for Payer: Mclaren Commercial |
$3,390.70
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: Nomi Health Commercial |
$3,089.31
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$2,942.06
|
| Rate for Payer: PHP Medicaid |
$1,433.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,301.04
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,640.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,315.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$4,145.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP DNSP |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
IP
|
$4,279.41
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,781.62 |
| Max. Negotiated Rate |
$4,279.41 |
| Rate for Payer: Aetna Commercial |
$3,851.47
|
| Rate for Payer: ASR ASR |
$4,151.03
|
| Rate for Payer: ASR Commercial |
$4,151.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,487.29
|
| Rate for Payer: BCN Commercial |
$3,317.83
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cofinity Commercial |
$4,022.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,423.53
|
| Rate for Payer: Healthscope Commercial |
$4,279.41
|
| Rate for Payer: Healthscope Whirlpool |
$4,151.03
|
| Rate for Payer: Mclaren Commercial |
$3,851.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,637.50
|
| Rate for Payer: Nomi Health Commercial |
$3,509.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,781.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,765.88
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
OP
|
$4,279.41
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,851.47
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,151.03
|
| Rate for Payer: ASR Commercial |
$4,151.03
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,504.41
|
| Rate for Payer: BCN Commercial |
$3,317.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cofinity Commercial |
$4,022.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,423.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,279.41
|
| Rate for Payer: Healthscope Whirlpool |
$4,151.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,851.47
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,637.50
|
| Rate for Payer: Nomi Health Commercial |
$3,509.12
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,781.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,749.62
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,999.87
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,765.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
OP
|
$696.30
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$696.30 |
| Rate for Payer: Aetna Commercial |
$626.67
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$675.41
|
| Rate for Payer: ASR Commercial |
$675.41
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$570.20
|
| Rate for Payer: BCN Commercial |
$539.84
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cofinity Commercial |
$654.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$696.30
|
| Rate for Payer: Healthscope Whirlpool |
$675.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$626.67
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: Nomi Health Commercial |
$570.97
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.10
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$488.11
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
IP
|
$696.30
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$452.60 |
| Max. Negotiated Rate |
$696.30 |
| Rate for Payer: Aetna Commercial |
$626.67
|
| Rate for Payer: ASR ASR |
$675.41
|
| Rate for Payer: ASR Commercial |
$675.41
|
| Rate for Payer: BCBS Trust/PPO |
$567.41
|
| Rate for Payer: BCN Commercial |
$539.84
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cofinity Commercial |
$654.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.04
|
| Rate for Payer: Healthscope Commercial |
$696.30
|
| Rate for Payer: Healthscope Whirlpool |
$675.41
|
| Rate for Payer: Mclaren Commercial |
$626.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: Nomi Health Commercial |
$570.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$612.74
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
IP
|
$1,096.38
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$712.65 |
| Max. Negotiated Rate |
$1,096.38 |
| Rate for Payer: Aetna Commercial |
$986.74
|
| Rate for Payer: ASR ASR |
$1,063.49
|
| Rate for Payer: ASR Commercial |
$1,063.49
|
| Rate for Payer: BCBS Trust/PPO |
$893.44
|
| Rate for Payer: BCN Commercial |
$850.02
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$1,030.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.10
|
| Rate for Payer: Healthscope Commercial |
$1,096.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.49
|
| Rate for Payer: Mclaren Commercial |
$986.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.92
|
| Rate for Payer: Nomi Health Commercial |
$899.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.81
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
OP
|
$1,096.38
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$438.55 |
| Max. Negotiated Rate |
$1,096.38 |
| Rate for Payer: Aetna Commercial |
$986.74
|
| Rate for Payer: Aetna Medicare |
$548.19
|
| Rate for Payer: ASR ASR |
$1,063.49
|
| Rate for Payer: ASR Commercial |
$1,063.49
|
| Rate for Payer: BCBS Complete |
$438.55
|
| Rate for Payer: BCBS Trust/PPO |
$897.83
|
| Rate for Payer: BCN Commercial |
$850.02
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$1,030.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.10
|
| Rate for Payer: Healthscope Commercial |
$1,096.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.49
|
| Rate for Payer: Mclaren Commercial |
$986.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.92
|
| Rate for Payer: Nomi Health Commercial |
$899.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.65
|
| Rate for Payer: Priority Health Narrow Network |
$768.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.81
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
IP
|
$6,262.87
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,070.87 |
| Max. Negotiated Rate |
$6,262.87 |
| Rate for Payer: Aetna Commercial |
$5,636.58
|
| Rate for Payer: ASR ASR |
$6,074.98
|
| Rate for Payer: ASR Commercial |
$6,074.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,103.61
|
| Rate for Payer: BCN Commercial |
$4,855.60
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cofinity Commercial |
$5,887.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.30
|
| Rate for Payer: Healthscope Commercial |
$6,262.87
|
| Rate for Payer: Healthscope Whirlpool |
$6,074.98
|
| Rate for Payer: Mclaren Commercial |
$5,636.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.44
|
| Rate for Payer: Nomi Health Commercial |
$5,135.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,511.33
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
OP
|
$6,262.87
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,505.15 |
| Max. Negotiated Rate |
$6,262.87 |
| Rate for Payer: Aetna Commercial |
$5,636.58
|
| Rate for Payer: Aetna Medicare |
$3,131.43
|
| Rate for Payer: ASR ASR |
$6,074.98
|
| Rate for Payer: ASR Commercial |
$6,074.98
|
| Rate for Payer: BCBS Complete |
$2,505.15
|
| Rate for Payer: BCBS Trust/PPO |
$5,128.66
|
| Rate for Payer: BCN Commercial |
$4,855.60
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cofinity Commercial |
$5,887.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.30
|
| Rate for Payer: Healthscope Commercial |
$6,262.87
|
| Rate for Payer: Healthscope Whirlpool |
$6,074.98
|
| Rate for Payer: Mclaren Commercial |
$5,636.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.44
|
| Rate for Payer: Nomi Health Commercial |
$5,135.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,487.53
|
| Rate for Payer: Priority Health Narrow Network |
$4,390.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,511.33
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
OP
|
$2,444.83
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$977.93 |
| Max. Negotiated Rate |
$2,444.83 |
| Rate for Payer: Aetna Commercial |
$2,200.35
|
| Rate for Payer: Aetna Medicare |
$1,222.41
|
| Rate for Payer: ASR ASR |
$2,371.49
|
| Rate for Payer: ASR Commercial |
$2,371.49
|
| Rate for Payer: BCBS Complete |
$977.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,002.07
|
| Rate for Payer: BCN Commercial |
$1,895.48
|
| Rate for Payer: Cash Price |
$1,955.86
|
| Rate for Payer: Cofinity Commercial |
$2,298.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,955.86
|
| Rate for Payer: Healthscope Commercial |
$2,444.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,371.49
|
| Rate for Payer: Mclaren Commercial |
$2,200.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.11
|
| Rate for Payer: Nomi Health Commercial |
$2,004.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,589.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,142.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,713.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,151.45
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
IP
|
$2,444.83
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,589.14 |
| Max. Negotiated Rate |
$2,444.83 |
| Rate for Payer: Aetna Commercial |
$2,200.35
|
| Rate for Payer: ASR ASR |
$2,371.49
|
| Rate for Payer: ASR Commercial |
$2,371.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,992.29
|
| Rate for Payer: BCN Commercial |
$1,895.48
|
| Rate for Payer: Cash Price |
$1,955.86
|
| Rate for Payer: Cofinity Commercial |
$2,298.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,955.86
|
| Rate for Payer: Healthscope Commercial |
$2,444.83
|
| Rate for Payer: Healthscope Whirlpool |
$2,371.49
|
| Rate for Payer: Mclaren Commercial |
$2,200.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.11
|
| Rate for Payer: Nomi Health Commercial |
$2,004.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,589.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,151.45
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$3,849.48 |
| Rate for Payer: Aetna Commercial |
$3,464.53
|
| Rate for Payer: ASR ASR |
$3,734.00
|
| Rate for Payer: ASR Commercial |
$3,734.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,136.94
|
| Rate for Payer: BCN Commercial |
$2,984.50
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,618.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,849.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,734.00
|
| Rate for Payer: Mclaren Commercial |
$3,464.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,387.54
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,464.53
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$3,734.00
|
| Rate for Payer: ASR Commercial |
$3,734.00
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,152.34
|
| Rate for Payer: BCN Commercial |
$2,984.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,618.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,849.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,734.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,464.53
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,372.91
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,698.49
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,387.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$3,464.53
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$3,734.00
|
| Rate for Payer: ASR Commercial |
$3,734.00
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,152.34
|
| Rate for Payer: BCN Commercial |
$2,984.50
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,618.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,849.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,734.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$3,464.53
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,372.91
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,698.49
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,387.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$3,849.48 |
| Rate for Payer: Aetna Commercial |
$3,464.53
|
| Rate for Payer: ASR ASR |
$3,734.00
|
| Rate for Payer: ASR Commercial |
$3,734.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,136.94
|
| Rate for Payer: BCN Commercial |
$2,984.50
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,618.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,849.48
|
| Rate for Payer: Healthscope Whirlpool |
$3,734.00
|
| Rate for Payer: Mclaren Commercial |
$3,464.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,387.54
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.44 |
| Max. Negotiated Rate |
$414.53 |
| Rate for Payer: Aetna Commercial |
$373.08
|
| Rate for Payer: ASR ASR |
$402.09
|
| Rate for Payer: ASR Commercial |
$402.09
|
| Rate for Payer: BCBS Trust/PPO |
$337.80
|
| Rate for Payer: BCN Commercial |
$321.39
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$389.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$414.53
|
| Rate for Payer: Healthscope Whirlpool |
$402.09
|
| Rate for Payer: Mclaren Commercial |
$373.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.79
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$165.81 |
| Max. Negotiated Rate |
$414.53 |
| Rate for Payer: Aetna Commercial |
$373.08
|
| Rate for Payer: Aetna Medicare |
$207.26
|
| Rate for Payer: ASR ASR |
$402.09
|
| Rate for Payer: ASR Commercial |
$402.09
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: BCBS Trust/PPO |
$339.46
|
| Rate for Payer: BCN Commercial |
$321.39
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$389.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$414.53
|
| Rate for Payer: Healthscope Whirlpool |
$402.09
|
| Rate for Payer: Mclaren Commercial |
$373.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.21
|
| Rate for Payer: Priority Health Narrow Network |
$290.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$364.79
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
IP
|
$1,024.11
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.67 |
| Max. Negotiated Rate |
$1,024.11 |
| Rate for Payer: Aetna Commercial |
$921.70
|
| Rate for Payer: ASR ASR |
$993.39
|
| Rate for Payer: ASR Commercial |
$993.39
|
| Rate for Payer: BCBS Trust/PPO |
$834.55
|
| Rate for Payer: BCN Commercial |
$793.99
|
| Rate for Payer: Cash Price |
$819.29
|
| Rate for Payer: Cofinity Commercial |
$962.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.29
|
| Rate for Payer: Healthscope Commercial |
$1,024.11
|
| Rate for Payer: Healthscope Whirlpool |
$993.39
|
| Rate for Payer: Mclaren Commercial |
$921.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.49
|
| Rate for Payer: Nomi Health Commercial |
$839.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$901.22
|
|
