|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
OP
|
$1,024.11
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$409.64 |
| Max. Negotiated Rate |
$1,024.11 |
| Rate for Payer: Aetna Commercial |
$921.70
|
| Rate for Payer: Aetna Medicare |
$512.05
|
| Rate for Payer: ASR ASR |
$993.39
|
| Rate for Payer: ASR Commercial |
$993.39
|
| Rate for Payer: BCBS Complete |
$409.64
|
| Rate for Payer: BCBS Trust/PPO |
$838.64
|
| 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: Priority Health HMO/PPO/Tiered Network |
$897.33
|
| Rate for Payer: Priority Health Narrow Network |
$717.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$901.22
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
OP
|
$1,277.63
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$511.05 |
| Max. Negotiated Rate |
$1,277.63 |
| Rate for Payer: Aetna Commercial |
$1,149.87
|
| Rate for Payer: Aetna Medicare |
$638.82
|
| Rate for Payer: ASR ASR |
$1,239.30
|
| Rate for Payer: ASR Commercial |
$1,239.30
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.25
|
| Rate for Payer: BCN Commercial |
$990.55
|
| Rate for Payer: Cash Price |
$1,022.10
|
| Rate for Payer: Cofinity Commercial |
$1,200.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,022.10
|
| Rate for Payer: Healthscope Commercial |
$1,277.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.30
|
| Rate for Payer: Mclaren Commercial |
$1,149.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.99
|
| Rate for Payer: Nomi Health Commercial |
$1,047.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,119.46
|
| Rate for Payer: Priority Health Narrow Network |
$895.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,124.31
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
IP
|
$1,277.63
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$830.46 |
| Max. Negotiated Rate |
$1,277.63 |
| Rate for Payer: Aetna Commercial |
$1,149.87
|
| Rate for Payer: ASR ASR |
$1,239.30
|
| Rate for Payer: ASR Commercial |
$1,239.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.14
|
| Rate for Payer: BCN Commercial |
$990.55
|
| Rate for Payer: Cash Price |
$1,022.10
|
| Rate for Payer: Cofinity Commercial |
$1,200.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,022.10
|
| Rate for Payer: Healthscope Commercial |
$1,277.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.30
|
| Rate for Payer: Mclaren Commercial |
$1,149.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.99
|
| Rate for Payer: Nomi Health Commercial |
$1,047.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,124.31
|
|
|
HC SP Z TRUE FILL
|
Facility
|
IP
|
$6,757.01
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,392.06 |
| Max. Negotiated Rate |
$6,757.01 |
| Rate for Payer: Aetna Commercial |
$6,081.31
|
| Rate for Payer: ASR ASR |
$6,554.30
|
| Rate for Payer: ASR Commercial |
$6,554.30
|
| Rate for Payer: BCBS Trust/PPO |
$5,506.29
|
| Rate for Payer: BCN Commercial |
$5,238.71
|
| Rate for Payer: Cash Price |
$5,405.61
|
| Rate for Payer: Cofinity Commercial |
$6,351.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.61
|
| Rate for Payer: Healthscope Commercial |
$6,757.01
|
| Rate for Payer: Healthscope Whirlpool |
$6,554.30
|
| Rate for Payer: Mclaren Commercial |
$6,081.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.46
|
| Rate for Payer: Nomi Health Commercial |
$5,540.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,392.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,946.17
|
|
|
HC SP Z TRUE FILL
|
Facility
|
OP
|
$6,757.01
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,702.80 |
| Max. Negotiated Rate |
$6,757.01 |
| Rate for Payer: Aetna Commercial |
$6,081.31
|
| Rate for Payer: Aetna Medicare |
$3,378.51
|
| Rate for Payer: ASR ASR |
$6,554.30
|
| Rate for Payer: ASR Commercial |
$6,554.30
|
| Rate for Payer: BCBS Complete |
$2,702.80
|
| Rate for Payer: BCBS Trust/PPO |
$5,533.32
|
| Rate for Payer: BCN Commercial |
$5,238.71
|
| Rate for Payer: Cash Price |
$5,405.61
|
| Rate for Payer: Cofinity Commercial |
$6,351.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.61
|
| Rate for Payer: Healthscope Commercial |
$6,757.01
|
| Rate for Payer: Healthscope Whirlpool |
$6,554.30
|
| Rate for Payer: Mclaren Commercial |
$6,081.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.46
|
| Rate for Payer: Nomi Health Commercial |
$5,540.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,392.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,920.49
|
| Rate for Payer: Priority Health Narrow Network |
$4,736.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,946.17
|
|
|
HC SQ ICD
|
Facility
|
IP
|
$56,418.24
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36,671.86 |
| Max. Negotiated Rate |
$56,418.24 |
| Rate for Payer: Aetna Commercial |
$50,776.42
|
| Rate for Payer: ASR ASR |
$54,725.69
|
| Rate for Payer: ASR Commercial |
$54,725.69
|
| Rate for Payer: BCBS Trust/PPO |
$45,975.22
|
| Rate for Payer: BCN Commercial |
$43,741.06
|
| Rate for Payer: Cash Price |
$45,134.59
|
| Rate for Payer: Cofinity Commercial |
$53,033.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45,134.59
|
| Rate for Payer: Healthscope Commercial |
$56,418.24
|
| Rate for Payer: Healthscope Whirlpool |
$54,725.69
|
| Rate for Payer: Mclaren Commercial |
$50,776.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,955.50
|
| Rate for Payer: Nomi Health Commercial |
$46,262.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36,671.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49,648.05
|
|
|
HC SQ ICD
|
Facility
|
OP
|
$56,418.24
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,567.30 |
| Max. Negotiated Rate |
$56,418.24 |
| Rate for Payer: Aetna Commercial |
$50,776.42
|
| Rate for Payer: Aetna Medicare |
$28,209.12
|
| Rate for Payer: ASR ASR |
$54,725.69
|
| Rate for Payer: ASR Commercial |
$54,725.69
|
| Rate for Payer: BCBS Complete |
$22,567.30
|
| Rate for Payer: BCBS Trust/PPO |
$46,200.90
|
| Rate for Payer: BCN Commercial |
$43,741.06
|
| Rate for Payer: Cash Price |
$45,134.59
|
| Rate for Payer: Cofinity Commercial |
$53,033.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45,134.59
|
| Rate for Payer: Healthscope Commercial |
$56,418.24
|
| Rate for Payer: Healthscope Whirlpool |
$54,725.69
|
| Rate for Payer: Mclaren Commercial |
$50,776.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,955.50
|
| Rate for Payer: Nomi Health Commercial |
$46,262.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36,671.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49,433.66
|
| Rate for Payer: Priority Health Narrow Network |
$39,549.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49,648.05
|
|
|
HC SQ ICD LEAD
|
Facility
|
OP
|
$14,662.50
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,865.00 |
| Max. Negotiated Rate |
$14,662.50 |
| Rate for Payer: Aetna Commercial |
$13,196.25
|
| Rate for Payer: Aetna Medicare |
$7,331.25
|
| Rate for Payer: ASR ASR |
$14,222.62
|
| Rate for Payer: ASR Commercial |
$14,222.62
|
| Rate for Payer: BCBS Complete |
$5,865.00
|
| Rate for Payer: BCBS Trust/PPO |
$12,007.12
|
| Rate for Payer: BCN Commercial |
$11,367.84
|
| Rate for Payer: Cash Price |
$11,730.00
|
| Rate for Payer: Cofinity Commercial |
$13,782.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,730.00
|
| Rate for Payer: Healthscope Commercial |
$14,662.50
|
| Rate for Payer: Healthscope Whirlpool |
$14,222.62
|
| Rate for Payer: Mclaren Commercial |
$13,196.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,463.12
|
| Rate for Payer: Nomi Health Commercial |
$12,023.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,530.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,847.28
|
| Rate for Payer: Priority Health Narrow Network |
$10,278.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,903.00
|
|
|
HC SQ ICD LEAD
|
Facility
|
IP
|
$14,662.50
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,530.62 |
| Max. Negotiated Rate |
$14,662.50 |
| Rate for Payer: Aetna Commercial |
$13,196.25
|
| Rate for Payer: ASR ASR |
$14,222.62
|
| Rate for Payer: ASR Commercial |
$14,222.62
|
| Rate for Payer: BCBS Trust/PPO |
$11,948.47
|
| Rate for Payer: BCN Commercial |
$11,367.84
|
| Rate for Payer: Cash Price |
$11,730.00
|
| Rate for Payer: Cofinity Commercial |
$13,782.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,730.00
|
| Rate for Payer: Healthscope Commercial |
$14,662.50
|
| Rate for Payer: Healthscope Whirlpool |
$14,222.62
|
| Rate for Payer: Mclaren Commercial |
$13,196.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,463.12
|
| Rate for Payer: Nomi Health Commercial |
$12,023.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,530.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,903.00
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
OP
|
$246.51
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$246.51 |
| Rate for Payer: Aetna Commercial |
$221.86
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$239.11
|
| Rate for Payer: ASR Commercial |
$239.11
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$201.87
|
| Rate for Payer: BCN Commercial |
$191.12
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cofinity Commercial |
$231.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$246.51
|
| Rate for Payer: Healthscope Whirlpool |
$239.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$221.86
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.53
|
| Rate for Payer: Nomi Health Commercial |
$202.14
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.99
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$172.80
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
IP
|
$246.51
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$160.23 |
| Max. Negotiated Rate |
$246.51 |
| Rate for Payer: Aetna Commercial |
$221.86
|
| Rate for Payer: ASR ASR |
$239.11
|
| Rate for Payer: ASR Commercial |
$239.11
|
| Rate for Payer: BCBS Trust/PPO |
$200.88
|
| Rate for Payer: BCN Commercial |
$191.12
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cofinity Commercial |
$231.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.21
|
| Rate for Payer: Healthscope Commercial |
$246.51
|
| Rate for Payer: Healthscope Whirlpool |
$239.11
|
| Rate for Payer: Mclaren Commercial |
$221.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.53
|
| Rate for Payer: Nomi Health Commercial |
$202.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.93
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
OP
|
$498.94
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$449.05
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$483.97
|
| Rate for Payer: ASR Commercial |
$483.97
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$408.58
|
| Rate for Payer: BCN Commercial |
$386.83
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cofinity Commercial |
$469.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$498.94
|
| Rate for Payer: Healthscope Whirlpool |
$483.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$449.05
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.10
|
| Rate for Payer: Nomi Health Commercial |
$409.13
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.17
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$349.76
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
IP
|
$498.94
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$324.31 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$449.05
|
| Rate for Payer: ASR ASR |
$483.97
|
| Rate for Payer: ASR Commercial |
$483.97
|
| Rate for Payer: BCBS Trust/PPO |
$406.59
|
| Rate for Payer: BCN Commercial |
$386.83
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cofinity Commercial |
$469.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.15
|
| Rate for Payer: Healthscope Commercial |
$498.94
|
| Rate for Payer: Healthscope Whirlpool |
$483.97
|
| Rate for Payer: Mclaren Commercial |
$449.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.10
|
| Rate for Payer: Nomi Health Commercial |
$409.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$439.07
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
OP
|
$149.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$149.79 |
| Rate for Payer: Aetna Commercial |
$134.81
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.76
|
| Rate for Payer: ASR ASR |
$145.30
|
| Rate for Payer: ASR Commercial |
$145.30
|
| Rate for Payer: BCBS Complete |
$39.06
|
| Rate for Payer: BCBS MAPPO |
$69.41
|
| Rate for Payer: BCBS Trust/PPO |
$122.66
|
| Rate for Payer: BCN Commercial |
$116.13
|
| Rate for Payer: BCN Medicare Advantage |
$69.41
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.41
|
| Rate for Payer: Healthscope Commercial |
$149.79
|
| Rate for Payer: Healthscope Whirlpool |
$145.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.41
|
| Rate for Payer: Mclaren Commercial |
$134.81
|
| Rate for Payer: Mclaren Medicaid |
$37.20
|
| Rate for Payer: Mclaren Medicare |
$69.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.88
|
| Rate for Payer: Meridian Medicaid |
$39.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: PACE Medicare |
$65.94
|
| Rate for Payer: PACE SWMI |
$69.41
|
| Rate for Payer: PHP Commercial |
$76.35
|
| Rate for Payer: PHP Medicaid |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.25
|
| Rate for Payer: Priority Health Medicare |
$69.41
|
| Rate for Payer: Priority Health Narrow Network |
$105.00
|
| Rate for Payer: Railroad Medicare Medicare |
$69.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.41
|
| Rate for Payer: UHC Exchange |
$107.59
|
| Rate for Payer: UHC Medicare Advantage |
$69.41
|
| Rate for Payer: UHCCP DNSP |
$69.41
|
| Rate for Payer: UHCCP Medicaid |
$37.20
|
| Rate for Payer: VA VA |
$69.41
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
IP
|
$149.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$97.36 |
| Max. Negotiated Rate |
$149.79 |
| Rate for Payer: Aetna Commercial |
$134.81
|
| Rate for Payer: ASR ASR |
$145.30
|
| Rate for Payer: ASR Commercial |
$145.30
|
| Rate for Payer: BCBS Trust/PPO |
$122.06
|
| Rate for Payer: BCN Commercial |
$116.13
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Healthscope Commercial |
$149.79
|
| Rate for Payer: Healthscope Whirlpool |
$145.30
|
| Rate for Payer: Mclaren Commercial |
$134.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.82
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$332.93 |
| Rate for Payer: Aetna Commercial |
$299.64
|
| Rate for Payer: Aetna Medicare |
$18.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: ASR ASR |
$322.94
|
| Rate for Payer: ASR Commercial |
$322.94
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$272.64
|
| Rate for Payer: BCN Commercial |
$258.12
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$312.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$332.93
|
| Rate for Payer: Healthscope Whirlpool |
$322.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.37
|
| Rate for Payer: Mclaren Commercial |
$299.64
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$20.21
|
| Rate for Payer: PHP Medicaid |
$9.85
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.71
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$233.38
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$28.47
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP DNSP |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: VA VA |
$18.37
|
|
|
HC SRA, LMWH
|
Facility
|
IP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$216.40 |
| Max. Negotiated Rate |
$332.93 |
| Rate for Payer: Aetna Commercial |
$299.64
|
| Rate for Payer: ASR ASR |
$322.94
|
| Rate for Payer: ASR Commercial |
$322.94
|
| Rate for Payer: BCBS Trust/PPO |
$271.30
|
| Rate for Payer: BCN Commercial |
$258.12
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$312.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Healthscope Commercial |
$332.93
|
| Rate for Payer: Healthscope Whirlpool |
$322.94
|
| Rate for Payer: Mclaren Commercial |
$299.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$292.98
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,015.93 |
| Max. Negotiated Rate |
$11,556.06 |
| Rate for Payer: Aetna Commercial |
$2,791.29
|
| Rate for Payer: Aetna Medicare |
$7,455.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,319.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,319.40
|
| Rate for Payer: ASR ASR |
$3,008.39
|
| Rate for Payer: ASR Commercial |
$3,008.39
|
| Rate for Payer: BCBS Complete |
$4,195.97
|
| Rate for Payer: BCBS MAPPO |
$7,455.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.76
|
| Rate for Payer: BCN Commercial |
$2,404.54
|
| Rate for Payer: BCN Medicare Advantage |
$7,455.52
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,915.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,455.52
|
| Rate for Payer: Healthscope Commercial |
$3,101.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,008.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,455.52
|
| Rate for Payer: Mclaren Commercial |
$2,791.29
|
| Rate for Payer: Mclaren Medicaid |
$3,996.16
|
| Rate for Payer: Mclaren Medicare |
$7,455.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,828.30
|
| Rate for Payer: Meridian Medicaid |
$4,195.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: PACE Medicare |
$7,082.74
|
| Rate for Payer: PACE SWMI |
$7,455.52
|
| Rate for Payer: PHP Commercial |
$8,201.07
|
| Rate for Payer: PHP Medicaid |
$3,996.16
|
| Rate for Payer: PHP Medicare Advantage |
$7,455.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,996.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,717.47
|
| Rate for Payer: Priority Health Medicare |
$7,455.52
|
| Rate for Payer: Priority Health Narrow Network |
$2,174.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7,455.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,729.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,455.52
|
| Rate for Payer: UHC Exchange |
$11,556.06
|
| Rate for Payer: UHC Medicare Advantage |
$7,455.52
|
| Rate for Payer: UHCCP DNSP |
$7,455.52
|
| Rate for Payer: UHCCP Medicaid |
$3,996.16
|
| Rate for Payer: VA VA |
$7,455.52
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,015.93 |
| Max. Negotiated Rate |
$3,101.43 |
| Rate for Payer: Aetna Commercial |
$2,791.29
|
| Rate for Payer: ASR ASR |
$3,008.39
|
| Rate for Payer: ASR Commercial |
$3,008.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.36
|
| Rate for Payer: BCN Commercial |
$2,404.54
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,915.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Healthscope Commercial |
$3,101.43
|
| Rate for Payer: Healthscope Whirlpool |
$3,008.39
|
| Rate for Payer: Mclaren Commercial |
$2,791.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,729.26
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,448.93 |
| Max. Negotiated Rate |
$5,306.04 |
| Rate for Payer: Aetna Commercial |
$4,775.44
|
| Rate for Payer: ASR ASR |
$5,146.86
|
| Rate for Payer: ASR Commercial |
$5,146.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,323.89
|
| Rate for Payer: BCN Commercial |
$4,113.77
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,987.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Commercial |
$5,306.04
|
| Rate for Payer: Healthscope Whirlpool |
$5,146.86
|
| Rate for Payer: Mclaren Commercial |
$4,775.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,669.32
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$917.90 |
| Max. Negotiated Rate |
$5,306.04 |
| Rate for Payer: Aetna Commercial |
$4,775.44
|
| Rate for Payer: Aetna Medicare |
$1,712.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,140.62
|
| Rate for Payer: ASR ASR |
$5,146.86
|
| Rate for Payer: ASR Commercial |
$5,146.86
|
| Rate for Payer: BCBS Complete |
$963.79
|
| Rate for Payer: BCBS MAPPO |
$1,712.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,345.12
|
| Rate for Payer: BCN Commercial |
$4,113.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,712.50
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,987.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,712.50
|
| Rate for Payer: Healthscope Commercial |
$5,306.04
|
| Rate for Payer: Healthscope Whirlpool |
$5,146.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,712.50
|
| Rate for Payer: Mclaren Commercial |
$4,775.44
|
| Rate for Payer: Mclaren Medicaid |
$917.90
|
| Rate for Payer: Mclaren Medicare |
$1,712.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,798.12
|
| Rate for Payer: Meridian Medicaid |
$963.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,969.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: PACE Medicare |
$1,626.88
|
| Rate for Payer: PACE SWMI |
$1,712.50
|
| Rate for Payer: PHP Commercial |
$1,883.75
|
| Rate for Payer: PHP Medicaid |
$917.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,712.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$917.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,649.15
|
| Rate for Payer: Priority Health Medicare |
$1,712.50
|
| Rate for Payer: Priority Health Narrow Network |
$3,719.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,712.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,669.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,712.50
|
| Rate for Payer: UHC Exchange |
$2,654.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,712.50
|
| Rate for Payer: UHCCP DNSP |
$1,712.50
|
| Rate for Payer: UHCCP Medicaid |
$917.90
|
| Rate for Payer: VA VA |
$1,712.50
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$72.93 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Aetna Commercial |
$100.98
|
| Rate for Payer: ASR ASR |
$108.83
|
| Rate for Payer: ASR Commercial |
$108.83
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$105.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$108.83
|
| Rate for Payer: Mclaren Commercial |
$100.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.74
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$100.98
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$108.83
|
| Rate for Payer: ASR Commercial |
$108.83
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$105.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$112.20
|
| Rate for Payer: Healthscope Whirlpool |
$108.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$100.98
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.31
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$78.65
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$606.64 |
| Max. Negotiated Rate |
$933.30 |
| Rate for Payer: Aetna Commercial |
$839.97
|
| Rate for Payer: ASR ASR |
$905.30
|
| Rate for Payer: ASR Commercial |
$905.30
|
| Rate for Payer: BCBS Trust/PPO |
$760.55
|
| Rate for Payer: BCN Commercial |
$723.59
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$877.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$933.30
|
| Rate for Payer: Healthscope Whirlpool |
$905.30
|
| Rate for Payer: Mclaren Commercial |
$839.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: Nomi Health Commercial |
$765.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.30
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$373.32 |
| Max. Negotiated Rate |
$933.30 |
| Rate for Payer: Aetna Commercial |
$839.97
|
| Rate for Payer: Aetna Medicare |
$466.65
|
| Rate for Payer: ASR ASR |
$905.30
|
| Rate for Payer: ASR Commercial |
$905.30
|
| Rate for Payer: BCBS Complete |
$373.32
|
| Rate for Payer: BCBS Trust/PPO |
$764.28
|
| Rate for Payer: BCN Commercial |
$723.59
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$877.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$933.30
|
| Rate for Payer: Healthscope Whirlpool |
$905.30
|
| Rate for Payer: Mclaren Commercial |
$839.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: Nomi Health Commercial |
$765.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.76
|
| Rate for Payer: Priority Health Narrow Network |
$654.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$821.30
|
|
