|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$14.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.01
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$8.11
|
| Rate for Payer: BCBS MAPPO |
$14.41
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$14.41
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.41
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.41
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$7.72
|
| Rate for Payer: Mclaren Medicare |
$14.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.13
|
| Rate for Payer: Meridian Medicaid |
$8.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$13.69
|
| Rate for Payer: PACE SWMI |
$14.41
|
| Rate for Payer: PHP Commercial |
$15.85
|
| Rate for Payer: PHP Medicaid |
$7.72
|
| Rate for Payer: PHP Medicare Advantage |
$14.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.47
|
| Rate for Payer: Priority Health Medicare |
$14.41
|
| Rate for Payer: Priority Health Narrow Network |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.41
|
| Rate for Payer: UHC Exchange |
$22.34
|
| Rate for Payer: UHC Medicare Advantage |
$14.41
|
| Rate for Payer: UHCCP DNSP |
$14.41
|
| Rate for Payer: UHCCP Medicaid |
$7.72
|
| Rate for Payer: VA VA |
$14.41
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$344.16 |
| Max. Negotiated Rate |
$529.47 |
| Rate for Payer: Aetna Commercial |
$476.52
|
| Rate for Payer: ASR ASR |
$513.59
|
| Rate for Payer: ASR Commercial |
$513.59
|
| Rate for Payer: BCBS Trust/PPO |
$431.47
|
| Rate for Payer: BCN Commercial |
$410.50
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$497.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Healthscope Commercial |
$529.47
|
| Rate for Payer: Healthscope Whirlpool |
$513.59
|
| Rate for Payer: Mclaren Commercial |
$476.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$434.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.93
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$249.87 |
| Max. Negotiated Rate |
$722.56 |
| Rate for Payer: Aetna Commercial |
$476.52
|
| Rate for Payer: Aetna Medicare |
$466.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.71
|
| Rate for Payer: ASR ASR |
$513.59
|
| Rate for Payer: ASR Commercial |
$513.59
|
| Rate for Payer: BCBS Complete |
$262.36
|
| Rate for Payer: BCBS MAPPO |
$466.17
|
| Rate for Payer: BCBS Trust/PPO |
$433.58
|
| Rate for Payer: BCN Commercial |
$410.50
|
| Rate for Payer: BCN Medicare Advantage |
$466.17
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$497.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.17
|
| Rate for Payer: Healthscope Commercial |
$529.47
|
| Rate for Payer: Healthscope Whirlpool |
$513.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$466.17
|
| Rate for Payer: Mclaren Commercial |
$476.52
|
| Rate for Payer: Mclaren Medicaid |
$249.87
|
| Rate for Payer: Mclaren Medicare |
$466.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.48
|
| Rate for Payer: Meridian Medicaid |
$262.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$434.17
|
| Rate for Payer: PACE Medicare |
$442.86
|
| Rate for Payer: PACE SWMI |
$466.17
|
| Rate for Payer: PHP Commercial |
$512.79
|
| Rate for Payer: PHP Medicaid |
$249.87
|
| Rate for Payer: PHP Medicare Advantage |
$466.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.92
|
| Rate for Payer: Priority Health Medicare |
$466.17
|
| Rate for Payer: Priority Health Narrow Network |
$371.16
|
| Rate for Payer: Railroad Medicare Medicare |
$466.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.17
|
| Rate for Payer: UHC Exchange |
$722.56
|
| Rate for Payer: UHC Medicare Advantage |
$466.17
|
| Rate for Payer: UHCCP DNSP |
$466.17
|
| Rate for Payer: UHCCP Medicaid |
$249.87
|
| Rate for Payer: VA VA |
$466.17
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$119.73 |
| Max. Negotiated Rate |
$299.32 |
| Rate for Payer: Aetna Commercial |
$269.39
|
| Rate for Payer: Aetna Medicare |
$149.66
|
| Rate for Payer: ASR ASR |
$290.34
|
| Rate for Payer: ASR Commercial |
$290.34
|
| Rate for Payer: BCBS Complete |
$119.73
|
| Rate for Payer: BCBS Trust/PPO |
$245.11
|
| Rate for Payer: BCN Commercial |
$232.06
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$281.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$299.32
|
| Rate for Payer: Healthscope Whirlpool |
$290.34
|
| Rate for Payer: Mclaren Commercial |
$269.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: Nomi Health Commercial |
$245.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$262.26
|
| Rate for Payer: Priority Health Narrow Network |
$209.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.40
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$194.56 |
| Max. Negotiated Rate |
$299.32 |
| Rate for Payer: Aetna Commercial |
$269.39
|
| Rate for Payer: ASR ASR |
$290.34
|
| Rate for Payer: ASR Commercial |
$290.34
|
| Rate for Payer: BCBS Trust/PPO |
$243.92
|
| Rate for Payer: BCN Commercial |
$232.06
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$281.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$299.32
|
| Rate for Payer: Healthscope Whirlpool |
$290.34
|
| Rate for Payer: Mclaren Commercial |
$269.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: Nomi Health Commercial |
$245.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.40
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$861.90 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Commercial |
$1,193.40
|
| Rate for Payer: ASR ASR |
$1,286.22
|
| Rate for Payer: ASR Commercial |
$1,286.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.56
|
| Rate for Payer: BCN Commercial |
$1,028.05
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,246.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Healthscope Commercial |
$1,326.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,286.22
|
| Rate for Payer: Mclaren Commercial |
$1,193.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,087.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.88
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Commercial |
$1,193.40
|
| Rate for Payer: Aetna Medicare |
$496.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: ASR ASR |
$1,286.22
|
| Rate for Payer: ASR Commercial |
$1,286.22
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.86
|
| Rate for Payer: BCN Commercial |
$1,028.05
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,246.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,326.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,286.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$496.66
|
| Rate for Payer: Mclaren Commercial |
$1,193.40
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,087.32
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$546.33
|
| Rate for Payer: PHP Medicaid |
$266.21
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,161.84
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health Narrow Network |
$929.53
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,166.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$769.82
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP DNSP |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: VA VA |
$496.66
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,244.33 |
| Max. Negotiated Rate |
$8,068.20 |
| Rate for Payer: Aetna Commercial |
$7,261.38
|
| Rate for Payer: ASR ASR |
$7,826.15
|
| Rate for Payer: ASR Commercial |
$7,826.15
|
| Rate for Payer: BCBS Trust/PPO |
$6,574.78
|
| Rate for Payer: BCN Commercial |
$6,255.28
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$7,584.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Healthscope Commercial |
$8,068.20
|
| Rate for Payer: Healthscope Whirlpool |
$7,826.15
|
| Rate for Payer: Mclaren Commercial |
$7,261.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,615.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,100.02
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,068.20 |
| Rate for Payer: Aetna Commercial |
$7,261.38
|
| Rate for Payer: Aetna Medicare |
$3,162.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: ASR ASR |
$7,826.15
|
| Rate for Payer: ASR Commercial |
$7,826.15
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,607.05
|
| Rate for Payer: BCN Commercial |
$6,255.28
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$7,584.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,068.20
|
| Rate for Payer: Healthscope Whirlpool |
$7,826.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,162.90
|
| Rate for Payer: Mclaren Commercial |
$7,261.38
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,615.92
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,479.19
|
| Rate for Payer: PHP Medicaid |
$1,695.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,069.36
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health Narrow Network |
$5,655.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7,100.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$4,902.49
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP DNSP |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$329.90 |
| Max. Negotiated Rate |
$507.54 |
| Rate for Payer: Aetna Commercial |
$456.79
|
| Rate for Payer: ASR ASR |
$492.31
|
| Rate for Payer: ASR Commercial |
$492.31
|
| Rate for Payer: BCBS Trust/PPO |
$413.59
|
| Rate for Payer: BCN Commercial |
$393.50
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$477.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$507.54
|
| Rate for Payer: Healthscope Whirlpool |
$492.31
|
| Rate for Payer: Mclaren Commercial |
$456.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: Nomi Health Commercial |
$416.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.64
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$203.02 |
| Max. Negotiated Rate |
$507.54 |
| Rate for Payer: Aetna Commercial |
$456.79
|
| Rate for Payer: Aetna Medicare |
$253.77
|
| Rate for Payer: ASR ASR |
$492.31
|
| Rate for Payer: ASR Commercial |
$492.31
|
| Rate for Payer: BCBS Complete |
$203.02
|
| Rate for Payer: BCBS Trust/PPO |
$415.62
|
| Rate for Payer: BCN Commercial |
$393.50
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$477.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$507.54
|
| Rate for Payer: Healthscope Whirlpool |
$492.31
|
| Rate for Payer: Mclaren Commercial |
$456.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: Nomi Health Commercial |
$416.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$444.71
|
| Rate for Payer: Priority Health Narrow Network |
$355.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$446.64
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.41 |
| Max. Negotiated Rate |
$351.04 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna Medicare |
$226.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: ASR ASR |
$172.23
|
| Rate for Payer: ASR Commercial |
$172.23
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCBS Trust/PPO |
$145.40
|
| Rate for Payer: BCN Commercial |
$137.66
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$166.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$177.56
|
| Rate for Payer: Healthscope Whirlpool |
$172.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$226.48
|
| Rate for Payer: Mclaren Commercial |
$159.80
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$145.60
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$249.13
|
| Rate for Payer: PHP Medicaid |
$121.39
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.58
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health Narrow Network |
$124.47
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$351.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP DNSP |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$226.48
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.41 |
| Max. Negotiated Rate |
$177.56 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: ASR ASR |
$172.23
|
| Rate for Payer: ASR Commercial |
$172.23
|
| Rate for Payer: BCBS Trust/PPO |
$144.69
|
| Rate for Payer: BCN Commercial |
$137.66
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$166.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Healthscope Commercial |
$177.56
|
| Rate for Payer: Healthscope Whirlpool |
$172.23
|
| Rate for Payer: Mclaren Commercial |
$159.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$145.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.25
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$119.65 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Trust/PPO |
$97.50
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Mclaren Commercial |
$107.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.86 |
| Max. Negotiated Rate |
$119.65 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: Aetna Medicare |
$59.83
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$97.98
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Mclaren Commercial |
$107.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.84
|
| Rate for Payer: Priority Health Narrow Network |
$83.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$194.80 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: Aetna Medicare |
$125.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.10
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$125.68
|
| Rate for Payer: BCBS Trust/PPO |
$97.98
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: BCN Medicare Advantage |
$125.68
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.68
|
| Rate for Payer: Mclaren Commercial |
$107.69
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$125.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.96
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PACE Medicare |
$119.40
|
| Rate for Payer: PACE SWMI |
$125.68
|
| Rate for Payer: PHP Commercial |
$138.25
|
| Rate for Payer: PHP Medicaid |
$67.36
|
| Rate for Payer: PHP Medicare Advantage |
$125.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.84
|
| Rate for Payer: Priority Health Medicare |
$125.68
|
| Rate for Payer: Priority Health Narrow Network |
$83.87
|
| Rate for Payer: Railroad Medicare Medicare |
$125.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.68
|
| Rate for Payer: UHC Exchange |
$194.80
|
| Rate for Payer: UHC Medicare Advantage |
$125.68
|
| Rate for Payer: UHCCP DNSP |
$125.68
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: VA VA |
$125.68
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$119.65 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Trust/PPO |
$97.50
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Mclaren Commercial |
$107.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$119.65 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Trust/PPO |
$97.50
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Mclaren Commercial |
$107.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$194.80 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: Aetna Medicare |
$125.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.10
|
| Rate for Payer: ASR ASR |
$116.06
|
| Rate for Payer: ASR Commercial |
$116.06
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$125.68
|
| Rate for Payer: BCBS Trust/PPO |
$97.98
|
| Rate for Payer: BCN Commercial |
$92.76
|
| Rate for Payer: BCN Medicare Advantage |
$125.68
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$119.65
|
| Rate for Payer: Healthscope Whirlpool |
$116.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.68
|
| Rate for Payer: Mclaren Commercial |
$107.69
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$125.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.96
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PACE Medicare |
$119.40
|
| Rate for Payer: PACE SWMI |
$125.68
|
| Rate for Payer: PHP Commercial |
$138.25
|
| Rate for Payer: PHP Medicaid |
$67.36
|
| Rate for Payer: PHP Medicare Advantage |
$125.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.84
|
| Rate for Payer: Priority Health Medicare |
$125.68
|
| Rate for Payer: Priority Health Narrow Network |
$83.87
|
| Rate for Payer: Railroad Medicare Medicare |
$125.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.68
|
| Rate for Payer: UHC Exchange |
$194.80
|
| Rate for Payer: UHC Medicare Advantage |
$125.68
|
| Rate for Payer: UHCCP DNSP |
$125.68
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: VA VA |
$125.68
|
|
|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$24,969.60
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,230.24 |
| Max. Negotiated Rate |
$24,969.60 |
| Rate for Payer: Aetna Commercial |
$22,472.64
|
| Rate for Payer: ASR ASR |
$24,220.51
|
| Rate for Payer: ASR Commercial |
$24,220.51
|
| Rate for Payer: BCBS Trust/PPO |
$20,347.73
|
| Rate for Payer: BCN Commercial |
$19,358.93
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cofinity Commercial |
$23,471.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,975.68
|
| Rate for Payer: Healthscope Commercial |
$24,969.60
|
| Rate for Payer: Healthscope Whirlpool |
$24,220.51
|
| Rate for Payer: Mclaren Commercial |
$22,472.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,224.16
|
| Rate for Payer: Nomi Health Commercial |
$20,475.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,230.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,973.25
|
|
|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$24,969.60
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,969.45 |
| Max. Negotiated Rate |
$28,829.57 |
| Rate for Payer: Aetna Commercial |
$22,472.64
|
| Rate for Payer: Aetna Medicare |
$18,599.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,249.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,249.65
|
| Rate for Payer: ASR ASR |
$24,220.51
|
| Rate for Payer: ASR Commercial |
$24,220.51
|
| Rate for Payer: BCBS Complete |
$10,467.92
|
| Rate for Payer: BCBS MAPPO |
$18,599.72
|
| Rate for Payer: BCBS Trust/PPO |
$20,447.61
|
| Rate for Payer: BCN Commercial |
$19,358.93
|
| Rate for Payer: BCN Medicare Advantage |
$18,599.72
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cofinity Commercial |
$23,471.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,975.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,599.72
|
| Rate for Payer: Healthscope Commercial |
$24,969.60
|
| Rate for Payer: Healthscope Whirlpool |
$24,220.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,599.72
|
| Rate for Payer: Mclaren Commercial |
$22,472.64
|
| Rate for Payer: Mclaren Medicaid |
$9,969.45
|
| Rate for Payer: Mclaren Medicare |
$18,599.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,529.71
|
| Rate for Payer: Meridian Medicaid |
$10,467.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,389.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,224.16
|
| Rate for Payer: Nomi Health Commercial |
$20,475.07
|
| Rate for Payer: PACE Medicare |
$17,669.73
|
| Rate for Payer: PACE SWMI |
$18,599.72
|
| Rate for Payer: PHP Commercial |
$20,459.69
|
| Rate for Payer: PHP Medicaid |
$9,969.45
|
| Rate for Payer: PHP Medicare Advantage |
$18,599.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,969.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,230.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,878.36
|
| Rate for Payer: Priority Health Medicare |
$18,599.72
|
| Rate for Payer: Priority Health Narrow Network |
$17,503.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18,599.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21,973.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,599.72
|
| Rate for Payer: UHC Exchange |
$28,829.57
|
| Rate for Payer: UHC Medicare Advantage |
$18,599.72
|
| Rate for Payer: UHCCP DNSP |
$18,599.72
|
| Rate for Payer: UHCCP Medicaid |
$9,969.45
|
| Rate for Payer: VA VA |
$18,599.72
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
IP
|
$43,221.34
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$28,093.87 |
| Max. Negotiated Rate |
$43,221.34 |
| Rate for Payer: Aetna Commercial |
$38,899.21
|
| Rate for Payer: ASR ASR |
$41,924.70
|
| Rate for Payer: ASR Commercial |
$41,924.70
|
| Rate for Payer: BCBS Trust/PPO |
$35,221.07
|
| Rate for Payer: BCN Commercial |
$33,509.50
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cofinity Commercial |
$40,628.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34,577.07
|
| Rate for Payer: Healthscope Commercial |
$43,221.34
|
| Rate for Payer: Healthscope Whirlpool |
$41,924.70
|
| Rate for Payer: Mclaren Commercial |
$38,899.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,738.14
|
| Rate for Payer: Nomi Health Commercial |
$35,441.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,093.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38,034.78
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
OP
|
$43,221.34
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,288.54 |
| Max. Negotiated Rate |
$43,221.34 |
| Rate for Payer: Aetna Commercial |
$38,899.21
|
| Rate for Payer: Aetna Medicare |
$21,610.67
|
| Rate for Payer: ASR ASR |
$41,924.70
|
| Rate for Payer: ASR Commercial |
$41,924.70
|
| Rate for Payer: BCBS Complete |
$17,288.54
|
| Rate for Payer: BCBS Trust/PPO |
$35,393.96
|
| Rate for Payer: BCN Commercial |
$33,509.50
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cofinity Commercial |
$40,628.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34,577.07
|
| Rate for Payer: Healthscope Commercial |
$43,221.34
|
| Rate for Payer: Healthscope Whirlpool |
$41,924.70
|
| Rate for Payer: Mclaren Commercial |
$38,899.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,738.14
|
| Rate for Payer: Nomi Health Commercial |
$35,441.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,093.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37,870.54
|
| Rate for Payer: Priority Health Narrow Network |
$30,298.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38,034.78
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$3,891.10
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,529.22 |
| Max. Negotiated Rate |
$3,891.10 |
| Rate for Payer: Aetna Commercial |
$3,501.99
|
| Rate for Payer: ASR ASR |
$3,774.37
|
| Rate for Payer: ASR Commercial |
$3,774.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,170.86
|
| Rate for Payer: BCN Commercial |
$3,016.77
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cofinity Commercial |
$3,657.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.88
|
| Rate for Payer: Healthscope Commercial |
$3,891.10
|
| Rate for Payer: Healthscope Whirlpool |
$3,774.37
|
| Rate for Payer: Mclaren Commercial |
$3,501.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.43
|
| Rate for Payer: Nomi Health Commercial |
$3,190.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,424.17
|
|
