|
HC ZINC URINE
|
Facility
|
IP
|
$71.37
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.53 |
| Max. Negotiated Rate |
$71.37 |
| Rate for Payer: Aetna Commercial |
$64.23
|
| Rate for Payer: ASR ASR |
$69.23
|
| Rate for Payer: BCBS Trust/PPO |
$58.61
|
| Rate for Payer: BCN Commercial |
$58.61
|
| Rate for Payer: Cash Price |
$57.10
|
| Rate for Payer: Cofinity Commercial |
$67.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.10
|
| Rate for Payer: Healthscope Commercial |
$69.23
|
| Rate for Payer: Healthscope Whirlpool |
$71.37
|
| Rate for Payer: Mclaren Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.66
|
| Rate for Payer: Nomi Health Commercial |
$58.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.81
|
|
|
HC ZINC URINE
|
Facility
|
OP
|
$71.37
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$71.37 |
| Rate for Payer: Aetna Commercial |
$64.23
|
| Rate for Payer: Aetna Medicare |
$11.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.24
|
| Rate for Payer: ASR ASR |
$69.23
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$11.39
|
| Rate for Payer: BCBS Trust/PPO |
$58.84
|
| Rate for Payer: BCN Commercial |
$58.84
|
| Rate for Payer: BCN Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$57.10
|
| Rate for Payer: Cash Price |
$57.10
|
| Rate for Payer: Cofinity Commercial |
$67.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.39
|
| Rate for Payer: Healthscope Commercial |
$69.23
|
| Rate for Payer: Healthscope Whirlpool |
$71.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.39
|
| Rate for Payer: Mclaren Commercial |
$64.23
|
| Rate for Payer: Mclaren Medicaid |
$11.39
|
| Rate for Payer: Mclaren Medicare |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.96
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.66
|
| Rate for Payer: Nomi Health Commercial |
$58.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.53
|
| Rate for Payer: PACE Medicare |
$10.82
|
| Rate for Payer: PACE SWMI |
$11.39
|
| Rate for Payer: PHP Commercial |
$12.53
|
| Rate for Payer: PHP Medicaid |
$6.11
|
| Rate for Payer: PHP Medicare Advantage |
$11.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.91
|
| Rate for Payer: Priority Health Medicare |
$11.39
|
| Rate for Payer: Priority Health Narrow Network |
$45.53
|
| Rate for Payer: Railroad Medicare Medicare |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$62.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.39
|
| Rate for Payer: UHC Exchange |
$17.65
|
| Rate for Payer: UHC Medicaid |
$5.96
|
| Rate for Payer: UHCCP DNSP |
$11.39
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: VA VA |
$11.39
|
|
|
HC Z INFUSION WIRE
|
Facility
|
OP
|
$892.35
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$330.17 |
| Max. Negotiated Rate |
$892.35 |
| Rate for Payer: Aetna Commercial |
$803.12
|
| Rate for Payer: Aetna Medicare |
$330.17
|
| Rate for Payer: ASR ASR |
$865.58
|
| Rate for Payer: BCBS Complete |
$356.94
|
| Rate for Payer: BCBS Trust/PPO |
$735.74
|
| Rate for Payer: BCN Commercial |
$735.74
|
| Rate for Payer: Cash Price |
$713.88
|
| Rate for Payer: Cofinity Commercial |
$838.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.88
|
| Rate for Payer: Healthscope Commercial |
$865.58
|
| Rate for Payer: Healthscope Whirlpool |
$892.35
|
| Rate for Payer: Mclaren Commercial |
$803.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$713.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.50
|
| Rate for Payer: Nomi Health Commercial |
$731.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$781.88
|
| Rate for Payer: Priority Health Narrow Network |
$625.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$785.27
|
|
|
HC Z INFUSION WIRE
|
Facility
|
IP
|
$892.35
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$669.26 |
| Max. Negotiated Rate |
$892.35 |
| Rate for Payer: Aetna Commercial |
$803.12
|
| Rate for Payer: ASR ASR |
$865.58
|
| Rate for Payer: BCBS Trust/PPO |
$732.80
|
| Rate for Payer: BCN Commercial |
$732.80
|
| Rate for Payer: Cash Price |
$713.88
|
| Rate for Payer: Cofinity Commercial |
$838.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.88
|
| Rate for Payer: Healthscope Commercial |
$865.58
|
| Rate for Payer: Healthscope Whirlpool |
$892.35
|
| Rate for Payer: Mclaren Commercial |
$803.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.50
|
| Rate for Payer: Nomi Health Commercial |
$731.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$785.27
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
OP
|
$13,401.24
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,958.46 |
| Max. Negotiated Rate |
$13,401.24 |
| Rate for Payer: Aetna Commercial |
$12,061.12
|
| Rate for Payer: Aetna Medicare |
$4,958.46
|
| Rate for Payer: ASR ASR |
$12,999.20
|
| Rate for Payer: BCBS Complete |
$5,360.50
|
| Rate for Payer: BCBS Trust/PPO |
$11,049.32
|
| Rate for Payer: BCN Commercial |
$11,049.32
|
| Rate for Payer: Cash Price |
$10,720.99
|
| Rate for Payer: Cofinity Commercial |
$12,597.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,720.99
|
| Rate for Payer: Healthscope Commercial |
$12,999.20
|
| Rate for Payer: Healthscope Whirlpool |
$13,401.24
|
| Rate for Payer: Mclaren Commercial |
$12,061.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,720.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,391.05
|
| Rate for Payer: Nomi Health Commercial |
$10,989.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,050.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,742.17
|
| Rate for Payer: Priority Health Narrow Network |
$9,394.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,793.09
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
IP
|
$13,401.24
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,050.93 |
| Max. Negotiated Rate |
$13,401.24 |
| Rate for Payer: Aetna Commercial |
$12,061.12
|
| Rate for Payer: ASR ASR |
$12,999.20
|
| Rate for Payer: BCBS Trust/PPO |
$11,005.10
|
| Rate for Payer: BCN Commercial |
$11,005.10
|
| Rate for Payer: Cash Price |
$10,720.99
|
| Rate for Payer: Cofinity Commercial |
$12,597.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,720.99
|
| Rate for Payer: Healthscope Commercial |
$12,999.20
|
| Rate for Payer: Healthscope Whirlpool |
$13,401.24
|
| Rate for Payer: Mclaren Commercial |
$12,061.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,391.05
|
| Rate for Payer: Nomi Health Commercial |
$10,989.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,050.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,793.09
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
OP
|
$335.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.26 |
| Max. Negotiated Rate |
$335.84 |
| Rate for Payer: Aetna Commercial |
$302.26
|
| Rate for Payer: Aetna Medicare |
$124.26
|
| Rate for Payer: ASR ASR |
$325.76
|
| Rate for Payer: BCBS Complete |
$134.34
|
| Rate for Payer: BCBS Trust/PPO |
$276.90
|
| Rate for Payer: BCN Commercial |
$276.90
|
| Rate for Payer: Cash Price |
$268.67
|
| Rate for Payer: Cofinity Commercial |
$315.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.67
|
| Rate for Payer: Healthscope Commercial |
$325.76
|
| Rate for Payer: Healthscope Whirlpool |
$335.84
|
| Rate for Payer: Mclaren Commercial |
$302.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.46
|
| Rate for Payer: Nomi Health Commercial |
$275.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$294.26
|
| Rate for Payer: Priority Health Narrow Network |
$235.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.54
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
IP
|
$335.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.88 |
| Max. Negotiated Rate |
$335.84 |
| Rate for Payer: Aetna Commercial |
$302.26
|
| Rate for Payer: ASR ASR |
$325.76
|
| Rate for Payer: BCBS Trust/PPO |
$275.79
|
| Rate for Payer: BCN Commercial |
$275.79
|
| Rate for Payer: Cash Price |
$268.67
|
| Rate for Payer: Cofinity Commercial |
$315.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.67
|
| Rate for Payer: Healthscope Commercial |
$325.76
|
| Rate for Payer: Healthscope Whirlpool |
$335.84
|
| Rate for Payer: Mclaren Commercial |
$302.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.46
|
| Rate for Payer: Nomi Health Commercial |
$275.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.54
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
IP
|
$3,851.00
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,888.25 |
| Max. Negotiated Rate |
$3,851.00 |
| Rate for Payer: Aetna Commercial |
$3,465.90
|
| Rate for Payer: ASR ASR |
$3,735.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,162.44
|
| Rate for Payer: BCN Commercial |
$3,162.44
|
| Rate for Payer: Cash Price |
$3,080.80
|
| Rate for Payer: Cofinity Commercial |
$3,619.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,080.80
|
| Rate for Payer: Healthscope Commercial |
$3,735.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,851.00
|
| Rate for Payer: Mclaren Commercial |
$3,465.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,273.35
|
| Rate for Payer: Nomi Health Commercial |
$3,157.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,888.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,388.88
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
OP
|
$3,851.00
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,424.87 |
| Max. Negotiated Rate |
$3,851.00 |
| Rate for Payer: Aetna Commercial |
$3,465.90
|
| Rate for Payer: Aetna Medicare |
$1,424.87
|
| Rate for Payer: ASR ASR |
$3,735.47
|
| Rate for Payer: BCBS Complete |
$1,540.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,175.15
|
| Rate for Payer: BCN Commercial |
$3,175.15
|
| Rate for Payer: Cash Price |
$3,080.80
|
| Rate for Payer: Cofinity Commercial |
$3,619.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,080.80
|
| Rate for Payer: Healthscope Commercial |
$3,735.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,851.00
|
| Rate for Payer: Mclaren Commercial |
$3,465.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,080.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,273.35
|
| Rate for Payer: Nomi Health Commercial |
$3,157.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,888.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,374.25
|
| Rate for Payer: Priority Health Narrow Network |
$2,699.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,388.88
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
OP
|
$791.29
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$292.78 |
| Max. Negotiated Rate |
$791.29 |
| Rate for Payer: Aetna Commercial |
$712.16
|
| Rate for Payer: Aetna Medicare |
$292.78
|
| Rate for Payer: ASR ASR |
$767.55
|
| Rate for Payer: BCBS Complete |
$316.52
|
| Rate for Payer: BCBS Trust/PPO |
$652.42
|
| Rate for Payer: BCN Commercial |
$652.42
|
| Rate for Payer: Cash Price |
$633.03
|
| Rate for Payer: Cofinity Commercial |
$743.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$633.03
|
| Rate for Payer: Healthscope Commercial |
$767.55
|
| Rate for Payer: Healthscope Whirlpool |
$791.29
|
| Rate for Payer: Mclaren Commercial |
$712.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$633.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.60
|
| Rate for Payer: Nomi Health Commercial |
$648.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$693.33
|
| Rate for Payer: Priority Health Narrow Network |
$554.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$696.34
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
IP
|
$791.29
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$593.47 |
| Max. Negotiated Rate |
$791.29 |
| Rate for Payer: Aetna Commercial |
$712.16
|
| Rate for Payer: ASR ASR |
$767.55
|
| Rate for Payer: BCBS Trust/PPO |
$649.81
|
| Rate for Payer: BCN Commercial |
$649.81
|
| Rate for Payer: Cash Price |
$633.03
|
| Rate for Payer: Cofinity Commercial |
$743.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$633.03
|
| Rate for Payer: Healthscope Commercial |
$767.55
|
| Rate for Payer: Healthscope Whirlpool |
$791.29
|
| Rate for Payer: Mclaren Commercial |
$712.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.60
|
| Rate for Payer: Nomi Health Commercial |
$648.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$696.34
|
|
|
HC ZONISAMIDE
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$64.34
|
| Rate for Payer: BCN Commercial |
$64.34
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$13.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$7.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.57
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.85
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$18.28
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.25
|
| Rate for Payer: UHC Exchange |
$20.54
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHCCP DNSP |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC ZONISAMIDE
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.52 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$64.08
|
| Rate for Payer: BCN Commercial |
$64.08
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$75.69
|
| Rate for Payer: Healthscope Whirlpool |
$78.03
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM
|
Facility
|
OP
|
$178.29
|
|
|
Service Code
|
CPT 90750
|
| Hospital Charge Code |
63600123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.97 |
| Max. Negotiated Rate |
$245.68 |
| Rate for Payer: Aetna Commercial |
$160.46
|
| Rate for Payer: Aetna Medicare |
$65.97
|
| Rate for Payer: ASR ASR |
$172.94
|
| Rate for Payer: BCBS Complete |
$71.32
|
| Rate for Payer: BCBS Trust/PPO |
$147.00
|
| Rate for Payer: BCN Commercial |
$147.00
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Commercial |
$167.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$172.94
|
| Rate for Payer: Healthscope Whirlpool |
$178.29
|
| Rate for Payer: Mclaren Commercial |
$160.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Nomi Health Commercial |
$146.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$245.68
|
| Rate for Payer: Priority Health Narrow Network |
$196.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.90
|
|
|
HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM
|
Facility
|
IP
|
$178.29
|
|
|
Service Code
|
CPT 90750
|
| Hospital Charge Code |
63600123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$133.72 |
| Max. Negotiated Rate |
$178.29 |
| Rate for Payer: Aetna Commercial |
$160.46
|
| Rate for Payer: ASR ASR |
$172.94
|
| Rate for Payer: BCBS Trust/PPO |
$146.41
|
| Rate for Payer: BCN Commercial |
$146.41
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Commercial |
$167.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$172.94
|
| Rate for Payer: Healthscope Whirlpool |
$178.29
|
| Rate for Payer: Mclaren Commercial |
$160.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Nomi Health Commercial |
$146.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.90
|
|
|
HC Z RETRIEVAL SNARE
|
Facility
|
OP
|
$1,359.49
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$503.01 |
| Max. Negotiated Rate |
$1,359.49 |
| Rate for Payer: Aetna Commercial |
$1,223.54
|
| Rate for Payer: Aetna Medicare |
$503.01
|
| Rate for Payer: ASR ASR |
$1,318.71
|
| Rate for Payer: BCBS Complete |
$543.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.90
|
| Rate for Payer: BCN Commercial |
$1,120.90
|
| Rate for Payer: Cash Price |
$1,087.59
|
| Rate for Payer: Cofinity Commercial |
$1,277.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,087.59
|
| Rate for Payer: Healthscope Commercial |
$1,318.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,359.49
|
| Rate for Payer: Mclaren Commercial |
$1,223.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,087.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,155.57
|
| Rate for Payer: Nomi Health Commercial |
$1,114.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,019.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,191.19
|
| Rate for Payer: Priority Health Narrow Network |
$953.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,196.35
|
|
|
HC Z RETRIEVAL SNARE
|
Facility
|
IP
|
$1,359.49
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,019.62 |
| Max. Negotiated Rate |
$1,359.49 |
| Rate for Payer: Aetna Commercial |
$1,223.54
|
| Rate for Payer: ASR ASR |
$1,318.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,116.41
|
| Rate for Payer: BCN Commercial |
$1,116.41
|
| Rate for Payer: Cash Price |
$1,087.59
|
| Rate for Payer: Cofinity Commercial |
$1,277.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,087.59
|
| Rate for Payer: Healthscope Commercial |
$1,318.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,359.49
|
| Rate for Payer: Mclaren Commercial |
$1,223.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,155.57
|
| Rate for Payer: Nomi Health Commercial |
$1,114.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,019.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,196.35
|
|
|
HC Z STENT URETERAL
|
Facility
|
OP
|
$1,237.12
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$457.73 |
| Max. Negotiated Rate |
$1,237.12 |
| Rate for Payer: Aetna Commercial |
$1,113.41
|
| Rate for Payer: Aetna Medicare |
$457.73
|
| Rate for Payer: ASR ASR |
$1,200.01
|
| Rate for Payer: BCBS Complete |
$494.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.01
|
| Rate for Payer: BCN Commercial |
$1,020.01
|
| Rate for Payer: Cash Price |
$989.70
|
| Rate for Payer: Cofinity Commercial |
$1,162.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.70
|
| Rate for Payer: Healthscope Commercial |
$1,200.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,237.12
|
| Rate for Payer: Mclaren Commercial |
$1,113.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$989.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.55
|
| Rate for Payer: Nomi Health Commercial |
$1,014.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,083.96
|
| Rate for Payer: Priority Health Narrow Network |
$867.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,088.67
|
|
|
HC Z STENT URETERAL
|
Facility
|
IP
|
$1,237.12
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$927.84 |
| Max. Negotiated Rate |
$1,237.12 |
| Rate for Payer: Aetna Commercial |
$1,113.41
|
| Rate for Payer: ASR ASR |
$1,200.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.92
|
| Rate for Payer: BCN Commercial |
$1,015.92
|
| Rate for Payer: Cash Price |
$989.70
|
| Rate for Payer: Cofinity Commercial |
$1,162.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.70
|
| Rate for Payer: Healthscope Commercial |
$1,200.01
|
| Rate for Payer: Healthscope Whirlpool |
$1,237.12
|
| Rate for Payer: Mclaren Commercial |
$1,113.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.55
|
| Rate for Payer: Nomi Health Commercial |
$1,014.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,088.67
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,792.08
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.07 |
| Max. Negotiated Rate |
$1,792.08 |
| Rate for Payer: Aetna Commercial |
$1,612.87
|
| Rate for Payer: Aetna Medicare |
$663.07
|
| Rate for Payer: ASR ASR |
$1,738.32
|
| Rate for Payer: BCBS Complete |
$716.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.57
|
| Rate for Payer: BCN Commercial |
$1,477.57
|
| Rate for Payer: Cash Price |
$1,433.66
|
| Rate for Payer: Cofinity Commercial |
$1,684.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.66
|
| Rate for Payer: Healthscope Commercial |
$1,738.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,792.08
|
| Rate for Payer: Mclaren Commercial |
$1,612.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,433.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.27
|
| Rate for Payer: Nomi Health Commercial |
$1,469.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,570.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,256.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,577.03
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,792.08
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,344.06 |
| Max. Negotiated Rate |
$1,792.08 |
| Rate for Payer: Aetna Commercial |
$1,612.87
|
| Rate for Payer: ASR ASR |
$1,738.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.66
|
| Rate for Payer: BCN Commercial |
$1,471.66
|
| Rate for Payer: Cash Price |
$1,433.66
|
| Rate for Payer: Cofinity Commercial |
$1,684.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.66
|
| Rate for Payer: Healthscope Commercial |
$1,738.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,792.08
|
| Rate for Payer: Mclaren Commercial |
$1,612.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.27
|
| Rate for Payer: Nomi Health Commercial |
$1,469.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,577.03
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
OP
|
$659.22
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$243.91 |
| Max. Negotiated Rate |
$659.22 |
| Rate for Payer: Aetna Commercial |
$593.30
|
| Rate for Payer: Aetna Medicare |
$243.91
|
| Rate for Payer: ASR ASR |
$639.44
|
| Rate for Payer: BCBS Complete |
$263.69
|
| Rate for Payer: BCBS Trust/PPO |
$543.53
|
| Rate for Payer: BCN Commercial |
$543.53
|
| Rate for Payer: Cash Price |
$527.38
|
| Rate for Payer: Cofinity Commercial |
$619.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.38
|
| Rate for Payer: Healthscope Commercial |
$639.44
|
| Rate for Payer: Healthscope Whirlpool |
$659.22
|
| Rate for Payer: Mclaren Commercial |
$593.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$527.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.34
|
| Rate for Payer: Nomi Health Commercial |
$540.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$494.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$577.61
|
| Rate for Payer: Priority Health Narrow Network |
$462.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.11
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
IP
|
$659.22
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$494.42 |
| Max. Negotiated Rate |
$659.22 |
| Rate for Payer: Aetna Commercial |
$593.30
|
| Rate for Payer: ASR ASR |
$639.44
|
| Rate for Payer: BCBS Trust/PPO |
$541.35
|
| Rate for Payer: BCN Commercial |
$541.35
|
| Rate for Payer: Cash Price |
$527.38
|
| Rate for Payer: Cofinity Commercial |
$619.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.38
|
| Rate for Payer: Healthscope Commercial |
$639.44
|
| Rate for Payer: Healthscope Whirlpool |
$659.22
|
| Rate for Payer: Mclaren Commercial |
$593.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.34
|
| Rate for Payer: Nomi Health Commercial |
$540.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$494.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$580.11
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
OP
|
$1,041.32
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$385.29 |
| Max. Negotiated Rate |
$1,041.32 |
| Rate for Payer: Aetna Commercial |
$937.19
|
| Rate for Payer: Aetna Medicare |
$385.29
|
| Rate for Payer: ASR ASR |
$1,010.08
|
| Rate for Payer: BCBS Complete |
$416.53
|
| Rate for Payer: BCBS Trust/PPO |
$858.57
|
| Rate for Payer: BCN Commercial |
$858.57
|
| Rate for Payer: Cash Price |
$833.06
|
| Rate for Payer: Cofinity Commercial |
$978.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.06
|
| Rate for Payer: Healthscope Commercial |
$1,010.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,041.32
|
| Rate for Payer: Mclaren Commercial |
$937.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$833.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.12
|
| Rate for Payer: Nomi Health Commercial |
$853.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$912.40
|
| Rate for Payer: Priority Health Narrow Network |
$729.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$916.36
|
|
