|
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSCULAR SOLUTION
|
Facility
|
IP
|
$510.53
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
116868
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$382.89 |
| Max. Negotiated Rate |
$510.53 |
| Rate for Payer: Aetna Commercial |
$459.47
|
| Rate for Payer: ASR ASR |
$495.21
|
| Rate for Payer: BCBS Trust/PPO |
$419.24
|
| Rate for Payer: BCN Commercial |
$419.24
|
| Rate for Payer: Cash Price |
$408.42
|
| Rate for Payer: Cofinity Commercial |
$479.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.42
|
| Rate for Payer: Healthscope Commercial |
$495.21
|
| Rate for Payer: Healthscope Whirlpool |
$510.53
|
| Rate for Payer: Mclaren Commercial |
$459.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.95
|
| Rate for Payer: Nomi Health Commercial |
$418.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.26
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$23,871.17
|
|
|
Service Code
|
MSDRG 421
|
| Min. Negotiated Rate |
$13,553.29 |
| Max. Negotiated Rate |
$23,871.17 |
| Rate for Payer: Aetna Medicare |
$14,266.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,833.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,833.28
|
| Rate for Payer: BCBS MAPPO |
$14,266.62
|
| Rate for Payer: BCN Medicare Advantage |
$14,266.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,266.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$14,266.62
|
| Rate for Payer: Mclaren Medicare |
$14,266.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,979.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,406.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,693.28
|
| Rate for Payer: PACE Medicare |
$13,553.29
|
| Rate for Payer: PACE SWMI |
$14,266.62
|
| Rate for Payer: PHP Commercial |
$15,693.28
|
| Rate for Payer: PHP Medicare Advantage |
$14,266.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23,871.17
|
| Rate for Payer: Priority Health Medicare |
$14,266.62
|
| Rate for Payer: Priority Health Narrow Network |
$19,096.93
|
| Rate for Payer: Railroad Medicare Medicare |
$14,266.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,266.62
|
| Rate for Payer: UHC Exchange |
$22,113.26
|
| Rate for Payer: UHCCP DNSP |
$14,266.62
|
| Rate for Payer: VA VA |
$14,266.62
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$46,809.47
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$24,975.33 |
| Max. Negotiated Rate |
$46,809.47 |
| Rate for Payer: Aetna Medicare |
$26,289.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,862.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,862.28
|
| Rate for Payer: BCBS MAPPO |
$26,289.82
|
| Rate for Payer: BCN Medicare Advantage |
$26,289.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26,289.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$26,289.82
|
| Rate for Payer: Mclaren Medicare |
$26,289.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27,604.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30,233.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$28,918.80
|
| Rate for Payer: PACE Medicare |
$24,975.33
|
| Rate for Payer: PACE SWMI |
$26,289.82
|
| Rate for Payer: PHP Commercial |
$28,918.80
|
| Rate for Payer: PHP Medicare Advantage |
$26,289.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46,809.47
|
| Rate for Payer: Priority Health Medicare |
$26,289.82
|
| Rate for Payer: Priority Health Narrow Network |
$37,447.57
|
| Rate for Payer: Railroad Medicare Medicare |
$26,289.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26,289.82
|
| Rate for Payer: UHC Exchange |
$40,749.22
|
| Rate for Payer: UHCCP DNSP |
$26,289.82
|
| Rate for Payer: VA VA |
$26,289.82
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$19,227.45
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$11,240.97 |
| Max. Negotiated Rate |
$19,227.45 |
| Rate for Payer: Aetna Medicare |
$11,832.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,790.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,790.75
|
| Rate for Payer: BCBS MAPPO |
$11,832.60
|
| Rate for Payer: BCN Medicare Advantage |
$11,832.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,832.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,832.60
|
| Rate for Payer: Mclaren Medicare |
$11,832.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,424.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,607.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,015.86
|
| Rate for Payer: PACE Medicare |
$11,240.97
|
| Rate for Payer: PACE SWMI |
$11,832.60
|
| Rate for Payer: PHP Commercial |
$13,015.86
|
| Rate for Payer: PHP Medicare Advantage |
$11,832.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19,227.45
|
| Rate for Payer: Priority Health Medicare |
$11,832.60
|
| Rate for Payer: Priority Health Narrow Network |
$15,381.96
|
| Rate for Payer: Railroad Medicare Medicare |
$11,832.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,832.60
|
| Rate for Payer: UHC Exchange |
$18,340.53
|
| Rate for Payer: UHCCP DNSP |
$11,832.60
|
| Rate for Payer: VA VA |
$11,832.60
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$23,114.16
|
|
|
Service Code
|
MSDRG 354
|
| Min. Negotiated Rate |
$13,176.35 |
| Max. Negotiated Rate |
$23,114.16 |
| Rate for Payer: Aetna Medicare |
$13,869.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,337.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,337.30
|
| Rate for Payer: BCBS MAPPO |
$13,869.84
|
| Rate for Payer: BCN Medicare Advantage |
$13,869.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,869.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$13,869.84
|
| Rate for Payer: Mclaren Medicare |
$13,869.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,563.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,950.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,256.82
|
| Rate for Payer: PACE Medicare |
$13,176.35
|
| Rate for Payer: PACE SWMI |
$13,869.84
|
| Rate for Payer: PHP Commercial |
$15,256.82
|
| Rate for Payer: PHP Medicare Advantage |
$13,869.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23,114.16
|
| Rate for Payer: Priority Health Medicare |
$13,869.84
|
| Rate for Payer: Priority Health Narrow Network |
$18,491.33
|
| Rate for Payer: Railroad Medicare Medicare |
$13,869.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,869.84
|
| Rate for Payer: UHC Exchange |
$21,498.25
|
| Rate for Payer: UHCCP DNSP |
$13,869.84
|
| Rate for Payer: VA VA |
$13,869.84
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$39,870.00
|
|
|
Service Code
|
MSDRG 353
|
| Min. Negotiated Rate |
$21,519.84 |
| Max. Negotiated Rate |
$39,870.00 |
| Rate for Payer: Aetna Medicare |
$22,652.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28,315.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28,315.58
|
| Rate for Payer: BCBS MAPPO |
$22,652.46
|
| Rate for Payer: BCN Medicare Advantage |
$22,652.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,652.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$22,652.46
|
| Rate for Payer: Mclaren Medicare |
$22,652.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,785.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26,050.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,917.71
|
| Rate for Payer: PACE Medicare |
$21,519.84
|
| Rate for Payer: PACE SWMI |
$22,652.46
|
| Rate for Payer: PHP Commercial |
$24,917.71
|
| Rate for Payer: PHP Medicare Advantage |
$22,652.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39,870.00
|
| Rate for Payer: Priority Health Medicare |
$22,652.46
|
| Rate for Payer: Priority Health Narrow Network |
$31,896.00
|
| Rate for Payer: Railroad Medicare Medicare |
$22,652.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,652.46
|
| Rate for Payer: UHC Exchange |
$35,111.31
|
| Rate for Payer: UHCCP DNSP |
$22,652.46
|
| Rate for Payer: VA VA |
$22,652.46
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$18,478.69
|
|
|
Service Code
|
MSDRG 355
|
| Min. Negotiated Rate |
$10,868.11 |
| Max. Negotiated Rate |
$18,478.69 |
| Rate for Payer: Aetna Medicare |
$11,440.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,300.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,300.15
|
| Rate for Payer: BCBS MAPPO |
$11,440.12
|
| Rate for Payer: BCN Medicare Advantage |
$11,440.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,440.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,440.12
|
| Rate for Payer: Mclaren Medicare |
$11,440.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,012.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,156.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,584.13
|
| Rate for Payer: PACE Medicare |
$10,868.11
|
| Rate for Payer: PACE SWMI |
$11,440.12
|
| Rate for Payer: PHP Commercial |
$12,584.13
|
| Rate for Payer: PHP Medicare Advantage |
$11,440.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$18,478.69
|
| Rate for Payer: Priority Health Medicare |
$11,440.12
|
| Rate for Payer: Priority Health Narrow Network |
$14,782.95
|
| Rate for Payer: Railroad Medicare Medicare |
$11,440.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,440.12
|
| Rate for Payer: UHC Exchange |
$17,732.19
|
| Rate for Payer: UHCCP DNSP |
$11,440.12
|
| Rate for Payer: VA VA |
$11,440.12
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
|
Facility
|
IP
|
$8,424.38
|
|
|
Service Code
|
APR-DRG 2271
|
| Min. Negotiated Rate |
$7,616.65 |
| Max. Negotiated Rate |
$8,424.38 |
| Rate for Payer: BCBS Complete |
$8,424.38
|
| Rate for Payer: Mclaren Medicaid |
$8,023.22
|
| Rate for Payer: Meridian Medicaid |
$8,424.38
|
| Rate for Payer: PHP Medicaid |
$7,616.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,023.22
|
| Rate for Payer: UHC Medicaid |
$8,023.22
|
| Rate for Payer: UHCCP Medicaid |
$8,023.22
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
|
Facility
|
IP
|
$11,930.05
|
|
|
Service Code
|
APR-DRG 2273
|
| Min. Negotiated Rate |
$10,786.19 |
| Max. Negotiated Rate |
$11,930.05 |
| Rate for Payer: BCBS Complete |
$11,930.05
|
| Rate for Payer: Mclaren Medicaid |
$11,361.95
|
| Rate for Payer: Meridian Medicaid |
$11,930.05
|
| Rate for Payer: PHP Medicaid |
$10,786.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,361.95
|
| Rate for Payer: UHC Medicaid |
$11,361.95
|
| Rate for Payer: UHCCP Medicaid |
$11,361.95
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
|
Facility
|
IP
|
$19,558.80
|
|
|
Service Code
|
APR-DRG 2274
|
| Min. Negotiated Rate |
$17,683.50 |
| Max. Negotiated Rate |
$19,558.80 |
| Rate for Payer: BCBS Complete |
$19,558.80
|
| Rate for Payer: Mclaren Medicaid |
$18,627.43
|
| Rate for Payer: Meridian Medicaid |
$19,558.80
|
| Rate for Payer: PHP Medicaid |
$17,683.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$18,627.43
|
| Rate for Payer: UHC Medicaid |
$18,627.43
|
| Rate for Payer: UHCCP Medicaid |
$18,627.43
|
|
|
HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL
|
Facility
|
IP
|
$10,390.02
|
|
|
Service Code
|
APR-DRG 2272
|
| Min. Negotiated Rate |
$9,393.82 |
| Max. Negotiated Rate |
$10,390.02 |
| Rate for Payer: BCBS Complete |
$10,390.02
|
| Rate for Payer: Mclaren Medicaid |
$9,895.25
|
| Rate for Payer: Meridian Medicaid |
$10,390.02
|
| Rate for Payer: PHP Medicaid |
$9,393.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,895.25
|
| Rate for Payer: UHC Medicaid |
$9,895.25
|
| Rate for Payer: UHCCP Medicaid |
$9,895.25
|
|
|
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$222.72
|
|
|
Service Code
|
NDC 409724813
|
| Hospital Charge Code |
25174
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$167.04 |
| Max. Negotiated Rate |
$222.72 |
| Rate for Payer: Aetna Commercial |
$200.45
|
| Rate for Payer: ASR ASR |
$216.04
|
| Rate for Payer: BCBS Trust/PPO |
$182.90
|
| Rate for Payer: BCN Commercial |
$182.90
|
| Rate for Payer: Cash Price |
$178.18
|
| Rate for Payer: Cofinity Commercial |
$209.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.18
|
| Rate for Payer: Healthscope Commercial |
$216.04
|
| Rate for Payer: Healthscope Whirlpool |
$222.72
|
| Rate for Payer: Mclaren Commercial |
$200.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.31
|
| Rate for Payer: Nomi Health Commercial |
$182.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.99
|
|
|
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$222.72
|
|
|
Service Code
|
NDC 409724803
|
| Hospital Charge Code |
25174
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$167.04 |
| Max. Negotiated Rate |
$222.72 |
| Rate for Payer: Aetna Commercial |
$200.45
|
| Rate for Payer: ASR ASR |
$216.04
|
| Rate for Payer: BCBS Trust/PPO |
$182.90
|
| Rate for Payer: BCN Commercial |
$182.90
|
| Rate for Payer: Cash Price |
$178.18
|
| Rate for Payer: Cofinity Commercial |
$209.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.18
|
| Rate for Payer: Healthscope Commercial |
$216.04
|
| Rate for Payer: Healthscope Whirlpool |
$222.72
|
| Rate for Payer: Mclaren Commercial |
$200.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.31
|
| Rate for Payer: Nomi Health Commercial |
$182.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.99
|
|
|
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$222.72
|
|
|
Service Code
|
NDC 409724813
|
| Hospital Charge Code |
25174
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$222.72 |
| Rate for Payer: Aetna Commercial |
$200.45
|
| Rate for Payer: Aetna Medicare |
$82.41
|
| Rate for Payer: ASR ASR |
$216.04
|
| Rate for Payer: BCBS Complete |
$89.09
|
| Rate for Payer: BCBS Trust/PPO |
$183.63
|
| Rate for Payer: BCN Commercial |
$183.63
|
| Rate for Payer: Cash Price |
$178.18
|
| Rate for Payer: Cofinity Commercial |
$209.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.18
|
| Rate for Payer: Healthscope Commercial |
$216.04
|
| Rate for Payer: Healthscope Whirlpool |
$222.72
|
| Rate for Payer: Mclaren Commercial |
$200.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.31
|
| Rate for Payer: Nomi Health Commercial |
$182.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$195.15
|
| Rate for Payer: Priority Health Narrow Network |
$156.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.99
|
|
|
HETASTARCH 6 % IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$222.72
|
|
|
Service Code
|
NDC 409724803
|
| Hospital Charge Code |
25174
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$222.72 |
| Rate for Payer: Aetna Commercial |
$200.45
|
| Rate for Payer: Aetna Medicare |
$82.41
|
| Rate for Payer: ASR ASR |
$216.04
|
| Rate for Payer: BCBS Complete |
$89.09
|
| Rate for Payer: BCBS Trust/PPO |
$183.63
|
| Rate for Payer: BCN Commercial |
$183.63
|
| Rate for Payer: Cash Price |
$178.18
|
| Rate for Payer: Cofinity Commercial |
$209.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.18
|
| Rate for Payer: Healthscope Commercial |
$216.04
|
| Rate for Payer: Healthscope Whirlpool |
$222.72
|
| Rate for Payer: Mclaren Commercial |
$200.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.31
|
| Rate for Payer: Nomi Health Commercial |
$182.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$195.15
|
| Rate for Payer: Priority Health Narrow Network |
$156.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.99
|
|
|
HH CATHETER LEG STRAP BARD
|
Facility
|
OP
|
$12.47
|
|
|
Service Code
|
HCPCS A4334
|
| Hospital Charge Code |
27000598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.61 |
| Max. Negotiated Rate |
$12.47 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: Aetna Medicare |
$4.61
|
| Rate for Payer: ASR ASR |
$12.10
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$10.28
|
| Rate for Payer: BCN Commercial |
$10.28
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.10
|
| Rate for Payer: Healthscope Whirlpool |
$12.47
|
| Rate for Payer: Mclaren Commercial |
$11.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.60
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.93
|
| Rate for Payer: Priority Health Narrow Network |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.97
|
|
|
HH CATHETER LEG STRAP BARD
|
Facility
|
IP
|
$12.47
|
|
|
Service Code
|
HCPCS A4334
|
| Hospital Charge Code |
27000598
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$12.47 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: ASR ASR |
$12.10
|
| Rate for Payer: BCBS Trust/PPO |
$10.24
|
| Rate for Payer: BCN Commercial |
$10.24
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$11.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$12.10
|
| Rate for Payer: Healthscope Whirlpool |
$12.47
|
| Rate for Payer: Mclaren Commercial |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.60
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.97
|
|
|
HH DRSG MEPILEX AG FOAM 4X4 EA
|
Facility
|
IP
|
$27.70
|
|
|
Service Code
|
HCPCS A6209
|
| Hospital Charge Code |
62300044
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$20.77 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: ASR ASR |
$26.87
|
| Rate for Payer: BCBS Trust/PPO |
$22.75
|
| Rate for Payer: BCN Commercial |
$22.75
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$26.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Healthscope Whirlpool |
$27.70
|
| Rate for Payer: Mclaren Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.38
|
|
|
HH DRSG MEPILEX AG FOAM 4X4 EA
|
Facility
|
OP
|
$27.70
|
|
|
Service Code
|
HCPCS A6209
|
| Hospital Charge Code |
62300044
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$27.70 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna Medicare |
$10.25
|
| Rate for Payer: ASR ASR |
$26.87
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS Trust/PPO |
$22.84
|
| Rate for Payer: BCN Commercial |
$22.84
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$26.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Healthscope Whirlpool |
$27.70
|
| Rate for Payer: Mclaren Commercial |
$24.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.55
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$24.27
|
| Rate for Payer: Priority Health Narrow Network |
$19.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.38
|
|
|
HH DRSG MEPILEX BORDER 4X4 EA
|
Facility
|
IP
|
$9.98
|
|
|
Service Code
|
HCPCS A6212
|
| Hospital Charge Code |
62300017
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$9.98 |
| Rate for Payer: Aetna Commercial |
$8.98
|
| Rate for Payer: ASR ASR |
$9.68
|
| Rate for Payer: BCBS Trust/PPO |
$8.20
|
| Rate for Payer: BCN Commercial |
$8.20
|
| Rate for Payer: Cash Price |
$7.98
|
| Rate for Payer: Cofinity Commercial |
$9.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.98
|
| Rate for Payer: Healthscope Commercial |
$9.68
|
| Rate for Payer: Healthscope Whirlpool |
$9.98
|
| Rate for Payer: Mclaren Commercial |
$8.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.48
|
| Rate for Payer: Nomi Health Commercial |
$8.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.78
|
|
|
HH DRSG MEPILEX BORDER 4X4 EA
|
Facility
|
OP
|
$9.98
|
|
|
Service Code
|
HCPCS A6212
|
| Hospital Charge Code |
62300017
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$9.98 |
| Rate for Payer: Aetna Commercial |
$8.98
|
| Rate for Payer: Aetna Medicare |
$3.69
|
| Rate for Payer: ASR ASR |
$9.68
|
| Rate for Payer: BCBS Complete |
$3.99
|
| Rate for Payer: BCBS Trust/PPO |
$8.23
|
| Rate for Payer: BCN Commercial |
$8.23
|
| Rate for Payer: Cash Price |
$7.98
|
| Rate for Payer: Cofinity Commercial |
$9.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.98
|
| Rate for Payer: Healthscope Commercial |
$9.68
|
| Rate for Payer: Healthscope Whirlpool |
$9.98
|
| Rate for Payer: Mclaren Commercial |
$8.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.48
|
| Rate for Payer: Nomi Health Commercial |
$8.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8.74
|
| Rate for Payer: Priority Health Narrow Network |
$7.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.78
|
|
|
HH DRSG MEPILEX BORDER 6X6 EA
|
Facility
|
IP
|
$22.31
|
|
|
Service Code
|
HCPCS A6212
|
| Hospital Charge Code |
62300067
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$16.73 |
| Max. Negotiated Rate |
$22.31 |
| Rate for Payer: Aetna Commercial |
$20.08
|
| Rate for Payer: ASR ASR |
$21.64
|
| Rate for Payer: BCBS Trust/PPO |
$18.32
|
| Rate for Payer: BCN Commercial |
$18.32
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$20.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Healthscope Commercial |
$21.64
|
| Rate for Payer: Healthscope Whirlpool |
$22.31
|
| Rate for Payer: Mclaren Commercial |
$20.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.63
|
|
|
HH DRSG MEPILEX BORDER 6X6 EA
|
Facility
|
OP
|
$22.31
|
|
|
Service Code
|
HCPCS A6212
|
| Hospital Charge Code |
62300067
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$22.31 |
| Rate for Payer: Aetna Commercial |
$20.08
|
| Rate for Payer: Aetna Medicare |
$8.25
|
| Rate for Payer: ASR ASR |
$21.64
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$18.39
|
| Rate for Payer: BCN Commercial |
$18.39
|
| Rate for Payer: Cash Price |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$20.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.85
|
| Rate for Payer: Healthscope Commercial |
$21.64
|
| Rate for Payer: Healthscope Whirlpool |
$22.31
|
| Rate for Payer: Mclaren Commercial |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.96
|
| Rate for Payer: Nomi Health Commercial |
$18.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.55
|
| Rate for Payer: Priority Health Narrow Network |
$15.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.63
|
|
|
HH DRSG MEPILEX BORDER 6X8 EA
|
Facility
|
IP
|
$22.92
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300053
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$17.19 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Aetna Commercial |
$20.63
|
| Rate for Payer: ASR ASR |
$22.23
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$18.82
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$21.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$22.23
|
| Rate for Payer: Healthscope Whirlpool |
$22.92
|
| Rate for Payer: Mclaren Commercial |
$20.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.48
|
| Rate for Payer: Nomi Health Commercial |
$18.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.17
|
|
|
HH DRSG MEPILEX BORDER 6X8 EA
|
Facility
|
OP
|
$22.92
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300053
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Aetna Commercial |
$20.63
|
| Rate for Payer: Aetna Medicare |
$8.48
|
| Rate for Payer: ASR ASR |
$22.23
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS Trust/PPO |
$18.90
|
| Rate for Payer: BCN Commercial |
$18.90
|
| Rate for Payer: Cash Price |
$18.34
|
| Rate for Payer: Cofinity Commercial |
$21.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.34
|
| Rate for Payer: Healthscope Commercial |
$22.23
|
| Rate for Payer: Healthscope Whirlpool |
$22.92
|
| Rate for Payer: Mclaren Commercial |
$20.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.48
|
| Rate for Payer: Nomi Health Commercial |
$18.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.08
|
| Rate for Payer: Priority Health Narrow Network |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.17
|
|
