|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.33 |
| Max. Negotiated Rate |
$408.20 |
| Rate for Payer: Aetna Commercial |
$367.38
|
| Rate for Payer: ASR ASR |
$395.95
|
| Rate for Payer: ASR Commercial |
$395.95
|
| Rate for Payer: BCBS Trust/PPO |
$332.64
|
| Rate for Payer: BCN Commercial |
$316.48
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$383.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$408.20
|
| Rate for Payer: Healthscope Whirlpool |
$395.95
|
| Rate for Payer: Mclaren Commercial |
$367.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.22
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$408.20 |
| Rate for Payer: Aetna Commercial |
$367.38
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$395.95
|
| Rate for Payer: ASR Commercial |
$395.95
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$334.27
|
| Rate for Payer: BCN Commercial |
$316.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$383.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$408.20
|
| Rate for Payer: Healthscope Whirlpool |
$395.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$367.38
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.66
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$286.15
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$359.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$16.26
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna Commercial |
$14.63
|
| Rate for Payer: ASR ASR |
$15.77
|
| Rate for Payer: ASR Commercial |
$15.77
|
| Rate for Payer: BCBS Trust/PPO |
$13.25
|
| Rate for Payer: BCN Commercial |
$12.61
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Healthscope Whirlpool |
$15.77
|
| Rate for Payer: Mclaren Commercial |
$14.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.31
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
OP
|
$16.26
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna Commercial |
$14.63
|
| Rate for Payer: Aetna Medicare |
$8.13
|
| Rate for Payer: ASR ASR |
$15.77
|
| Rate for Payer: ASR Commercial |
$15.77
|
| Rate for Payer: BCBS Complete |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$13.32
|
| Rate for Payer: BCN Commercial |
$12.61
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Healthscope Whirlpool |
$15.77
|
| Rate for Payer: Mclaren Commercial |
$14.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.25
|
| Rate for Payer: Priority Health Narrow Network |
$11.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.31
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$53.58
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.43 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$48.22
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: ASR ASR |
$51.97
|
| Rate for Payer: ASR Commercial |
$51.97
|
| Rate for Payer: BCBS Complete |
$21.43
|
| Rate for Payer: BCBS Trust/PPO |
$43.88
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Commercial |
$50.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$53.58
|
| Rate for Payer: Healthscope Whirlpool |
$51.97
|
| Rate for Payer: Mclaren Commercial |
$48.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: Nomi Health Commercial |
$43.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.95
|
| Rate for Payer: Priority Health Narrow Network |
$37.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.15
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$53.58
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.83 |
| Max. Negotiated Rate |
$53.58 |
| Rate for Payer: Aetna Commercial |
$48.22
|
| Rate for Payer: ASR ASR |
$51.97
|
| Rate for Payer: ASR Commercial |
$51.97
|
| Rate for Payer: BCBS Trust/PPO |
$43.66
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Commercial |
$50.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$53.58
|
| Rate for Payer: Healthscope Whirlpool |
$51.97
|
| Rate for Payer: Mclaren Commercial |
$48.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: Nomi Health Commercial |
$43.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.15
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$42.08 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: Aetna Medicare |
$21.04
|
| Rate for Payer: ASR ASR |
$40.82
|
| Rate for Payer: ASR Commercial |
$40.82
|
| Rate for Payer: BCBS Complete |
$16.83
|
| Rate for Payer: BCBS Trust/PPO |
$34.46
|
| Rate for Payer: BCN Commercial |
$32.62
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$42.08
|
| Rate for Payer: Healthscope Whirlpool |
$40.82
|
| Rate for Payer: Mclaren Commercial |
$37.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: Nomi Health Commercial |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.87
|
| Rate for Payer: Priority Health Narrow Network |
$29.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.03
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.35 |
| Max. Negotiated Rate |
$42.08 |
| Rate for Payer: Aetna Commercial |
$37.87
|
| Rate for Payer: ASR ASR |
$40.82
|
| Rate for Payer: ASR Commercial |
$40.82
|
| Rate for Payer: BCBS Trust/PPO |
$34.29
|
| Rate for Payer: BCN Commercial |
$32.62
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$42.08
|
| Rate for Payer: Healthscope Whirlpool |
$40.82
|
| Rate for Payer: Mclaren Commercial |
$37.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: Nomi Health Commercial |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.03
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33,006.68 |
| Max. Negotiated Rate |
$50,779.51 |
| Rate for Payer: Aetna Commercial |
$45,701.56
|
| Rate for Payer: ASR ASR |
$49,256.12
|
| Rate for Payer: ASR Commercial |
$49,256.12
|
| Rate for Payer: BCBS Trust/PPO |
$41,380.22
|
| Rate for Payer: BCN Commercial |
$39,369.35
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$47,732.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Healthscope Commercial |
$50,779.51
|
| Rate for Payer: Healthscope Whirlpool |
$49,256.12
|
| Rate for Payer: Mclaren Commercial |
$45,701.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: Nomi Health Commercial |
$41,639.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44,685.97
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,140.34 |
| Max. Negotiated Rate |
$50,779.51 |
| Rate for Payer: Aetna Commercial |
$45,701.56
|
| Rate for Payer: Aetna Medicare |
$17,052.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,316.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,316.09
|
| Rate for Payer: ASR ASR |
$49,256.12
|
| Rate for Payer: ASR Commercial |
$49,256.12
|
| Rate for Payer: BCBS Complete |
$9,597.36
|
| Rate for Payer: BCBS MAPPO |
$17,052.87
|
| Rate for Payer: BCBS Trust/PPO |
$41,583.34
|
| Rate for Payer: BCN Commercial |
$39,369.35
|
| Rate for Payer: BCN Medicare Advantage |
$17,052.87
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$47,732.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,052.87
|
| Rate for Payer: Healthscope Commercial |
$50,779.51
|
| Rate for Payer: Healthscope Whirlpool |
$49,256.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,052.87
|
| Rate for Payer: Mclaren Commercial |
$45,701.56
|
| Rate for Payer: Mclaren Medicaid |
$9,140.34
|
| Rate for Payer: Mclaren Medicare |
$17,052.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,905.51
|
| Rate for Payer: Meridian Medicaid |
$9,597.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,610.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: Nomi Health Commercial |
$41,639.20
|
| Rate for Payer: PACE Medicare |
$16,200.23
|
| Rate for Payer: PACE SWMI |
$17,052.87
|
| Rate for Payer: PHP Commercial |
$18,758.16
|
| Rate for Payer: PHP Medicaid |
$9,140.34
|
| Rate for Payer: PHP Medicare Advantage |
$17,052.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,140.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44,493.01
|
| Rate for Payer: Priority Health Medicare |
$17,052.87
|
| Rate for Payer: Priority Health Narrow Network |
$35,596.44
|
| Rate for Payer: Railroad Medicare Medicare |
$17,052.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44,685.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,052.87
|
| Rate for Payer: UHC Exchange |
$26,431.95
|
| Rate for Payer: UHC Medicare Advantage |
$17,052.87
|
| Rate for Payer: UHCCP DNSP |
$17,052.87
|
| Rate for Payer: UHCCP Medicaid |
$9,140.34
|
| Rate for Payer: VA VA |
$17,052.87
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.73 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna Medicare |
$20.91
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: ASR Commercial |
$40.57
|
| Rate for Payer: BCBS Complete |
$16.73
|
| Rate for Payer: BCBS Trust/PPO |
$34.25
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$39.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$40.57
|
| Rate for Payer: Mclaren Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.64
|
| Rate for Payer: Priority Health Narrow Network |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$41.82 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: ASR ASR |
$40.57
|
| Rate for Payer: ASR Commercial |
$40.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$39.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$40.57
|
| Rate for Payer: Mclaren Commercial |
$37.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.80
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.94 |
| Max. Negotiated Rate |
$204.86 |
| Rate for Payer: Aetna Commercial |
$184.37
|
| Rate for Payer: Aetna Medicare |
$102.43
|
| Rate for Payer: ASR ASR |
$198.71
|
| Rate for Payer: ASR Commercial |
$198.71
|
| Rate for Payer: BCBS Complete |
$81.94
|
| Rate for Payer: BCBS Trust/PPO |
$167.76
|
| Rate for Payer: BCN Commercial |
$158.83
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$192.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$204.86
|
| Rate for Payer: Healthscope Whirlpool |
$198.71
|
| Rate for Payer: Mclaren Commercial |
$184.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: Nomi Health Commercial |
$167.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.50
|
| Rate for Payer: Priority Health Narrow Network |
$143.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.28
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.16 |
| Max. Negotiated Rate |
$204.86 |
| Rate for Payer: Aetna Commercial |
$184.37
|
| Rate for Payer: ASR ASR |
$198.71
|
| Rate for Payer: ASR Commercial |
$198.71
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$158.83
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$192.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$204.86
|
| Rate for Payer: Healthscope Whirlpool |
$198.71
|
| Rate for Payer: Mclaren Commercial |
$184.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: Nomi Health Commercial |
$167.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.28
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,546.44 |
| Max. Negotiated Rate |
$6,366.11 |
| Rate for Payer: Aetna Commercial |
$5,729.50
|
| Rate for Payer: Aetna Medicare |
$3,183.05
|
| Rate for Payer: ASR ASR |
$6,175.13
|
| Rate for Payer: ASR Commercial |
$6,175.13
|
| Rate for Payer: BCBS Complete |
$2,546.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,213.21
|
| Rate for Payer: BCN Commercial |
$4,935.65
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$5,984.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$6,366.11
|
| Rate for Payer: Healthscope Whirlpool |
$6,175.13
|
| Rate for Payer: Mclaren Commercial |
$5,729.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: Nomi Health Commercial |
$5,220.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,577.99
|
| Rate for Payer: Priority Health Narrow Network |
$4,462.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,602.18
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,137.97 |
| Max. Negotiated Rate |
$6,366.11 |
| Rate for Payer: Aetna Commercial |
$5,729.50
|
| Rate for Payer: ASR ASR |
$6,175.13
|
| Rate for Payer: ASR Commercial |
$6,175.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,187.74
|
| Rate for Payer: BCN Commercial |
$4,935.65
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$5,984.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$6,366.11
|
| Rate for Payer: Healthscope Whirlpool |
$6,175.13
|
| Rate for Payer: Mclaren Commercial |
$5,729.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: Nomi Health Commercial |
$5,220.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,602.18
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$437.63 |
| Rate for Payer: Aetna Commercial |
$393.87
|
| Rate for Payer: ASR ASR |
$424.50
|
| Rate for Payer: ASR Commercial |
$424.50
|
| Rate for Payer: BCBS Trust/PPO |
$356.62
|
| Rate for Payer: BCN Commercial |
$339.29
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$411.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$437.63
|
| Rate for Payer: Healthscope Whirlpool |
$424.50
|
| Rate for Payer: Mclaren Commercial |
$393.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.11
|
|
