|
HC Z INFUSION WIRE
|
Facility
|
OP
|
$874.85
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$349.94 |
| Max. Negotiated Rate |
$874.85 |
| Rate for Payer: Aetna Commercial |
$787.36
|
| Rate for Payer: Aetna Medicare |
$437.42
|
| Rate for Payer: ASR ASR |
$848.60
|
| Rate for Payer: ASR Commercial |
$848.60
|
| Rate for Payer: BCBS Complete |
$349.94
|
| Rate for Payer: BCBS Trust/PPO |
$716.41
|
| Rate for Payer: BCN Commercial |
$678.27
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cofinity Commercial |
$822.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.88
|
| Rate for Payer: Healthscope Commercial |
$874.85
|
| Rate for Payer: Healthscope Whirlpool |
$848.60
|
| Rate for Payer: Mclaren Commercial |
$787.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.62
|
| Rate for Payer: Nomi Health Commercial |
$717.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$766.54
|
| Rate for Payer: Priority Health Narrow Network |
$613.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$769.87
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
OP
|
$13,138.47
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,255.39 |
| Max. Negotiated Rate |
$13,138.47 |
| Rate for Payer: Aetna Commercial |
$11,824.62
|
| Rate for Payer: Aetna Medicare |
$6,569.24
|
| Rate for Payer: ASR ASR |
$12,744.32
|
| Rate for Payer: ASR Commercial |
$12,744.32
|
| Rate for Payer: BCBS Complete |
$5,255.39
|
| Rate for Payer: BCBS Trust/PPO |
$10,759.09
|
| Rate for Payer: BCN Commercial |
$10,186.26
|
| Rate for Payer: Cash Price |
$10,510.78
|
| Rate for Payer: Cofinity Commercial |
$12,350.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,510.78
|
| Rate for Payer: Healthscope Commercial |
$13,138.47
|
| Rate for Payer: Healthscope Whirlpool |
$12,744.32
|
| Rate for Payer: Mclaren Commercial |
$11,824.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,167.70
|
| Rate for Payer: Nomi Health Commercial |
$10,773.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,540.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,511.93
|
| Rate for Payer: Priority Health Narrow Network |
$9,210.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,561.85
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
IP
|
$13,138.47
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,540.01 |
| Max. Negotiated Rate |
$13,138.47 |
| Rate for Payer: Aetna Commercial |
$11,824.62
|
| Rate for Payer: ASR ASR |
$12,744.32
|
| Rate for Payer: ASR Commercial |
$12,744.32
|
| Rate for Payer: BCBS Trust/PPO |
$10,706.54
|
| Rate for Payer: BCN Commercial |
$10,186.26
|
| Rate for Payer: Cash Price |
$10,510.78
|
| Rate for Payer: Cofinity Commercial |
$12,350.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,510.78
|
| Rate for Payer: Healthscope Commercial |
$13,138.47
|
| Rate for Payer: Healthscope Whirlpool |
$12,744.32
|
| Rate for Payer: Mclaren Commercial |
$11,824.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,167.70
|
| Rate for Payer: Nomi Health Commercial |
$10,773.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,540.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,561.85
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
OP
|
$329.25
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.70 |
| Max. Negotiated Rate |
$329.25 |
| Rate for Payer: Aetna Commercial |
$296.32
|
| Rate for Payer: Aetna Medicare |
$164.62
|
| Rate for Payer: ASR ASR |
$319.37
|
| Rate for Payer: ASR Commercial |
$319.37
|
| Rate for Payer: BCBS Complete |
$131.70
|
| Rate for Payer: BCBS Trust/PPO |
$269.62
|
| Rate for Payer: BCN Commercial |
$255.27
|
| Rate for Payer: Cash Price |
$263.40
|
| Rate for Payer: Cofinity Commercial |
$309.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.40
|
| Rate for Payer: Healthscope Commercial |
$329.25
|
| Rate for Payer: Healthscope Whirlpool |
$319.37
|
| Rate for Payer: Mclaren Commercial |
$296.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.86
|
| Rate for Payer: Nomi Health Commercial |
$269.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.49
|
| Rate for Payer: Priority Health Narrow Network |
$230.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.74
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
IP
|
$329.25
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.01 |
| Max. Negotiated Rate |
$329.25 |
| Rate for Payer: Aetna Commercial |
$296.32
|
| Rate for Payer: ASR ASR |
$319.37
|
| Rate for Payer: ASR Commercial |
$319.37
|
| Rate for Payer: BCBS Trust/PPO |
$268.31
|
| Rate for Payer: BCN Commercial |
$255.27
|
| Rate for Payer: Cash Price |
$263.40
|
| Rate for Payer: Cofinity Commercial |
$309.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.40
|
| Rate for Payer: Healthscope Commercial |
$329.25
|
| Rate for Payer: Healthscope Whirlpool |
$319.37
|
| Rate for Payer: Mclaren Commercial |
$296.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.86
|
| Rate for Payer: Nomi Health Commercial |
$269.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.74
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
IP
|
$3,775.49
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,454.07 |
| Max. Negotiated Rate |
$3,775.49 |
| Rate for Payer: Aetna Commercial |
$3,397.94
|
| Rate for Payer: ASR ASR |
$3,662.23
|
| Rate for Payer: ASR Commercial |
$3,662.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,076.65
|
| Rate for Payer: BCN Commercial |
$2,927.14
|
| Rate for Payer: Cash Price |
$3,020.39
|
| Rate for Payer: Cofinity Commercial |
$3,548.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,020.39
|
| Rate for Payer: Healthscope Commercial |
$3,775.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,662.23
|
| Rate for Payer: Mclaren Commercial |
$3,397.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,209.17
|
| Rate for Payer: Nomi Health Commercial |
$3,095.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,454.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,322.43
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
OP
|
$3,775.49
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,510.20 |
| Max. Negotiated Rate |
$3,775.49 |
| Rate for Payer: Aetna Commercial |
$3,397.94
|
| Rate for Payer: Aetna Medicare |
$1,887.74
|
| Rate for Payer: ASR ASR |
$3,662.23
|
| Rate for Payer: ASR Commercial |
$3,662.23
|
| Rate for Payer: BCBS Complete |
$1,510.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,091.75
|
| Rate for Payer: BCN Commercial |
$2,927.14
|
| Rate for Payer: Cash Price |
$3,020.39
|
| Rate for Payer: Cofinity Commercial |
$3,548.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,020.39
|
| Rate for Payer: Healthscope Commercial |
$3,775.49
|
| Rate for Payer: Healthscope Whirlpool |
$3,662.23
|
| Rate for Payer: Mclaren Commercial |
$3,397.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,209.17
|
| Rate for Payer: Nomi Health Commercial |
$3,095.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,454.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,308.08
|
| Rate for Payer: Priority Health Narrow Network |
$2,646.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,322.43
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
OP
|
$775.77
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$310.31 |
| Max. Negotiated Rate |
$775.77 |
| Rate for Payer: Aetna Commercial |
$698.19
|
| Rate for Payer: Aetna Medicare |
$387.88
|
| Rate for Payer: ASR ASR |
$752.50
|
| Rate for Payer: ASR Commercial |
$752.50
|
| Rate for Payer: BCBS Complete |
$310.31
|
| Rate for Payer: BCBS Trust/PPO |
$635.28
|
| Rate for Payer: BCN Commercial |
$601.45
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$729.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$775.77
|
| Rate for Payer: Healthscope Whirlpool |
$752.50
|
| Rate for Payer: Mclaren Commercial |
$698.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.40
|
| Rate for Payer: Nomi Health Commercial |
$636.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.73
|
| Rate for Payer: Priority Health Narrow Network |
$543.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.68
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
IP
|
$775.77
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$504.25 |
| Max. Negotiated Rate |
$775.77 |
| Rate for Payer: Aetna Commercial |
$698.19
|
| Rate for Payer: ASR ASR |
$752.50
|
| Rate for Payer: ASR Commercial |
$752.50
|
| Rate for Payer: BCBS Trust/PPO |
$632.17
|
| Rate for Payer: BCN Commercial |
$601.45
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$729.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$775.77
|
| Rate for Payer: Healthscope Whirlpool |
$752.50
|
| Rate for Payer: Mclaren Commercial |
$698.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.40
|
| Rate for Payer: Nomi Health Commercial |
$636.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$682.68
|
|
|
HC ZONISAMIDE
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| 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 |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Complete |
$7.46
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.25
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| 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 |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$14.58
|
| Rate for Payer: PHP Medicaid |
$7.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.72
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$16.58
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Exchange |
$20.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
| Rate for Payer: UHCCP DNSP |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: VA VA |
$13.25
|
|
|
HC ZONISAMIDE
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: ASR ASR |
$74.20
|
| Rate for Payer: ASR Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.34
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$71.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Healthscope Whirlpool |
$74.20
|
| Rate for Payer: Mclaren Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.32
|
|
|
HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 90750
|
| Hospital Charge Code |
63600123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$69.92 |
| Max. Negotiated Rate |
$245.68 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: Aetna Medicare |
$87.40
|
| Rate for Payer: ASR ASR |
$169.55
|
| Rate for Payer: ASR Commercial |
$169.55
|
| Rate for Payer: BCBS Complete |
$69.92
|
| Rate for Payer: BCBS Trust/PPO |
$143.14
|
| Rate for Payer: BCN Commercial |
$135.51
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$164.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$174.79
|
| Rate for Payer: Healthscope Whirlpool |
$169.55
|
| Rate for Payer: Mclaren Commercial |
$157.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: 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 |
$153.82
|
|
|
HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 90750
|
| Hospital Charge Code |
63600123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$113.61 |
| Max. Negotiated Rate |
$174.79 |
| Rate for Payer: Aetna Commercial |
$157.31
|
| Rate for Payer: ASR ASR |
$169.55
|
| Rate for Payer: ASR Commercial |
$169.55
|
| Rate for Payer: BCBS Trust/PPO |
$142.44
|
| Rate for Payer: BCN Commercial |
$135.51
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$164.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$174.79
|
| Rate for Payer: Healthscope Whirlpool |
$169.55
|
| Rate for Payer: Mclaren Commercial |
$157.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.82
|
|
|
HC Z RETRIEVAL SNARE
|
Facility
|
OP
|
$1,332.83
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$533.13 |
| Max. Negotiated Rate |
$1,332.83 |
| Rate for Payer: Aetna Commercial |
$1,199.55
|
| Rate for Payer: Aetna Medicare |
$666.42
|
| Rate for Payer: ASR ASR |
$1,292.85
|
| Rate for Payer: ASR Commercial |
$1,292.85
|
| Rate for Payer: BCBS Complete |
$533.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,091.45
|
| Rate for Payer: BCN Commercial |
$1,033.34
|
| Rate for Payer: Cash Price |
$1,066.26
|
| Rate for Payer: Cofinity Commercial |
$1,252.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.26
|
| Rate for Payer: Healthscope Commercial |
$1,332.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.85
|
| Rate for Payer: Mclaren Commercial |
$1,199.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.91
|
| Rate for Payer: Nomi Health Commercial |
$1,092.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$866.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,167.83
|
| Rate for Payer: Priority Health Narrow Network |
$934.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,172.89
|
|
|
HC Z RETRIEVAL SNARE
|
Facility
|
IP
|
$1,332.83
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$866.34 |
| Max. Negotiated Rate |
$1,332.83 |
| Rate for Payer: Aetna Commercial |
$1,199.55
|
| Rate for Payer: ASR ASR |
$1,292.85
|
| Rate for Payer: ASR Commercial |
$1,292.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.12
|
| Rate for Payer: BCN Commercial |
$1,033.34
|
| Rate for Payer: Cash Price |
$1,066.26
|
| Rate for Payer: Cofinity Commercial |
$1,252.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.26
|
| Rate for Payer: Healthscope Commercial |
$1,332.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,292.85
|
| Rate for Payer: Mclaren Commercial |
$1,199.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.91
|
| Rate for Payer: Nomi Health Commercial |
$1,092.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$866.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,172.89
|
|
|
HC Z STENT URETERAL
|
Facility
|
OP
|
$1,212.86
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$485.14 |
| Max. Negotiated Rate |
$1,212.86 |
| Rate for Payer: Aetna Commercial |
$1,091.57
|
| Rate for Payer: Aetna Medicare |
$606.43
|
| Rate for Payer: ASR ASR |
$1,176.47
|
| Rate for Payer: ASR Commercial |
$1,176.47
|
| Rate for Payer: BCBS Complete |
$485.14
|
| Rate for Payer: BCBS Trust/PPO |
$993.21
|
| Rate for Payer: BCN Commercial |
$940.33
|
| Rate for Payer: Cash Price |
$970.29
|
| Rate for Payer: Cofinity Commercial |
$1,140.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.29
|
| Rate for Payer: Healthscope Commercial |
$1,212.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.47
|
| Rate for Payer: Mclaren Commercial |
$1,091.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.93
|
| Rate for Payer: Nomi Health Commercial |
$994.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,062.71
|
| Rate for Payer: Priority Health Narrow Network |
$850.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.32
|
|
|
HC Z STENT URETERAL
|
Facility
|
IP
|
$1,212.86
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$788.36 |
| Max. Negotiated Rate |
$1,212.86 |
| Rate for Payer: Aetna Commercial |
$1,091.57
|
| Rate for Payer: ASR ASR |
$1,176.47
|
| Rate for Payer: ASR Commercial |
$1,176.47
|
| Rate for Payer: BCBS Trust/PPO |
$988.36
|
| Rate for Payer: BCN Commercial |
$940.33
|
| Rate for Payer: Cash Price |
$970.29
|
| Rate for Payer: Cofinity Commercial |
$1,140.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.29
|
| Rate for Payer: Healthscope Commercial |
$1,212.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.47
|
| Rate for Payer: Mclaren Commercial |
$1,091.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.93
|
| Rate for Payer: Nomi Health Commercial |
$994.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,067.32
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,756.94
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$702.78 |
| Max. Negotiated Rate |
$1,756.94 |
| Rate for Payer: Aetna Commercial |
$1,581.25
|
| Rate for Payer: Aetna Medicare |
$878.47
|
| Rate for Payer: ASR ASR |
$1,704.23
|
| Rate for Payer: ASR Commercial |
$1,704.23
|
| Rate for Payer: BCBS Complete |
$702.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.76
|
| Rate for Payer: BCN Commercial |
$1,362.16
|
| Rate for Payer: Cash Price |
$1,405.55
|
| Rate for Payer: Cofinity Commercial |
$1,651.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.55
|
| Rate for Payer: Healthscope Commercial |
$1,756.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,704.23
|
| Rate for Payer: Mclaren Commercial |
$1,581.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.40
|
| Rate for Payer: Nomi Health Commercial |
$1,440.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,546.11
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,756.94
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,142.01 |
| Max. Negotiated Rate |
$1,756.94 |
| Rate for Payer: Aetna Commercial |
$1,581.25
|
| Rate for Payer: ASR ASR |
$1,704.23
|
| Rate for Payer: ASR Commercial |
$1,704.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,431.73
|
| Rate for Payer: BCN Commercial |
$1,362.16
|
| Rate for Payer: Cash Price |
$1,405.55
|
| Rate for Payer: Cofinity Commercial |
$1,651.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.55
|
| Rate for Payer: Healthscope Commercial |
$1,756.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,704.23
|
| Rate for Payer: Mclaren Commercial |
$1,581.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.40
|
| Rate for Payer: Nomi Health Commercial |
$1,440.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,546.11
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
IP
|
$646.29
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$420.09 |
| Max. Negotiated Rate |
$646.29 |
| Rate for Payer: Aetna Commercial |
$581.66
|
| Rate for Payer: ASR ASR |
$626.90
|
| Rate for Payer: ASR Commercial |
$626.90
|
| Rate for Payer: BCBS Trust/PPO |
$526.66
|
| Rate for Payer: BCN Commercial |
$501.07
|
| Rate for Payer: Cash Price |
$517.03
|
| Rate for Payer: Cofinity Commercial |
$607.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.03
|
| Rate for Payer: Healthscope Commercial |
$646.29
|
| Rate for Payer: Healthscope Whirlpool |
$626.90
|
| Rate for Payer: Mclaren Commercial |
$581.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.35
|
| Rate for Payer: Nomi Health Commercial |
$529.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$568.74
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
OP
|
$646.29
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$258.52 |
| Max. Negotiated Rate |
$646.29 |
| Rate for Payer: Aetna Commercial |
$581.66
|
| Rate for Payer: Aetna Medicare |
$323.14
|
| Rate for Payer: ASR ASR |
$626.90
|
| Rate for Payer: ASR Commercial |
$626.90
|
| Rate for Payer: BCBS Complete |
$258.52
|
| Rate for Payer: BCBS Trust/PPO |
$529.25
|
| Rate for Payer: BCN Commercial |
$501.07
|
| Rate for Payer: Cash Price |
$517.03
|
| Rate for Payer: Cofinity Commercial |
$607.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.03
|
| Rate for Payer: Healthscope Commercial |
$646.29
|
| Rate for Payer: Healthscope Whirlpool |
$626.90
|
| Rate for Payer: Mclaren Commercial |
$581.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.35
|
| Rate for Payer: Nomi Health Commercial |
$529.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$566.28
|
| Rate for Payer: Priority Health Narrow Network |
$453.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$568.74
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
OP
|
$1,020.90
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$408.36 |
| Max. Negotiated Rate |
$1,020.90 |
| Rate for Payer: Aetna Commercial |
$918.81
|
| Rate for Payer: Aetna Medicare |
$510.45
|
| Rate for Payer: ASR ASR |
$990.27
|
| Rate for Payer: ASR Commercial |
$990.27
|
| Rate for Payer: BCBS Complete |
$408.36
|
| Rate for Payer: BCBS Trust/PPO |
$836.02
|
| Rate for Payer: BCN Commercial |
$791.50
|
| Rate for Payer: Cash Price |
$816.72
|
| Rate for Payer: Cofinity Commercial |
$959.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.72
|
| Rate for Payer: Healthscope Commercial |
$1,020.90
|
| Rate for Payer: Healthscope Whirlpool |
$990.27
|
| Rate for Payer: Mclaren Commercial |
$918.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$837.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$894.51
|
| Rate for Payer: Priority Health Narrow Network |
$715.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$898.39
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
IP
|
$1,020.90
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.58 |
| Max. Negotiated Rate |
$1,020.90 |
| Rate for Payer: Aetna Commercial |
$918.81
|
| Rate for Payer: ASR ASR |
$990.27
|
| Rate for Payer: ASR Commercial |
$990.27
|
| Rate for Payer: BCBS Trust/PPO |
$831.93
|
| Rate for Payer: BCN Commercial |
$791.50
|
| Rate for Payer: Cash Price |
$816.72
|
| Rate for Payer: Cofinity Commercial |
$959.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.72
|
| Rate for Payer: Healthscope Commercial |
$1,020.90
|
| Rate for Payer: Healthscope Whirlpool |
$990.27
|
| Rate for Payer: Mclaren Commercial |
$918.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$837.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$898.39
|
|
|
HC Z VENA CAVA FILTER
|
Facility
|
OP
|
$5,871.33
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,348.53 |
| Max. Negotiated Rate |
$5,871.33 |
| Rate for Payer: Aetna Commercial |
$5,284.20
|
| Rate for Payer: Aetna Medicare |
$2,935.66
|
| Rate for Payer: ASR ASR |
$5,695.19
|
| Rate for Payer: ASR Commercial |
$5,695.19
|
| Rate for Payer: BCBS Complete |
$2,348.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,808.03
|
| Rate for Payer: BCN Commercial |
$4,552.04
|
| Rate for Payer: Cash Price |
$4,697.06
|
| Rate for Payer: Cofinity Commercial |
$5,519.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,697.06
|
| Rate for Payer: Healthscope Commercial |
$5,871.33
|
| Rate for Payer: Healthscope Whirlpool |
$5,695.19
|
| Rate for Payer: Mclaren Commercial |
$5,284.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,990.63
|
| Rate for Payer: Nomi Health Commercial |
$4,814.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,816.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,144.46
|
| Rate for Payer: Priority Health Narrow Network |
$4,115.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,166.77
|
|
|
HC Z VENA CAVA FILTER
|
Facility
|
IP
|
$5,871.33
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,816.36 |
| Max. Negotiated Rate |
$5,871.33 |
| Rate for Payer: Aetna Commercial |
$5,284.20
|
| Rate for Payer: ASR ASR |
$5,695.19
|
| Rate for Payer: ASR Commercial |
$5,695.19
|
| Rate for Payer: BCBS Trust/PPO |
$4,784.55
|
| Rate for Payer: BCN Commercial |
$4,552.04
|
| Rate for Payer: Cash Price |
$4,697.06
|
| Rate for Payer: Cofinity Commercial |
$5,519.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,697.06
|
| Rate for Payer: Healthscope Commercial |
$5,871.33
|
| Rate for Payer: Healthscope Whirlpool |
$5,695.19
|
| Rate for Payer: Mclaren Commercial |
$5,284.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,990.63
|
| Rate for Payer: Nomi Health Commercial |
$4,814.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,816.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,166.77
|
|
