|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
OP
|
$809.36
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$809.36 |
| Rate for Payer: Aetna Commercial |
$728.42
|
| Rate for Payer: Aetna Medicare |
$217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: ASR ASR |
$785.08
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$627.50
|
| Rate for Payer: BCN Commercial |
$627.50
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cofinity Commercial |
$760.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$809.36
|
| Rate for Payer: Healthscope Whirlpool |
$785.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$217.81
|
| Rate for Payer: Mclaren Commercial |
$728.42
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$687.96
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$239.59
|
| Rate for Payer: PHP Medicaid |
$119.14
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.53
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$408.42
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$712.24
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: VA VA |
$217.81
|
|
|
HC 2 PIECE WAFER
|
Facility
|
IP
|
$13.16
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.21 |
| Max. Negotiated Rate |
$13.16 |
| Rate for Payer: Aetna Commercial |
$11.84
|
| Rate for Payer: ASR ASR |
$12.77
|
| Rate for Payer: BCBS Trust/PPO |
$10.20
|
| Rate for Payer: BCN Commercial |
$10.20
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$12.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$13.16
|
| Rate for Payer: Healthscope Whirlpool |
$12.77
|
| Rate for Payer: Mclaren Commercial |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.58
|
|
|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.16
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$13.16 |
| Rate for Payer: Aetna Commercial |
$11.84
|
| Rate for Payer: ASR ASR |
$12.77
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: BCBS Trust/PPO |
$10.20
|
| Rate for Payer: BCN Commercial |
$10.20
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$12.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$13.16
|
| Rate for Payer: Healthscope Whirlpool |
$12.77
|
| Rate for Payer: Mclaren Commercial |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11.58
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$656.07
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$459.25 |
| Max. Negotiated Rate |
$656.07 |
| Rate for Payer: Aetna Commercial |
$590.46
|
| Rate for Payer: ASR ASR |
$636.39
|
| Rate for Payer: BCBS Trust/PPO |
$508.65
|
| Rate for Payer: BCN Commercial |
$508.65
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cofinity Commercial |
$616.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.86
|
| Rate for Payer: Healthscope Commercial |
$656.07
|
| Rate for Payer: Healthscope Whirlpool |
$636.39
|
| Rate for Payer: Mclaren Commercial |
$590.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.34
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$656.07
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$656.07 |
| Rate for Payer: Aetna Commercial |
$590.46
|
| Rate for Payer: ASR ASR |
$636.39
|
| Rate for Payer: BCBS Complete |
$262.43
|
| Rate for Payer: BCBS Trust/PPO |
$508.65
|
| Rate for Payer: BCN Commercial |
$508.65
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cofinity Commercial |
$616.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.86
|
| Rate for Payer: Healthscope Commercial |
$656.07
|
| Rate for Payer: Healthscope Whirlpool |
$636.39
|
| Rate for Payer: Mclaren Commercial |
$590.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.52
|
| Rate for Payer: Priority Health Narrow Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$577.34
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$625.36
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$85.38 |
| Max. Negotiated Rate |
$625.36 |
| Rate for Payer: Aetna Commercial |
$562.82
|
| Rate for Payer: ASR ASR |
$606.60
|
| Rate for Payer: BCBS Complete |
$250.14
|
| Rate for Payer: BCBS Trust/PPO |
$484.84
|
| Rate for Payer: BCN Commercial |
$484.84
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.29
|
| Rate for Payer: Healthscope Commercial |
$625.36
|
| Rate for Payer: Healthscope Whirlpool |
$606.60
|
| Rate for Payer: Mclaren Commercial |
$562.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$531.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.72
|
| Rate for Payer: Priority Health Narrow Network |
$85.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$550.32
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$625.36
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$437.75 |
| Max. Negotiated Rate |
$625.36 |
| Rate for Payer: Aetna Commercial |
$562.82
|
| Rate for Payer: ASR ASR |
$606.60
|
| Rate for Payer: BCBS Trust/PPO |
$484.84
|
| Rate for Payer: BCN Commercial |
$484.84
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.29
|
| Rate for Payer: Healthscope Commercial |
$625.36
|
| Rate for Payer: Healthscope Whirlpool |
$606.60
|
| Rate for Payer: Mclaren Commercial |
$562.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$531.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$550.32
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$24.03
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.82 |
| Max. Negotiated Rate |
$24.03 |
| Rate for Payer: Aetna Commercial |
$21.63
|
| Rate for Payer: ASR ASR |
$23.31
|
| Rate for Payer: BCBS Trust/PPO |
$18.63
|
| Rate for Payer: BCN Commercial |
$18.63
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$22.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$24.03
|
| Rate for Payer: Healthscope Whirlpool |
$23.31
|
| Rate for Payer: Mclaren Commercial |
$21.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.15
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$24.03
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$24.03 |
| Rate for Payer: Aetna Commercial |
$21.63
|
| Rate for Payer: ASR ASR |
$23.31
|
| Rate for Payer: BCBS Complete |
$9.61
|
| Rate for Payer: BCBS Trust/PPO |
$18.63
|
| Rate for Payer: BCN Commercial |
$18.63
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$22.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$24.03
|
| Rate for Payer: Healthscope Whirlpool |
$23.31
|
| Rate for Payer: Mclaren Commercial |
$21.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.87
|
| Rate for Payer: Priority Health Narrow Network |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.15
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,104.48
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$441.79 |
| Max. Negotiated Rate |
$1,104.48 |
| Rate for Payer: Aetna Commercial |
$994.03
|
| Rate for Payer: ASR ASR |
$1,071.35
|
| Rate for Payer: BCBS Complete |
$441.79
|
| Rate for Payer: BCBS Trust/PPO |
$856.30
|
| Rate for Payer: BCN Commercial |
$856.30
|
| Rate for Payer: Cash Price |
$883.58
|
| Rate for Payer: Cofinity Commercial |
$1,038.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.58
|
| Rate for Payer: Healthscope Commercial |
$1,104.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,071.35
|
| Rate for Payer: Mclaren Commercial |
$994.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$938.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.08
|
| Rate for Payer: Priority Health Narrow Network |
$784.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$971.94
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,104.48
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$773.14 |
| Max. Negotiated Rate |
$1,104.48 |
| Rate for Payer: Aetna Commercial |
$994.03
|
| Rate for Payer: ASR ASR |
$1,071.35
|
| Rate for Payer: BCBS Trust/PPO |
$856.30
|
| Rate for Payer: BCN Commercial |
$856.30
|
| Rate for Payer: Cash Price |
$883.58
|
| Rate for Payer: Cofinity Commercial |
$1,038.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.58
|
| Rate for Payer: Healthscope Commercial |
$1,104.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,071.35
|
| Rate for Payer: Mclaren Commercial |
$994.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$938.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$971.94
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$957.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$669.98 |
| Max. Negotiated Rate |
$957.12 |
| Rate for Payer: Aetna Commercial |
$861.41
|
| Rate for Payer: ASR ASR |
$928.41
|
| Rate for Payer: BCBS Trust/PPO |
$742.06
|
| Rate for Payer: BCN Commercial |
$742.06
|
| Rate for Payer: Cash Price |
$765.70
|
| Rate for Payer: Cofinity Commercial |
$899.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.70
|
| Rate for Payer: Healthscope Commercial |
$957.12
|
| Rate for Payer: Healthscope Whirlpool |
$928.41
|
| Rate for Payer: Mclaren Commercial |
$861.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$813.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$842.27
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$957.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$382.85 |
| Max. Negotiated Rate |
$957.12 |
| Rate for Payer: Aetna Commercial |
$861.41
|
| Rate for Payer: ASR ASR |
$928.41
|
| Rate for Payer: BCBS Complete |
$382.85
|
| Rate for Payer: BCBS Trust/PPO |
$742.06
|
| Rate for Payer: BCN Commercial |
$742.06
|
| Rate for Payer: Cash Price |
$765.70
|
| Rate for Payer: Cofinity Commercial |
$899.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.70
|
| Rate for Payer: Healthscope Commercial |
$957.12
|
| Rate for Payer: Healthscope Whirlpool |
$928.41
|
| Rate for Payer: Mclaren Commercial |
$861.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$813.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.98
|
| Rate for Payer: Priority Health Narrow Network |
$679.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$842.27
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$843.43 |
| Max. Negotiated Rate |
$1,204.90 |
| Rate for Payer: Aetna Commercial |
$1,084.41
|
| Rate for Payer: ASR ASR |
$1,168.75
|
| Rate for Payer: BCBS Trust/PPO |
$934.16
|
| Rate for Payer: BCN Commercial |
$934.16
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,132.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,204.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.75
|
| Rate for Payer: Mclaren Commercial |
$1,084.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.31
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$481.96 |
| Max. Negotiated Rate |
$1,204.90 |
| Rate for Payer: Aetna Commercial |
$1,084.41
|
| Rate for Payer: ASR ASR |
$1,168.75
|
| Rate for Payer: BCBS Complete |
$481.96
|
| Rate for Payer: BCBS Trust/PPO |
$934.16
|
| Rate for Payer: BCN Commercial |
$934.16
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,132.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,204.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.75
|
| Rate for Payer: Mclaren Commercial |
$1,084.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,096.46
|
| Rate for Payer: Priority Health Narrow Network |
$855.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.31
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,044.13
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$417.65 |
| Max. Negotiated Rate |
$1,044.13 |
| Rate for Payer: Aetna Commercial |
$939.72
|
| Rate for Payer: ASR ASR |
$1,012.81
|
| Rate for Payer: BCBS Complete |
$417.65
|
| Rate for Payer: BCBS Trust/PPO |
$809.51
|
| Rate for Payer: BCN Commercial |
$809.51
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$981.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$1,044.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.81
|
| Rate for Payer: Mclaren Commercial |
$939.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.16
|
| Rate for Payer: Priority Health Narrow Network |
$741.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.83
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,044.13
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$730.89 |
| Max. Negotiated Rate |
$1,044.13 |
| Rate for Payer: Aetna Commercial |
$939.72
|
| Rate for Payer: ASR ASR |
$1,012.81
|
| Rate for Payer: BCBS Trust/PPO |
$809.51
|
| Rate for Payer: BCN Commercial |
$809.51
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$981.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$1,044.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.81
|
| Rate for Payer: Mclaren Commercial |
$939.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.83
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$481.96 |
| Max. Negotiated Rate |
$1,204.90 |
| Rate for Payer: Aetna Commercial |
$1,084.41
|
| Rate for Payer: ASR ASR |
$1,168.75
|
| Rate for Payer: BCBS Complete |
$481.96
|
| Rate for Payer: BCBS Trust/PPO |
$934.16
|
| Rate for Payer: BCN Commercial |
$934.16
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,132.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,204.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.75
|
| Rate for Payer: Mclaren Commercial |
$1,084.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,096.46
|
| Rate for Payer: Priority Health Narrow Network |
$855.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.31
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$843.43 |
| Max. Negotiated Rate |
$1,204.90 |
| Rate for Payer: Aetna Commercial |
$1,084.41
|
| Rate for Payer: ASR ASR |
$1,168.75
|
| Rate for Payer: BCBS Trust/PPO |
$934.16
|
| Rate for Payer: BCN Commercial |
$934.16
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,132.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,204.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,168.75
|
| Rate for Payer: Mclaren Commercial |
$1,084.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,060.31
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,044.13
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$417.65 |
| Max. Negotiated Rate |
$1,044.13 |
| Rate for Payer: Aetna Commercial |
$939.72
|
| Rate for Payer: ASR ASR |
$1,012.81
|
| Rate for Payer: BCBS Complete |
$417.65
|
| Rate for Payer: BCBS Trust/PPO |
$809.51
|
| Rate for Payer: BCN Commercial |
$809.51
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$981.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$1,044.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.81
|
| Rate for Payer: Mclaren Commercial |
$939.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.16
|
| Rate for Payer: Priority Health Narrow Network |
$741.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.83
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,044.13
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$730.89 |
| Max. Negotiated Rate |
$1,044.13 |
| Rate for Payer: Aetna Commercial |
$939.72
|
| Rate for Payer: ASR ASR |
$1,012.81
|
| Rate for Payer: BCBS Trust/PPO |
$809.51
|
| Rate for Payer: BCN Commercial |
$809.51
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$981.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$1,044.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,012.81
|
| Rate for Payer: Mclaren Commercial |
$939.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$918.83
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$72.59
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.04 |
| Max. Negotiated Rate |
$72.59 |
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: ASR ASR |
$70.41
|
| Rate for Payer: BCBS Complete |
$29.04
|
| Rate for Payer: BCBS Trust/PPO |
$56.28
|
| Rate for Payer: BCN Commercial |
$56.28
|
| Rate for Payer: Cash Price |
$58.07
|
| Rate for Payer: Cofinity Commercial |
$68.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.07
|
| Rate for Payer: Healthscope Commercial |
$72.59
|
| Rate for Payer: Healthscope Whirlpool |
$70.41
|
| Rate for Payer: Mclaren Commercial |
$65.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.06
|
| Rate for Payer: Priority Health Narrow Network |
$51.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.88
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$72.59
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.81 |
| Max. Negotiated Rate |
$72.59 |
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: ASR ASR |
$70.41
|
| Rate for Payer: BCBS Trust/PPO |
$56.28
|
| Rate for Payer: BCN Commercial |
$56.28
|
| Rate for Payer: Cash Price |
$58.07
|
| Rate for Payer: Cofinity Commercial |
$68.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.07
|
| Rate for Payer: Healthscope Commercial |
$72.59
|
| Rate for Payer: Healthscope Whirlpool |
$70.41
|
| Rate for Payer: Mclaren Commercial |
$65.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.88
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.18 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: ASR ASR |
$46.50
|
| Rate for Payer: BCBS Complete |
$13.84
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.17
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$24.09
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Mclaren Medicaid |
$13.18
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$13.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$26.50
|
| Rate for Payer: PHP Medicaid |
$13.18
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.63
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$34.04
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$24.81
|
| Rate for Payer: VA VA |
$24.09
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.56 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Aetna Commercial |
$43.15
|
| Rate for Payer: ASR ASR |
$46.50
|
| Rate for Payer: BCBS Trust/PPO |
$37.17
|
| Rate for Payer: BCN Commercial |
$37.17
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$47.94
|
| Rate for Payer: Healthscope Whirlpool |
$46.50
|
| Rate for Payer: Mclaren Commercial |
$43.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.19
|
|
