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Charge Type Price  
Service Code CPT 99214
Hospital Charge Code 6599214
Min. Negotiated Rate $42.74
Max. Negotiated Rate $197.42
Rate for Payer: Aetna Better Health CHIP/Medicaid $56.10
Rate for Payer: Humana Commercial $146.86
Rate for Payer: Humana Commercial $136.37
Rate for Payer: Humana Medicare $146.86
Rate for Payer: Humana Medicare $136.37
Rate for Payer: Magellan Medicaid $53.43
Rate for Payer: Molina Complete Care CHIP/Medicaid $53.43
Rate for Payer: Prime Health Services Workers Comp $197.42
Rate for Payer: Sunshine Health FHK $53.43
Rate for Payer: Sunshine Health Medicaid $53.43
Rate for Payer: Sunshine Health Medicaid $42.74
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $77.38
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $67.70
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $72.54
Service Code CPT T1015
Hospital Charge Code 166T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Service Code CPT T1015
Hospital Charge Code 167T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Rate for Payer: Sunshine Health Medicaid $71.61
Service Code CPT 99213
Hospital Charge Code 6299213
Min. Negotiated Rate $27.43
Max. Negotiated Rate $139.81
Rate for Payer: Aetna Better Health CHIP/Medicaid $36.00
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $64.61
Rate for Payer: Behavioral Services Network Medicare $64.61
Rate for Payer: Carelon Commercial/Medicare $51.12
Rate for Payer: Carelon Medicare $64.61
Rate for Payer: Humana Commercial $92.92
Rate for Payer: Humana Commercial $100.06
Rate for Payer: Humana Medicare $92.92
Rate for Payer: Humana Medicare $100.06
Rate for Payer: Lucet Commercial $48.46
Rate for Payer: Lucet Commercial $54.92
Rate for Payer: Lucet Commercial $58.15
Rate for Payer: Magellan Medicaid $34.29
Rate for Payer: Molina Complete Care CHIP/Medicaid $34.29
Rate for Payer: Molina Complete Care Medicare $64.61
Rate for Payer: Prime Health Services Workers Comp $139.81
Rate for Payer: Sunshine Health FHK $34.29
Rate for Payer: Sunshine Health Medicaid $34.29
Rate for Payer: Sunshine Health Medicaid $27.43
Rate for Payer: Sunshine Health MMP/Medicare $64.61
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $52.54
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $49.26
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $45.98
Service Code CPT T1015
Hospital Charge Code 163T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Service Code CPT 99215
Hospital Charge Code 6899215
Min. Negotiated Rate $68.36
Max. Negotiated Rate $278.85
Rate for Payer: Aetna Better Health CHIP/Medicaid $89.72
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $141.34
Rate for Payer: Behavioral Services Network Medicare $141.34
Rate for Payer: Carelon Medicare $141.34
Rate for Payer: Humana Commercial $182.70
Rate for Payer: Humana Commercial $196.76
Rate for Payer: Humana Medicare $196.76
Rate for Payer: Humana Medicare $182.70
Rate for Payer: Lucet Commercial $120.14
Rate for Payer: Lucet Commercial $127.21
Rate for Payer: Lucet Commercial $106.00
Rate for Payer: Magellan Medicaid $85.45
Rate for Payer: Molina Complete Care CHIP/Medicaid $85.45
Rate for Payer: Molina Complete Care Medicare $141.34
Rate for Payer: Prime Health Services Workers Comp $278.85
Rate for Payer: Sunshine Health FHK $85.45
Rate for Payer: Sunshine Health Medicaid $85.45
Rate for Payer: Sunshine Health Medicaid $68.36
Rate for Payer: Sunshine Health MMP/Medicare $141.34
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $114.94
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $107.76
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $100.58
Service Code CPT T1015
Hospital Charge Code 164T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Rate for Payer: Sunshine Health Medicaid $71.61
Service Code CPT 99211
Hospital Charge Code 5299211
Min. Negotiated Rate $6.07
Max. Negotiated Rate $34.95
Rate for Payer: Aetna Better Health CHIP/Medicaid $18.48
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $8.53
Rate for Payer: Behavioral Services Network Medicare $8.53
Rate for Payer: Carelon Medicare $8.53
Rate for Payer: Humana Commercial $27.66
Rate for Payer: Humana Commercial $25.69
Rate for Payer: Humana Medicare $25.69
Rate for Payer: Humana Medicare $27.66
Rate for Payer: Lucet Commercial $7.25
Rate for Payer: Lucet Commercial $6.40
Rate for Payer: Lucet Commercial $7.68
Rate for Payer: Magellan Medicaid $17.60
Rate for Payer: Molina Complete Care CHIP/Medicaid $17.60
Rate for Payer: Molina Complete Care Medicare $8.53
Rate for Payer: Prime Health Services Workers Comp $34.95
Rate for Payer: Sunshine Health FHK $17.60
Rate for Payer: Sunshine Health Medicaid $14.08
Rate for Payer: Sunshine Health Medicaid $17.60
Rate for Payer: Sunshine Health MMP/Medicare $8.53
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.50
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.94
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.07
Service Code CPT 99212
Hospital Charge Code 5899212
Min. Negotiated Rate $22.51
Max. Negotiated Rate $86.66
Rate for Payer: Aetna Better Health CHIP/Medicaid $29.55
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $34.73
Rate for Payer: Behavioral Services Network Medicare $34.73
Rate for Payer: Carelon Medicare $34.73
Rate for Payer: Humana Commercial $60.09
Rate for Payer: Humana Commercial $55.80
Rate for Payer: Humana Medicare $55.80
Rate for Payer: Humana Medicare $60.09
Rate for Payer: Lucet Commercial $29.52
Rate for Payer: Lucet Commercial $31.26
Rate for Payer: Lucet Commercial $26.05
Rate for Payer: Magellan Medicaid $28.14
Rate for Payer: Molina Complete Care CHIP/Medicaid $28.14
Rate for Payer: Molina Complete Care Medicare $34.73
Rate for Payer: Prime Health Services Workers Comp $86.66
Rate for Payer: Sunshine Health FHK $28.14
Rate for Payer: Sunshine Health Medicaid $28.14
Rate for Payer: Sunshine Health Medicaid $22.51
Rate for Payer: Sunshine Health MMP/Medicare $34.73
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $24.71
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $28.24
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $26.48
Service Code CPT T1015
Hospital Charge Code 165T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Rate for Payer: Sunshine Health Medicaid $71.61
Service Code CPT T1015
Hospital Charge Code 171T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Service Code CPT 99203
Hospital Charge Code 3699203
Min. Negotiated Rate $57.64
Max. Negotiated Rate $172.60
Rate for Payer: Aetna Better Health CHIP/Medicaid $88.45
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $81.01
Rate for Payer: Behavioral Services Network Medicare $81.01
Rate for Payer: Carelon Medicare $81.01
Rate for Payer: Humana Commercial $149.63
Rate for Payer: Humana Commercial $138.94
Rate for Payer: Humana Medicare $149.63
Rate for Payer: Humana Medicare $138.94
Rate for Payer: Lucet Commercial $60.76
Rate for Payer: Lucet Commercial $68.86
Rate for Payer: Lucet Commercial $72.91
Rate for Payer: Magellan Medicaid $84.24
Rate for Payer: Molina Complete Care CHIP/Medicaid $84.24
Rate for Payer: Molina Complete Care Medicare $81.01
Rate for Payer: Prime Health Services Workers Comp $172.60
Rate for Payer: Sunshine Health FHK $84.24
Rate for Payer: Sunshine Health Medicaid $67.39
Rate for Payer: Sunshine Health Medicaid $84.24
Rate for Payer: Sunshine Health MMP/Medicare $81.01
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $65.88
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $61.76
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $57.64
Service Code CPT 99205 HO
Hospital Charge Code 4399205
Min. Negotiated Rate $75.19
Max. Negotiated Rate $75.19
Rate for Payer: Molina Complete Care Marketplace $75.19
Service Code CPT T1015
Hospital Charge Code 168T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Service Code CPT 99205
Hospital Charge Code 4299205
Min. Negotiated Rate $127.22
Max. Negotiated Rate $342.51
Rate for Payer: Aetna Better Health CHIP/Medicaid $174.78
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $178.78
Rate for Payer: Behavioral Services Network Medicare $178.78
Rate for Payer: Carelon Medicare $178.78
Rate for Payer: Humana Commercial $282.77
Rate for Payer: Humana Commercial $262.57
Rate for Payer: Humana Medicare $262.57
Rate for Payer: Humana Medicare $282.77
Rate for Payer: Lucet Commercial $134.08
Rate for Payer: Lucet Commercial $160.90
Rate for Payer: Lucet Commercial $151.96
Rate for Payer: Magellan Medicaid $166.46
Rate for Payer: Molina Complete Care CHIP/Medicaid $166.46
Rate for Payer: Molina Complete Care Medicare $178.78
Rate for Payer: Prime Health Services Workers Comp $342.51
Rate for Payer: Sunshine Health FHK $166.46
Rate for Payer: Sunshine Health Medicaid $166.46
Rate for Payer: Sunshine Health Medicaid $133.17
Rate for Payer: Sunshine Health MMP/Medicare $178.78
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $145.39
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $136.30
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $127.22
Service Code CPT 99202
Hospital Charge Code 3399202
Min. Negotiated Rate $33.17
Max. Negotiated Rate $110.83
Rate for Payer: Aetna Better Health CHIP/Medicaid $57.30
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $46.61
Rate for Payer: Behavioral Services Network Medicare $46.61
Rate for Payer: Carelon Medicare $46.61
Rate for Payer: Humana Commercial $94.95
Rate for Payer: Humana Commercial $102.26
Rate for Payer: Humana Medicare $94.95
Rate for Payer: Humana Medicare $102.26
Rate for Payer: Lucet Commercial $39.62
Rate for Payer: Lucet Commercial $34.96
Rate for Payer: Lucet Commercial $41.95
Rate for Payer: Magellan Medicaid $54.57
Rate for Payer: Molina Complete Care CHIP/Medicaid $54.57
Rate for Payer: Molina Complete Care Medicare $46.61
Rate for Payer: Prime Health Services Workers Comp $110.83
Rate for Payer: Sunshine Health FHK $54.57
Rate for Payer: Sunshine Health Medicaid $54.57
Rate for Payer: Sunshine Health Medicaid $43.66
Rate for Payer: Sunshine Health MMP/Medicare $46.61
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $35.54
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $33.17
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $37.90
Service Code CPT T1015
Hospital Charge Code 169T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Rate for Payer: Sunshine Health Medicaid $71.61
Service Code CPT T1015
Hospital Charge Code 170T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Rate for Payer: Sunshine Health Medicaid $71.61
Service Code CPT 99204
Hospital Charge Code 3999204
Min. Negotiated Rate $93.53
Max. Negotiated Rate $259.28
Rate for Payer: Aetna Better Health CHIP/Medicaid $132.54
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $131.44
Rate for Payer: Behavioral Services Network Medicare $131.44
Rate for Payer: Carelon Medicare $131.44
Rate for Payer: Humana Commercial $228.62
Rate for Payer: Humana Commercial $212.28
Rate for Payer: Humana Medicare $228.62
Rate for Payer: Humana Medicare $212.28
Rate for Payer: Lucet Commercial $118.30
Rate for Payer: Lucet Commercial $111.72
Rate for Payer: Lucet Commercial $98.58
Rate for Payer: Magellan Medicaid $126.23
Rate for Payer: Molina Complete Care CHIP/Medicaid $126.23
Rate for Payer: Molina Complete Care Medicare $131.44
Rate for Payer: Prime Health Services Workers Comp $259.28
Rate for Payer: Sunshine Health FHK $126.23
Rate for Payer: Sunshine Health Medicaid $100.98
Rate for Payer: Sunshine Health Medicaid $126.23
Rate for Payer: Sunshine Health MMP/Medicare $131.44
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $100.22
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $93.53
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $106.90
Service Code CPT 99211
Hospital Charge Code 5499211
Min. Negotiated Rate $6.07
Max. Negotiated Rate $34.95
Rate for Payer: Aetna Better Health CHIP/Medicaid $18.48
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $8.53
Rate for Payer: Behavioral Services Network Medicare $8.53
Rate for Payer: Carelon Medicare $8.53
Rate for Payer: Humana Commercial $25.69
Rate for Payer: Humana Commercial $27.66
Rate for Payer: Humana Medicare $27.66
Rate for Payer: Humana Medicare $25.69
Rate for Payer: Lucet Commercial $7.25
Rate for Payer: Lucet Commercial $6.40
Rate for Payer: Lucet Commercial $7.68
Rate for Payer: Magellan Medicaid $17.60
Rate for Payer: Molina Complete Care CHIP/Medicaid $17.60
Rate for Payer: Molina Complete Care Medicare $8.53
Rate for Payer: Prime Health Services Workers Comp $34.95
Rate for Payer: Sunshine Health FHK $17.60
Rate for Payer: Sunshine Health Medicaid $14.08
Rate for Payer: Sunshine Health Medicaid $17.60
Rate for Payer: Sunshine Health MMP/Medicare $8.53
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.50
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.07
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.94
Service Code CPT 99211
Hospital Charge Code 5599211
Min. Negotiated Rate $6.07
Max. Negotiated Rate $34.95
Rate for Payer: Aetna Better Health CHIP/Medicaid $18.48
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $8.53
Rate for Payer: Behavioral Services Network Medicare $8.53
Rate for Payer: Carelon Medicare $8.53
Rate for Payer: Humana Commercial $27.66
Rate for Payer: Humana Commercial $25.69
Rate for Payer: Humana Medicare $27.66
Rate for Payer: Humana Medicare $25.69
Rate for Payer: Lucet Commercial $6.40
Rate for Payer: Lucet Commercial $7.68
Rate for Payer: Lucet Commercial $7.25
Rate for Payer: Magellan Medicaid $17.60
Rate for Payer: Molina Complete Care CHIP/Medicaid $17.60
Rate for Payer: Molina Complete Care Medicare $8.53
Rate for Payer: Prime Health Services Workers Comp $34.95
Rate for Payer: Sunshine Health FHK $17.60
Rate for Payer: Sunshine Health Medicaid $17.60
Rate for Payer: Sunshine Health Medicaid $14.08
Rate for Payer: Sunshine Health MMP/Medicare $8.53
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.94
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.07
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.50
Service Code CPT H0048
Hospital Charge Code 103H0048
Min. Negotiated Rate $8.07
Max. Negotiated Rate $10.59
Rate for Payer: Aetna Better Health CHIP/Medicaid $10.59
Rate for Payer: Carelon Medicaid $10.00
Rate for Payer: Magellan Medicaid $10.09
Rate for Payer: Molina Complete Care CHIP/Medicaid $10.09
Rate for Payer: Molina Complete Care Marketplace $10.09
Rate for Payer: Sunshine Health FHK $10.09
Rate for Payer: Sunshine Health Medicaid $10.09
Rate for Payer: Sunshine Health Medicaid $8.07
Service Code CPT 99211
Hospital Charge Code 5399211
Min. Negotiated Rate $6.07
Max. Negotiated Rate $34.95
Rate for Payer: Aetna Better Health CHIP/Medicaid $18.48
Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility $8.53
Rate for Payer: Behavioral Services Network Medicare $8.53
Rate for Payer: Carelon Medicare $8.53
Rate for Payer: Humana Commercial $27.66
Rate for Payer: Humana Commercial $25.69
Rate for Payer: Humana Medicare $25.69
Rate for Payer: Humana Medicare $27.66
Rate for Payer: Lucet Commercial $7.68
Rate for Payer: Lucet Commercial $6.40
Rate for Payer: Lucet Commercial $7.25
Rate for Payer: Magellan Medicaid $17.60
Rate for Payer: Molina Complete Care CHIP/Medicaid $17.60
Rate for Payer: Molina Complete Care Medicare $8.53
Rate for Payer: Prime Health Services Workers Comp $34.95
Rate for Payer: Sunshine Health FHK $17.60
Rate for Payer: Sunshine Health Medicaid $14.08
Rate for Payer: Sunshine Health Medicaid $17.60
Rate for Payer: Sunshine Health MMP/Medicare $8.53
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.07
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.94
Rate for Payer: Tricare Military (Humana Behavioral Health) CHAMPVA/Tricare $6.50
Service Code CPT T1015
Hospital Charge Code 172T1015
Min. Negotiated Rate $57.29
Max. Negotiated Rate $75.19
Rate for Payer: Aetna Better Health CHIP/Medicaid $75.19
Rate for Payer: Carelon Medicaid $60.00
Rate for Payer: Magellan Medicaid $71.61
Rate for Payer: Molina Complete Care CHIP/Medicaid $71.61
Rate for Payer: Molina Complete Care Marketplace $75.19
Rate for Payer: Sunshine Health FHK $71.61
Rate for Payer: Sunshine Health Medicaid $71.61
Rate for Payer: Sunshine Health Medicaid $57.29
Service Code CPT T1015 HF
Hospital Charge Code 173T1015
Min. Negotiated Rate $8.07
Max. Negotiated Rate $10.59
Rate for Payer: Aetna Better Health CHIP/Medicaid $10.59
Rate for Payer: Carelon Medicaid $10.00
Rate for Payer: Magellan Medicaid $10.09
Rate for Payer: Molina Complete Care CHIP/Medicaid $10.09
Rate for Payer: Sunshine Health FHK $10.09
Rate for Payer: Sunshine Health Medicaid $8.07
Rate for Payer: Sunshine Health Medicaid $10.09