|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 23077
|
| Min. Negotiated Rate |
$820.40 |
| Max. Negotiated Rate |
$2,027.19 |
| Rate for Payer: Aetna Commercial |
$1,468.35
|
| Rate for Payer: Aetna Medicare |
$1,139.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,577.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.35
|
| Rate for Payer: BCBS Complete |
$820.40
|
| Rate for Payer: BCBS MAPPO |
$1,095.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,095.78
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,577.92
|
| Rate for Payer: Cofinity Commercial |
$1,468.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,095.78
|
| Rate for Payer: Healthscope Commercial |
$2,027.19
|
| Rate for Payer: Healthscope Commercial |
$1,753.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.15
|
| Rate for Payer: Nomi Health Commercial |
$1,314.94
|
| Rate for Payer: PACE SWMI |
$1,095.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,095.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.15
|
| Rate for Payer: Priority Health Medicare |
$1,095.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,095.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.78
|
|
|
PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>
|
Professional
|
Both
|
$6,657.00
|
|
|
Service Code
|
HCPCS 27364
|
| Min. Negotiated Rate |
$1,512.06 |
| Max. Negotiated Rate |
$4,327.05 |
| Rate for Payer: Aetna Commercial |
$2,026.16
|
| Rate for Payer: Aetna Medicare |
$1,572.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,177.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,026.16
|
| Rate for Payer: BCBS Complete |
$2,662.80
|
| Rate for Payer: BCBS MAPPO |
$1,512.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,512.06
|
| Rate for Payer: Cash Price |
$5,325.60
|
| Rate for Payer: Cash Price |
$5,325.60
|
| Rate for Payer: Cofinity Commercial |
$2,177.37
|
| Rate for Payer: Cofinity Commercial |
$2,026.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,512.06
|
| Rate for Payer: Healthscope Commercial |
$2,419.30
|
| Rate for Payer: Healthscope Commercial |
$2,797.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,587.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,327.05
|
| Rate for Payer: Nomi Health Commercial |
$1,814.47
|
| Rate for Payer: PACE SWMI |
$1,512.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,512.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,327.05
|
| Rate for Payer: Priority Health Medicare |
$1,512.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,512.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,512.06
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 25077
|
| Min. Negotiated Rate |
$835.39 |
| Max. Negotiated Rate |
$1,869.40 |
| Rate for Payer: Aetna Commercial |
$1,119.42
|
| Rate for Payer: Aetna Medicare |
$868.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.42
|
| Rate for Payer: BCBS Complete |
$1,150.40
|
| Rate for Payer: BCBS MAPPO |
$835.39
|
| Rate for Payer: BCN Medicare Advantage |
$835.39
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,202.96
|
| Rate for Payer: Cofinity Commercial |
$1,119.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.39
|
| Rate for Payer: Healthscope Commercial |
$1,545.47
|
| Rate for Payer: Healthscope Commercial |
$1,336.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,869.40
|
| Rate for Payer: Nomi Health Commercial |
$1,002.47
|
| Rate for Payer: PACE SWMI |
$835.39
|
| Rate for Payer: PHP Medicare Advantage |
$835.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health Medicare |
$835.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.39
|
| Rate for Payer: UHC Medicare Advantage |
$835.39
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
IP
|
$2,876.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,811.88 |
| Max. Negotiated Rate |
$2,588.40 |
| Rate for Payer: Aetna Commercial |
$2,444.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,869.40
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$2,013.20
|
| Rate for Payer: Cofinity Commercial |
$2,473.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,013.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,300.80
|
| Rate for Payer: Healthscope Commercial |
$2,588.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,444.60
|
| Rate for Payer: PHP Commercial |
$2,444.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health SBD |
$1,811.88
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$835.39 |
| Max. Negotiated Rate |
$1,869.40 |
| Rate for Payer: Aetna Commercial |
$1,119.42
|
| Rate for Payer: Aetna Medicare |
$868.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.42
|
| Rate for Payer: BCBS Complete |
$1,150.40
|
| Rate for Payer: BCBS MAPPO |
$835.39
|
| Rate for Payer: BCN Medicare Advantage |
$835.39
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,202.96
|
| Rate for Payer: Cofinity Commercial |
$1,119.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.39
|
| Rate for Payer: Healthscope Commercial |
$1,336.62
|
| Rate for Payer: Healthscope Commercial |
$1,545.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,869.40
|
| Rate for Payer: Nomi Health Commercial |
$1,002.47
|
| Rate for Payer: PACE SWMI |
$835.39
|
| Rate for Payer: PHP Medicare Advantage |
$835.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health Medicare |
$835.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.39
|
| Rate for Payer: UHC Medicare Advantage |
$835.39
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
OP
|
$2,876.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$2,444.60
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,869.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$2,473.36
|
| Rate for Payer: Cofinity Commercial |
$2,013.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,013.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,300.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,588.40
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,444.60
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$2,444.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,811.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 21557
|
| Min. Negotiated Rate |
$670.80 |
| Max. Negotiated Rate |
$1,699.69 |
| Rate for Payer: Aetna Commercial |
$1,231.12
|
| Rate for Payer: Aetna Medicare |
$955.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.12
|
| Rate for Payer: BCBS Complete |
$670.80
|
| Rate for Payer: BCBS MAPPO |
$918.75
|
| Rate for Payer: BCN Medicare Advantage |
$918.75
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,323.00
|
| Rate for Payer: Cofinity Commercial |
$1,231.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.75
|
| Rate for Payer: Healthscope Commercial |
$1,470.00
|
| Rate for Payer: Healthscope Commercial |
$1,699.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,090.05
|
| Rate for Payer: Nomi Health Commercial |
$1,102.50
|
| Rate for Payer: PACE SWMI |
$918.75
|
| Rate for Payer: PHP Medicare Advantage |
$918.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.05
|
| Rate for Payer: Priority Health Medicare |
$918.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.75
|
| Rate for Payer: UHC Medicare Advantage |
$918.75
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 21558
|
| Min. Negotiated Rate |
$1,292.74 |
| Max. Negotiated Rate |
$2,391.57 |
| Rate for Payer: Aetna Commercial |
$1,732.27
|
| Rate for Payer: Aetna Medicare |
$1,344.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,861.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,732.27
|
| Rate for Payer: BCBS Complete |
$1,367.20
|
| Rate for Payer: BCBS MAPPO |
$1,292.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,292.74
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cofinity Commercial |
$1,861.55
|
| Rate for Payer: Cofinity Commercial |
$1,732.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,292.74
|
| Rate for Payer: Healthscope Commercial |
$2,391.57
|
| Rate for Payer: Healthscope Commercial |
$2,068.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,357.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,221.70
|
| Rate for Payer: Nomi Health Commercial |
$1,551.29
|
| Rate for Payer: PACE SWMI |
$1,292.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,292.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health Medicare |
$1,292.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,292.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,292.74
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM
|
Professional
|
Both
|
$2,361.00
|
|
|
Service Code
|
HCPCS 26117
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$1,534.65 |
| Rate for Payer: Aetna Commercial |
$966.72
|
| Rate for Payer: Aetna Medicare |
$750.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,038.86
|
| Rate for Payer: BCBS Complete |
$944.40
|
| Rate for Payer: BCBS MAPPO |
$721.43
|
| Rate for Payer: BCN Medicare Advantage |
$721.43
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$966.72
|
| Rate for Payer: Cofinity Commercial |
$1,038.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$721.43
|
| Rate for Payer: Healthscope Commercial |
$1,154.29
|
| Rate for Payer: Healthscope Commercial |
$1,334.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$757.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.65
|
| Rate for Payer: Nomi Health Commercial |
$865.72
|
| Rate for Payer: PACE SWMI |
$721.43
|
| Rate for Payer: PHP Medicare Advantage |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.65
|
| Rate for Payer: Priority Health Medicare |
$721.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$721.43
|
| Rate for Payer: UHC Medicare Advantage |
$721.43
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 27049
|
| Min. Negotiated Rate |
$1,264.80 |
| Max. Negotiated Rate |
$2,539.90 |
| Rate for Payer: Aetna Commercial |
$1,839.71
|
| Rate for Payer: Aetna Medicare |
$1,427.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,977.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,839.71
|
| Rate for Payer: BCBS Complete |
$1,264.80
|
| Rate for Payer: BCBS MAPPO |
$1,372.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,372.92
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cofinity Commercial |
$1,977.00
|
| Rate for Payer: Cofinity Commercial |
$1,839.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,372.92
|
| Rate for Payer: Healthscope Commercial |
$2,539.90
|
| Rate for Payer: Healthscope Commercial |
$2,196.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,441.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,055.30
|
| Rate for Payer: Nomi Health Commercial |
$1,647.50
|
| Rate for Payer: PACE SWMI |
$1,372.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,372.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health Medicare |
$1,372.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,372.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,372.92
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM
|
Professional
|
Both
|
$3,378.00
|
|
|
Service Code
|
HCPCS 27329
|
| Min. Negotiated Rate |
$1,006.86 |
| Max. Negotiated Rate |
$2,195.70 |
| Rate for Payer: Aetna Commercial |
$1,349.19
|
| Rate for Payer: Aetna Medicare |
$1,047.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.19
|
| Rate for Payer: BCBS Complete |
$1,351.20
|
| Rate for Payer: BCBS MAPPO |
$1,006.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.86
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$1,449.88
|
| Rate for Payer: Cofinity Commercial |
$1,349.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.86
|
| Rate for Payer: Healthscope Commercial |
$1,610.98
|
| Rate for Payer: Healthscope Commercial |
$1,862.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,057.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.70
|
| Rate for Payer: Nomi Health Commercial |
$1,208.23
|
| Rate for Payer: PACE SWMI |
$1,006.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.70
|
| Rate for Payer: Priority Health Medicare |
$1,006.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,006.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,006.86
|
|
|
PR RAPID DESENSITIZATION PROCEDURE EACH HOUR
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 95180
|
| Min. Negotiated Rate |
$96.26 |
| Max. Negotiated Rate |
$178.08 |
| Rate for Payer: Aetna Commercial |
$128.99
|
| Rate for Payer: Aetna Medicare |
$100.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.99
|
| Rate for Payer: BCBS Complete |
$101.20
|
| Rate for Payer: BCBS MAPPO |
$96.26
|
| Rate for Payer: BCN Medicare Advantage |
$96.26
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$138.61
|
| Rate for Payer: Cofinity Commercial |
$128.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.26
|
| Rate for Payer: Healthscope Commercial |
$178.08
|
| Rate for Payer: Healthscope Commercial |
$154.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.45
|
| Rate for Payer: Nomi Health Commercial |
$115.51
|
| Rate for Payer: PACE SWMI |
$96.26
|
| Rate for Payer: PHP Medicare Advantage |
$96.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.45
|
| Rate for Payer: Priority Health Medicare |
$96.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.26
|
| Rate for Payer: UHC Medicare Advantage |
$96.26
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Facility
|
OP
|
$851.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$536.13 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$723.35
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$595.70
|
| Rate for Payer: Cofinity Commercial |
$731.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$595.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$765.90
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.35
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$723.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.15
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$536.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$340.40 |
| Max. Negotiated Rate |
$646.09 |
| Rate for Payer: Aetna Commercial |
$467.98
|
| Rate for Payer: Aetna Medicare |
$363.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.91
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$349.24
|
| Rate for Payer: BCN Medicare Advantage |
$349.24
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$502.91
|
| Rate for Payer: Cofinity Commercial |
$467.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.24
|
| Rate for Payer: Healthscope Commercial |
$558.78
|
| Rate for Payer: Healthscope Commercial |
$646.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.15
|
| Rate for Payer: Nomi Health Commercial |
$419.09
|
| Rate for Payer: PACE SWMI |
$349.24
|
| Rate for Payer: PHP Medicare Advantage |
$349.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.15
|
| Rate for Payer: Priority Health Medicare |
$349.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.24
|
| Rate for Payer: UHC Medicare Advantage |
$349.24
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Facility
|
IP
|
$851.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$536.13 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Aetna Commercial |
$723.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.15
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$595.70
|
| Rate for Payer: Cofinity Commercial |
$731.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$595.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.80
|
| Rate for Payer: Healthscope Commercial |
$765.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.35
|
| Rate for Payer: PHP Commercial |
$723.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.15
|
| Rate for Payer: Priority Health SBD |
$536.13
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 28313
|
| Min. Negotiated Rate |
$340.40 |
| Max. Negotiated Rate |
$646.09 |
| Rate for Payer: Aetna Commercial |
$467.98
|
| Rate for Payer: Aetna Medicare |
$363.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.98
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$349.24
|
| Rate for Payer: BCN Medicare Advantage |
$349.24
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$502.91
|
| Rate for Payer: Cofinity Commercial |
$467.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.24
|
| Rate for Payer: Healthscope Commercial |
$558.78
|
| Rate for Payer: Healthscope Commercial |
$646.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.15
|
| Rate for Payer: Nomi Health Commercial |
$419.09
|
| Rate for Payer: PACE SWMI |
$349.24
|
| Rate for Payer: PHP Medicare Advantage |
$349.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.15
|
| Rate for Payer: Priority Health Medicare |
$349.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.24
|
| Rate for Payer: UHC Medicare Advantage |
$349.24
|
|
|
PR RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD
|
Professional
|
Both
|
$7,196.00
|
|
|
Service Code
|
HCPCS 21175
|
| Min. Negotiated Rate |
$2,106.19 |
| Max. Negotiated Rate |
$4,677.40 |
| Rate for Payer: Aetna Commercial |
$2,822.29
|
| Rate for Payer: Aetna Medicare |
$2,190.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,032.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,822.29
|
| Rate for Payer: BCBS Complete |
$2,878.40
|
| Rate for Payer: BCBS MAPPO |
$2,106.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,106.19
|
| Rate for Payer: Cash Price |
$5,756.80
|
| Rate for Payer: Cash Price |
$5,756.80
|
| Rate for Payer: Cofinity Commercial |
$3,032.91
|
| Rate for Payer: Cofinity Commercial |
$2,822.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,106.19
|
| Rate for Payer: Healthscope Commercial |
$3,896.45
|
| Rate for Payer: Healthscope Commercial |
$3,369.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,211.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,677.40
|
| Rate for Payer: Nomi Health Commercial |
$2,527.43
|
| Rate for Payer: PACE SWMI |
$2,106.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,106.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,677.40
|
| Rate for Payer: Priority Health Medicare |
$2,106.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,106.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,106.19
|
|
|
PR RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT
|
Professional
|
Both
|
$1,216.00
|
|
|
Service Code
|
HCPCS 26545
|
| Min. Negotiated Rate |
$486.40 |
| Max. Negotiated Rate |
$1,270.28 |
| Rate for Payer: Aetna Commercial |
$920.10
|
| Rate for Payer: Aetna Medicare |
$714.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.10
|
| Rate for Payer: BCBS Complete |
$486.40
|
| Rate for Payer: BCBS MAPPO |
$686.64
|
| Rate for Payer: BCN Medicare Advantage |
$686.64
|
| Rate for Payer: Cash Price |
$972.80
|
| Rate for Payer: Cash Price |
$972.80
|
| Rate for Payer: Cofinity Commercial |
$988.76
|
| Rate for Payer: Cofinity Commercial |
$920.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.64
|
| Rate for Payer: Healthscope Commercial |
$1,098.62
|
| Rate for Payer: Healthscope Commercial |
$1,270.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.40
|
| Rate for Payer: Nomi Health Commercial |
$823.97
|
| Rate for Payer: PACE SWMI |
$686.64
|
| Rate for Payer: PHP Medicare Advantage |
$686.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$790.40
|
| Rate for Payer: Priority Health Medicare |
$686.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.64
|
| Rate for Payer: UHC Medicare Advantage |
$686.64
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS
|
Professional
|
Both
|
$3,566.00
|
|
|
Service Code
|
HCPCS 26542
|
| Min. Negotiated Rate |
$676.96 |
| Max. Negotiated Rate |
$2,317.90 |
| Rate for Payer: Aetna Commercial |
$907.13
|
| Rate for Payer: Aetna Medicare |
$704.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.13
|
| Rate for Payer: BCBS Complete |
$1,426.40
|
| Rate for Payer: BCBS MAPPO |
$676.96
|
| Rate for Payer: BCN Medicare Advantage |
$676.96
|
| Rate for Payer: Cash Price |
$2,852.80
|
| Rate for Payer: Cash Price |
$2,852.80
|
| Rate for Payer: Cofinity Commercial |
$974.82
|
| Rate for Payer: Cofinity Commercial |
$907.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.96
|
| Rate for Payer: Healthscope Commercial |
$1,252.38
|
| Rate for Payer: Healthscope Commercial |
$1,083.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,317.90
|
| Rate for Payer: Nomi Health Commercial |
$812.35
|
| Rate for Payer: PACE SWMI |
$676.96
|
| Rate for Payer: PHP Medicare Advantage |
$676.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,317.90
|
| Rate for Payer: Priority Health Medicare |
$676.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.96
|
| Rate for Payer: UHC Medicare Advantage |
$676.96
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF
|
Professional
|
Both
|
$2,380.00
|
|
|
Service Code
|
HCPCS 26541
|
| Min. Negotiated Rate |
$787.45 |
| Max. Negotiated Rate |
$1,547.00 |
| Rate for Payer: Aetna Commercial |
$1,055.18
|
| Rate for Payer: Aetna Medicare |
$818.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.18
|
| Rate for Payer: BCBS Complete |
$952.00
|
| Rate for Payer: BCBS MAPPO |
$787.45
|
| Rate for Payer: BCN Medicare Advantage |
$787.45
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cash Price |
$1,904.00
|
| Rate for Payer: Cofinity Commercial |
$1,133.93
|
| Rate for Payer: Cofinity Commercial |
$1,055.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.45
|
| Rate for Payer: Healthscope Commercial |
$1,259.92
|
| Rate for Payer: Healthscope Commercial |
$1,456.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,547.00
|
| Rate for Payer: Nomi Health Commercial |
$944.94
|
| Rate for Payer: PACE SWMI |
$787.45
|
| Rate for Payer: PHP Medicare Advantage |
$787.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.00
|
| Rate for Payer: Priority Health Medicare |
$787.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.45
|
| Rate for Payer: UHC Medicare Advantage |
$787.45
|
|
|
PR RCNSTJ DISLC PATELLA W/PATELLECTOMY
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 27424
|
| Min. Negotiated Rate |
$607.60 |
| Max. Negotiated Rate |
$1,341.47 |
| Rate for Payer: Aetna Commercial |
$971.66
|
| Rate for Payer: Aetna Medicare |
$754.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.17
|
| Rate for Payer: BCBS Complete |
$607.60
|
| Rate for Payer: BCBS MAPPO |
$725.12
|
| Rate for Payer: BCN Medicare Advantage |
$725.12
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cofinity Commercial |
$971.66
|
| Rate for Payer: Cofinity Commercial |
$1,044.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.12
|
| Rate for Payer: Healthscope Commercial |
$1,341.47
|
| Rate for Payer: Healthscope Commercial |
$1,160.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$761.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.35
|
| Rate for Payer: Nomi Health Commercial |
$870.14
|
| Rate for Payer: PACE SWMI |
$725.12
|
| Rate for Payer: PHP Medicare Advantage |
$725.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$987.35
|
| Rate for Payer: Priority Health Medicare |
$725.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$725.12
|
| Rate for Payer: UHC Medicare Advantage |
$725.12
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
OP
|
$2,313.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,457.19 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna Commercial |
$1,966.05
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,503.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$1,619.10
|
| Rate for Payer: Cofinity Commercial |
$1,989.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,850.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$2,081.70
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,966.05
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$1,966.05
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$1,457.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,922.50
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 27422
|
| Min. Negotiated Rate |
$719.01 |
| Max. Negotiated Rate |
$1,503.45 |
| Rate for Payer: Aetna Commercial |
$963.47
|
| Rate for Payer: Aetna Medicare |
$747.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.37
|
| Rate for Payer: BCBS Complete |
$925.20
|
| Rate for Payer: BCBS MAPPO |
$719.01
|
| Rate for Payer: BCN Medicare Advantage |
$719.01
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$963.47
|
| Rate for Payer: Cofinity Commercial |
$1,035.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.01
|
| Rate for Payer: Healthscope Commercial |
$1,150.42
|
| Rate for Payer: Healthscope Commercial |
$1,330.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,503.45
|
| Rate for Payer: Nomi Health Commercial |
$862.81
|
| Rate for Payer: PACE SWMI |
$719.01
|
| Rate for Payer: PHP Medicare Advantage |
$719.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health Medicare |
$719.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.01
|
| Rate for Payer: UHC Medicare Advantage |
$719.01
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
IP
|
$2,313.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,457.19 |
| Max. Negotiated Rate |
$2,081.70 |
| Rate for Payer: Aetna Commercial |
$1,966.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,503.45
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$1,619.10
|
| Rate for Payer: Cofinity Commercial |
$1,989.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,850.40
|
| Rate for Payer: Healthscope Commercial |
$2,081.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,966.05
|
| Rate for Payer: PHP Commercial |
$1,966.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health SBD |
$1,457.19
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 27422
|
| Hospital Charge Code |
27422
|
| Min. Negotiated Rate |
$719.01 |
| Max. Negotiated Rate |
$1,503.45 |
| Rate for Payer: Aetna Commercial |
$963.47
|
| Rate for Payer: Aetna Medicare |
$747.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.47
|
| Rate for Payer: BCBS Complete |
$925.20
|
| Rate for Payer: BCBS MAPPO |
$719.01
|
| Rate for Payer: BCN Medicare Advantage |
$719.01
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$963.47
|
| Rate for Payer: Cofinity Commercial |
$1,035.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.01
|
| Rate for Payer: Healthscope Commercial |
$1,150.42
|
| Rate for Payer: Healthscope Commercial |
$1,330.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,503.45
|
| Rate for Payer: Nomi Health Commercial |
$862.81
|
| Rate for Payer: PACE SWMI |
$719.01
|
| Rate for Payer: PHP Medicare Advantage |
$719.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health Medicare |
$719.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.01
|
| Rate for Payer: UHC Medicare Advantage |
$719.01
|
|
