|
PR RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$5,557.00
|
|
|
Service Code
|
HCPCS 46740
|
| Min. Negotiated Rate |
$2,105.37 |
| Max. Negotiated Rate |
$3,894.93 |
| Rate for Payer: Aetna Commercial |
$2,821.20
|
| Rate for Payer: Aetna Medicare |
$2,189.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,031.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,821.20
|
| Rate for Payer: BCBS Complete |
$2,222.80
|
| Rate for Payer: BCBS MAPPO |
$2,105.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,105.37
|
| Rate for Payer: Cash Price |
$4,445.60
|
| Rate for Payer: Cash Price |
$4,445.60
|
| Rate for Payer: Cofinity Commercial |
$3,031.73
|
| Rate for Payer: Cofinity Commercial |
$2,821.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,105.37
|
| Rate for Payer: Healthscope Commercial |
$3,368.59
|
| Rate for Payer: Healthscope Commercial |
$3,894.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,210.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,612.05
|
| Rate for Payer: Nomi Health Commercial |
$2,526.44
|
| Rate for Payer: PACE SWMI |
$2,105.37
|
| Rate for Payer: PHP Medicare Advantage |
$2,105.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,612.05
|
| Rate for Payer: Priority Health Medicare |
$2,105.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,105.37
|
| Rate for Payer: UHC Medicare Advantage |
$2,105.37
|
|
|
PR RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL
|
Professional
|
Both
|
$5,147.00
|
|
|
Service Code
|
HCPCS 46742
|
| Min. Negotiated Rate |
$2,058.80 |
| Max. Negotiated Rate |
$4,499.57 |
| Rate for Payer: Aetna Commercial |
$3,259.15
|
| Rate for Payer: Aetna Medicare |
$2,529.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,502.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,259.15
|
| Rate for Payer: BCBS Complete |
$2,058.80
|
| Rate for Payer: BCBS MAPPO |
$2,432.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,432.20
|
| Rate for Payer: Cash Price |
$4,117.60
|
| Rate for Payer: Cash Price |
$4,117.60
|
| Rate for Payer: Cofinity Commercial |
$3,502.37
|
| Rate for Payer: Cofinity Commercial |
$3,259.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,432.20
|
| Rate for Payer: Healthscope Commercial |
$4,499.57
|
| Rate for Payer: Healthscope Commercial |
$3,891.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,553.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.55
|
| Rate for Payer: Nomi Health Commercial |
$2,918.64
|
| Rate for Payer: PACE SWMI |
$2,432.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,432.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,345.55
|
| Rate for Payer: Priority Health Medicare |
$2,432.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,432.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,432.20
|
|
|
PR RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$3,879.00
|
|
|
Service Code
|
HCPCS 46730
|
| Min. Negotiated Rate |
$1,551.60 |
| Max. Negotiated Rate |
$3,568.43 |
| Rate for Payer: Aetna Commercial |
$2,584.70
|
| Rate for Payer: Aetna Medicare |
$2,006.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,777.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,584.70
|
| Rate for Payer: BCBS Complete |
$1,551.60
|
| Rate for Payer: BCBS MAPPO |
$1,928.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,928.88
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cofinity Commercial |
$2,777.59
|
| Rate for Payer: Cofinity Commercial |
$2,584.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,928.88
|
| Rate for Payer: Healthscope Commercial |
$3,086.21
|
| Rate for Payer: Healthscope Commercial |
$3,568.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,025.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,521.35
|
| Rate for Payer: Nomi Health Commercial |
$2,314.66
|
| Rate for Payer: PACE SWMI |
$1,928.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,928.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.35
|
| Rate for Payer: Priority Health Medicare |
$1,928.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,928.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,928.88
|
|
|
PR RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 54340
|
| Min. Negotiated Rate |
$544.04 |
| Max. Negotiated Rate |
$1,290.25 |
| Rate for Payer: Aetna Commercial |
$729.01
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.01
|
| Rate for Payer: BCBS Complete |
$794.00
|
| Rate for Payer: BCBS MAPPO |
$544.04
|
| Rate for Payer: BCN Medicare Advantage |
$544.04
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$783.42
|
| Rate for Payer: Cofinity Commercial |
$729.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.04
|
| Rate for Payer: Healthscope Commercial |
$870.46
|
| Rate for Payer: Healthscope Commercial |
$1,006.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,290.25
|
| Rate for Payer: Nomi Health Commercial |
$652.85
|
| Rate for Payer: PACE SWMI |
$544.04
|
| Rate for Payer: PHP Medicare Advantage |
$544.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health Medicare |
$544.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$544.04
|
| Rate for Payer: UHC Medicare Advantage |
$544.04
|
|
|
PR RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR
|
Professional
|
Both
|
$7,548.00
|
|
|
Service Code
|
HCPCS 33660
|
| Min. Negotiated Rate |
$1,685.84 |
| Max. Negotiated Rate |
$4,906.20 |
| Rate for Payer: Aetna Commercial |
$2,259.03
|
| Rate for Payer: Aetna Medicare |
$1,753.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,427.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,259.03
|
| Rate for Payer: BCBS Complete |
$3,019.20
|
| Rate for Payer: BCBS MAPPO |
$1,685.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,685.84
|
| Rate for Payer: Cash Price |
$6,038.40
|
| Rate for Payer: Cash Price |
$6,038.40
|
| Rate for Payer: Cofinity Commercial |
$2,427.61
|
| Rate for Payer: Cofinity Commercial |
$2,259.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,685.84
|
| Rate for Payer: Healthscope Commercial |
$2,697.34
|
| Rate for Payer: Healthscope Commercial |
$3,118.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,770.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,906.20
|
| Rate for Payer: Nomi Health Commercial |
$2,023.01
|
| Rate for Payer: PACE SWMI |
$1,685.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,685.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,906.20
|
| Rate for Payer: Priority Health Medicare |
$1,685.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,685.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,685.84
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 49525
|
| Min. Negotiated Rate |
$560.08 |
| Max. Negotiated Rate |
$1,063.40 |
| Rate for Payer: Aetna Commercial |
$750.51
|
| Rate for Payer: Aetna Medicare |
$582.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.51
|
| Rate for Payer: BCBS Complete |
$654.40
|
| Rate for Payer: BCBS MAPPO |
$560.08
|
| Rate for Payer: BCN Medicare Advantage |
$560.08
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$806.52
|
| Rate for Payer: Cofinity Commercial |
$750.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.08
|
| Rate for Payer: Healthscope Commercial |
$896.13
|
| Rate for Payer: Healthscope Commercial |
$1,036.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.40
|
| Rate for Payer: Nomi Health Commercial |
$672.10
|
| Rate for Payer: PACE SWMI |
$560.08
|
| Rate for Payer: PHP Medicare Advantage |
$560.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health Medicare |
$560.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.08
|
| Rate for Payer: UHC Medicare Advantage |
$560.08
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
OP
|
$1,636.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,030.68 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna Commercial |
$1,390.60
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,145.20
|
| Rate for Payer: Cofinity Commercial |
$1,406.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,145.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,472.40
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,390.60
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$1,390.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$1,030.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,937.74
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
IP
|
$1,636.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,030.68 |
| Max. Negotiated Rate |
$1,472.40 |
| Rate for Payer: Aetna Commercial |
$1,390.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.40
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,145.20
|
| Rate for Payer: Cofinity Commercial |
$1,406.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,145.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.80
|
| Rate for Payer: Healthscope Commercial |
$1,472.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,390.60
|
| Rate for Payer: PHP Commercial |
$1,390.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health SBD |
$1,030.68
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 49525
|
| Hospital Charge Code |
49525
|
| Min. Negotiated Rate |
$560.08 |
| Max. Negotiated Rate |
$1,063.40 |
| Rate for Payer: Aetna Commercial |
$750.51
|
| Rate for Payer: Aetna Medicare |
$582.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.52
|
| Rate for Payer: BCBS Complete |
$654.40
|
| Rate for Payer: BCBS MAPPO |
$560.08
|
| Rate for Payer: BCN Medicare Advantage |
$560.08
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$806.52
|
| Rate for Payer: Cofinity Commercial |
$750.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.08
|
| Rate for Payer: Healthscope Commercial |
$1,036.15
|
| Rate for Payer: Healthscope Commercial |
$896.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.40
|
| Rate for Payer: Nomi Health Commercial |
$672.10
|
| Rate for Payer: PACE SWMI |
$560.08
|
| Rate for Payer: PHP Medicare Advantage |
$560.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health Medicare |
$560.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.08
|
| Rate for Payer: UHC Medicare Advantage |
$560.08
|
|
|
PR RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 12046
|
| Min. Negotiated Rate |
$305.77 |
| Max. Negotiated Rate |
$603.20 |
| Rate for Payer: Aetna Commercial |
$409.73
|
| Rate for Payer: Aetna Medicare |
$318.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.73
|
| Rate for Payer: BCBS Complete |
$371.20
|
| Rate for Payer: BCBS MAPPO |
$305.77
|
| Rate for Payer: BCN Medicare Advantage |
$305.77
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$440.31
|
| Rate for Payer: Cofinity Commercial |
$409.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.77
|
| Rate for Payer: Healthscope Commercial |
$489.23
|
| Rate for Payer: Healthscope Commercial |
$565.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.20
|
| Rate for Payer: Nomi Health Commercial |
$366.92
|
| Rate for Payer: PACE SWMI |
$305.77
|
| Rate for Payer: PHP Medicare Advantage |
$305.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
| Rate for Payer: Priority Health Medicare |
$305.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.77
|
| Rate for Payer: UHC Medicare Advantage |
$305.77
|
|
|
PR RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 41250
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$271.69 |
| Rate for Payer: Aetna Commercial |
$196.79
|
| Rate for Payer: Aetna Medicare |
$152.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.79
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$146.86
|
| Rate for Payer: BCN Medicare Advantage |
$146.86
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$211.48
|
| Rate for Payer: Cofinity Commercial |
$196.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.86
|
| Rate for Payer: Healthscope Commercial |
$271.69
|
| Rate for Payer: Healthscope Commercial |
$234.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.40
|
| Rate for Payer: Nomi Health Commercial |
$176.23
|
| Rate for Payer: PACE SWMI |
$146.86
|
| Rate for Payer: PHP Medicare Advantage |
$146.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$146.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.86
|
| Rate for Payer: UHC Medicare Advantage |
$146.86
|
|
|
PR RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 41252
|
| Min. Negotiated Rate |
$199.55 |
| Max. Negotiated Rate |
$704.60 |
| Rate for Payer: Aetna Commercial |
$267.40
|
| Rate for Payer: Aetna Medicare |
$207.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.40
|
| Rate for Payer: BCBS Complete |
$433.60
|
| Rate for Payer: BCBS MAPPO |
$199.55
|
| Rate for Payer: BCN Medicare Advantage |
$199.55
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$287.35
|
| Rate for Payer: Cofinity Commercial |
$267.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.55
|
| Rate for Payer: Healthscope Commercial |
$319.28
|
| Rate for Payer: Healthscope Commercial |
$369.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$704.60
|
| Rate for Payer: Nomi Health Commercial |
$239.46
|
| Rate for Payer: PACE SWMI |
$199.55
|
| Rate for Payer: PHP Medicare Advantage |
$199.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health Medicare |
$199.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.55
|
| Rate for Payer: UHC Medicare Advantage |
$199.55
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH
|
Professional
|
Both
|
$3,409.00
|
|
|
Service Code
|
HCPCS 49606
|
| Min. Negotiated Rate |
$1,107.13 |
| Max. Negotiated Rate |
$2,215.85 |
| Rate for Payer: Aetna Commercial |
$1,483.55
|
| Rate for Payer: Aetna Medicare |
$1,151.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,483.55
|
| Rate for Payer: BCBS Complete |
$1,363.60
|
| Rate for Payer: BCBS MAPPO |
$1,107.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,107.13
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cofinity Commercial |
$1,594.27
|
| Rate for Payer: Cofinity Commercial |
$1,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,107.13
|
| Rate for Payer: Healthscope Commercial |
$2,048.19
|
| Rate for Payer: Healthscope Commercial |
$1,771.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,162.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,215.85
|
| Rate for Payer: Nomi Health Commercial |
$1,328.56
|
| Rate for Payer: PACE SWMI |
$1,107.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,107.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,215.85
|
| Rate for Payer: Priority Health Medicare |
$1,107.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,107.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,107.13
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH
|
Professional
|
Both
|
$9,119.00
|
|
|
Service Code
|
HCPCS 49605
|
| Min. Negotiated Rate |
$3,647.60 |
| Max. Negotiated Rate |
$8,842.91 |
| Rate for Payer: Aetna Commercial |
$6,405.13
|
| Rate for Payer: Aetna Medicare |
$4,971.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,883.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,405.13
|
| Rate for Payer: BCBS Complete |
$3,647.60
|
| Rate for Payer: BCBS MAPPO |
$4,779.95
|
| Rate for Payer: BCN Medicare Advantage |
$4,779.95
|
| Rate for Payer: Cash Price |
$7,295.20
|
| Rate for Payer: Cash Price |
$7,295.20
|
| Rate for Payer: Cofinity Commercial |
$6,883.13
|
| Rate for Payer: Cofinity Commercial |
$6,405.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,779.95
|
| Rate for Payer: Healthscope Commercial |
$7,647.92
|
| Rate for Payer: Healthscope Commercial |
$8,842.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,018.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,927.35
|
| Rate for Payer: Nomi Health Commercial |
$5,735.94
|
| Rate for Payer: PACE SWMI |
$4,779.95
|
| Rate for Payer: PHP Medicare Advantage |
$4,779.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,927.35
|
| Rate for Payer: Priority Health Medicare |
$4,779.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,779.95
|
| Rate for Payer: UHC Medicare Advantage |
$4,779.95
|
|
|
PR RPR LIP FTH OVER ONE-HALF VERT HEIGHT/COMPLEX
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 40654
|
| Min. Negotiated Rate |
$303.20 |
| Max. Negotiated Rate |
$752.84 |
| Rate for Payer: Aetna Commercial |
$545.30
|
| Rate for Payer: Aetna Medicare |
$423.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.30
|
| Rate for Payer: BCBS Complete |
$303.20
|
| Rate for Payer: BCBS MAPPO |
$406.94
|
| Rate for Payer: BCN Medicare Advantage |
$406.94
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$585.99
|
| Rate for Payer: Cofinity Commercial |
$545.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.94
|
| Rate for Payer: Healthscope Commercial |
$752.84
|
| Rate for Payer: Healthscope Commercial |
$651.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$492.70
|
| Rate for Payer: Nomi Health Commercial |
$488.33
|
| Rate for Payer: PACE SWMI |
$406.94
|
| Rate for Payer: PHP Medicare Advantage |
$406.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.70
|
| Rate for Payer: Priority Health Medicare |
$406.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.94
|
| Rate for Payer: UHC Medicare Advantage |
$406.94
|
|
|
PR RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 46715
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$995.19 |
| Rate for Payer: Aetna Commercial |
$720.84
|
| Rate for Payer: Aetna Medicare |
$559.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.84
|
| Rate for Payer: BCBS Complete |
$475.20
|
| Rate for Payer: BCBS MAPPO |
$537.94
|
| Rate for Payer: BCN Medicare Advantage |
$537.94
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$774.63
|
| Rate for Payer: Cofinity Commercial |
$720.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.94
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Healthscope Commercial |
$995.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.20
|
| Rate for Payer: Nomi Health Commercial |
$645.53
|
| Rate for Payer: PACE SWMI |
$537.94
|
| Rate for Payer: PHP Medicare Advantage |
$537.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.20
|
| Rate for Payer: Priority Health Medicare |
$537.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.94
|
| Rate for Payer: UHC Medicare Advantage |
$537.94
|
|
|
PR RPR LW IMPERFORATE ANUS W/TRPOS FISTULA
|
Professional
|
Both
|
$2,992.00
|
|
|
Service Code
|
HCPCS 46716
|
| Min. Negotiated Rate |
$1,196.80 |
| Max. Negotiated Rate |
$2,214.52 |
| Rate for Payer: Aetna Commercial |
$1,604.03
|
| Rate for Payer: Aetna Medicare |
$1,244.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,723.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,604.03
|
| Rate for Payer: BCBS Complete |
$1,196.80
|
| Rate for Payer: BCBS MAPPO |
$1,197.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,197.04
|
| Rate for Payer: Cash Price |
$2,393.60
|
| Rate for Payer: Cash Price |
$2,393.60
|
| Rate for Payer: Cofinity Commercial |
$1,723.74
|
| Rate for Payer: Cofinity Commercial |
$1,604.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,197.04
|
| Rate for Payer: Healthscope Commercial |
$2,214.52
|
| Rate for Payer: Healthscope Commercial |
$1,915.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,256.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,944.80
|
| Rate for Payer: Nomi Health Commercial |
$1,436.45
|
| Rate for Payer: PACE SWMI |
$1,197.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,197.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,944.80
|
| Rate for Payer: Priority Health Medicare |
$1,197.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,197.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,197.04
|
|
|
PR RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ
|
Professional
|
Both
|
$10,278.00
|
|
|
Service Code
|
HCPCS 39503
|
| Min. Negotiated Rate |
$4,111.20 |
| Max. Negotiated Rate |
$10,334.91 |
| Rate for Payer: Aetna Commercial |
$7,485.83
|
| Rate for Payer: Aetna Medicare |
$5,809.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,044.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,485.83
|
| Rate for Payer: BCBS Complete |
$4,111.20
|
| Rate for Payer: BCBS MAPPO |
$5,586.44
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.44
|
| Rate for Payer: Cash Price |
$8,222.40
|
| Rate for Payer: Cash Price |
$8,222.40
|
| Rate for Payer: Cofinity Commercial |
$8,044.47
|
| Rate for Payer: Cofinity Commercial |
$7,485.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.44
|
| Rate for Payer: Healthscope Commercial |
$10,334.91
|
| Rate for Payer: Healthscope Commercial |
$8,938.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,680.70
|
| Rate for Payer: Nomi Health Commercial |
$6,703.73
|
| Rate for Payer: PACE SWMI |
$5,586.44
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,680.70
|
| Rate for Payer: Priority Health Medicare |
$5,586.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.44
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.44
|
|
|
PR RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 53449
|
| Min. Negotiated Rate |
$466.00 |
| Max. Negotiated Rate |
$1,084.84 |
| Rate for Payer: Aetna Commercial |
$785.78
|
| Rate for Payer: Aetna Medicare |
$609.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.78
|
| Rate for Payer: BCBS Complete |
$466.00
|
| Rate for Payer: BCBS MAPPO |
$586.40
|
| Rate for Payer: BCN Medicare Advantage |
$586.40
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$844.42
|
| Rate for Payer: Cofinity Commercial |
$785.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.40
|
| Rate for Payer: Healthscope Commercial |
$938.24
|
| Rate for Payer: Healthscope Commercial |
$1,084.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.25
|
| Rate for Payer: Nomi Health Commercial |
$703.68
|
| Rate for Payer: PACE SWMI |
$586.40
|
| Rate for Payer: PHP Medicare Advantage |
$586.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health Medicare |
$586.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.40
|
| Rate for Payer: UHC Medicare Advantage |
$586.40
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE
|
Professional
|
Both
|
$3,865.00
|
|
|
Service Code
|
HCPCS 27472
|
| Min. Negotiated Rate |
$1,218.33 |
| Max. Negotiated Rate |
$2,512.25 |
| Rate for Payer: Aetna Commercial |
$1,632.56
|
| Rate for Payer: Aetna Medicare |
$1,267.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.56
|
| Rate for Payer: BCBS Complete |
$1,546.00
|
| Rate for Payer: BCBS MAPPO |
$1,218.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.33
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cofinity Commercial |
$1,754.40
|
| Rate for Payer: Cofinity Commercial |
$1,632.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.33
|
| Rate for Payer: Healthscope Commercial |
$1,949.33
|
| Rate for Payer: Healthscope Commercial |
$2,253.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,512.25
|
| Rate for Payer: Nomi Health Commercial |
$1,462.00
|
| Rate for Payer: PACE SWMI |
$1,218.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,512.25
|
| Rate for Payer: Priority Health Medicare |
$1,218.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.33
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/O GRF
|
Professional
|
Both
|
$2,927.00
|
|
|
Service Code
|
HCPCS 27470
|
| Min. Negotiated Rate |
$1,136.51 |
| Max. Negotiated Rate |
$2,102.54 |
| Rate for Payer: Aetna Commercial |
$1,522.92
|
| Rate for Payer: Aetna Medicare |
$1,181.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,636.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.92
|
| Rate for Payer: BCBS Complete |
$1,170.80
|
| Rate for Payer: BCBS MAPPO |
$1,136.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.51
|
| Rate for Payer: Cash Price |
$2,341.60
|
| Rate for Payer: Cash Price |
$2,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,636.57
|
| Rate for Payer: Cofinity Commercial |
$1,522.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.51
|
| Rate for Payer: Healthscope Commercial |
$2,102.54
|
| Rate for Payer: Healthscope Commercial |
$1,818.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,193.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,902.55
|
| Rate for Payer: Nomi Health Commercial |
$1,363.81
|
| Rate for Payer: PACE SWMI |
$1,136.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.55
|
| Rate for Payer: Priority Health Medicare |
$1,136.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.51
|
|
|
PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH
|
Professional
|
Both
|
$5,421.00
|
|
|
Service Code
|
HCPCS 27725
|
| Min. Negotiated Rate |
$1,171.90 |
| Max. Negotiated Rate |
$3,523.65 |
| Rate for Payer: Aetna Commercial |
$1,570.35
|
| Rate for Payer: Aetna Medicare |
$1,218.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,570.35
|
| Rate for Payer: BCBS Complete |
$2,168.40
|
| Rate for Payer: BCBS MAPPO |
$1,171.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.90
|
| Rate for Payer: Cash Price |
$4,336.80
|
| Rate for Payer: Cash Price |
$4,336.80
|
| Rate for Payer: Cofinity Commercial |
$1,687.54
|
| Rate for Payer: Cofinity Commercial |
$1,570.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.90
|
| Rate for Payer: Healthscope Commercial |
$1,875.04
|
| Rate for Payer: Healthscope Commercial |
$2,168.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.65
|
| Rate for Payer: Nomi Health Commercial |
$1,406.28
|
| Rate for Payer: PACE SWMI |
$1,171.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,523.65
|
| Rate for Payer: Priority Health Medicare |
$1,171.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,171.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,171.90
|
|
|
PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT
|
Professional
|
Both
|
$4,771.00
|
|
|
Service Code
|
HCPCS 27724
|
| Min. Negotiated Rate |
$1,208.33 |
| Max. Negotiated Rate |
$3,101.15 |
| Rate for Payer: Aetna Commercial |
$1,619.16
|
| Rate for Payer: Aetna Medicare |
$1,256.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,740.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,619.16
|
| Rate for Payer: BCBS Complete |
$1,908.40
|
| Rate for Payer: BCBS MAPPO |
$1,208.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,208.33
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cofinity Commercial |
$1,740.00
|
| Rate for Payer: Cofinity Commercial |
$1,619.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,208.33
|
| Rate for Payer: Healthscope Commercial |
$2,235.41
|
| Rate for Payer: Healthscope Commercial |
$1,933.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,268.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,101.15
|
| Rate for Payer: Nomi Health Commercial |
$1,450.00
|
| Rate for Payer: PACE SWMI |
$1,208.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,208.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.15
|
| Rate for Payer: Priority Health Medicare |
$1,208.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,208.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,208.33
|
|
|
PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT
|
Professional
|
Both
|
$1,316.00
|
|
|
Service Code
|
HCPCS 28322
|
| Min. Negotiated Rate |
$526.40 |
| Max. Negotiated Rate |
$1,026.05 |
| Rate for Payer: Aetna Commercial |
$743.19
|
| Rate for Payer: Aetna Medicare |
$576.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.19
|
| Rate for Payer: BCBS Complete |
$526.40
|
| Rate for Payer: BCBS MAPPO |
$554.62
|
| Rate for Payer: BCN Medicare Advantage |
$554.62
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$798.65
|
| Rate for Payer: Cofinity Commercial |
$743.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.62
|
| Rate for Payer: Healthscope Commercial |
$1,026.05
|
| Rate for Payer: Healthscope Commercial |
$887.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$855.40
|
| Rate for Payer: Nomi Health Commercial |
$665.54
|
| Rate for Payer: PACE SWMI |
$554.62
|
| Rate for Payer: PHP Medicare Advantage |
$554.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$855.40
|
| Rate for Payer: Priority Health Medicare |
$554.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.62
|
| Rate for Payer: UHC Medicare Advantage |
$554.62
|
|
|
PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS
|
Professional
|
Both
|
$7,025.00
|
|
|
Service Code
|
HCPCS 33496
|
| Min. Negotiated Rate |
$1,591.45 |
| Max. Negotiated Rate |
$4,566.25 |
| Rate for Payer: Aetna Commercial |
$2,132.54
|
| Rate for Payer: Aetna Medicare |
$1,655.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,291.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,132.54
|
| Rate for Payer: BCBS Complete |
$2,810.00
|
| Rate for Payer: BCBS MAPPO |
$1,591.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,591.45
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cofinity Commercial |
$2,291.69
|
| Rate for Payer: Cofinity Commercial |
$2,132.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.45
|
| Rate for Payer: Healthscope Commercial |
$2,944.18
|
| Rate for Payer: Healthscope Commercial |
$2,546.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,671.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,566.25
|
| Rate for Payer: Nomi Health Commercial |
$1,909.74
|
| Rate for Payer: PACE SWMI |
$1,591.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,591.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,566.25
|
| Rate for Payer: Priority Health Medicare |
$1,591.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,591.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,591.45
|
|
