|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
OP
|
$108.61
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$962.80 |
| Rate for Payer: Aetna Commercial |
$92.32
|
| Rate for Payer: Aetna Medicare |
$12.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.36
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.29
|
| Rate for Payer: BCBS Trust/PPO |
$10.88
|
| Rate for Payer: BCN Commercial |
$10.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.29
|
| Rate for Payer: Cash Price |
$86.89
|
| Rate for Payer: Cash Price |
$86.89
|
| Rate for Payer: Cofinity Commercial |
$76.03
|
| Rate for Payer: Cofinity Commercial |
$93.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.29
|
| Rate for Payer: Healthscope Commercial |
$97.75
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.90
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.32
|
| Rate for Payer: Nomi Health Commercial |
$18.44
|
| Rate for Payer: PACE Medicare |
$11.68
|
| Rate for Payer: PACE SWMI |
$12.29
|
| Rate for Payer: PHP Commercial |
$92.32
|
| Rate for Payer: PHP Medicare Advantage |
$12.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$12.29
|
| Rate for Payer: Priority Health Narrow Network |
$9.83
|
| Rate for Payer: Priority Health SBD |
$68.42
|
| Rate for Payer: Railroad Medicare Medicare |
$12.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.75
|
| Rate for Payer: UHC Core |
$962.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.29
|
| Rate for Payer: UHC Exchange |
$962.80
|
| Rate for Payer: UHC Medicare Advantage |
$12.29
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$12.29
|
|
|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
IP
|
$108.61
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.42 |
| Max. Negotiated Rate |
$97.75 |
| Rate for Payer: Aetna Commercial |
$92.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.60
|
| Rate for Payer: Cash Price |
$86.89
|
| Rate for Payer: Cofinity Commercial |
$76.03
|
| Rate for Payer: Cofinity Commercial |
$93.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.89
|
| Rate for Payer: Healthscope Commercial |
$97.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.32
|
| Rate for Payer: PHP Commercial |
$92.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.60
|
| Rate for Payer: Priority Health SBD |
$68.42
|
|
|
HC ACH RECEPTOR MUSCLE MOD AB
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30000061
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health SBD |
$62.27
|
|
|
HC ACH RECEPTOR MUSCLE MOD AB
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30000061
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$16.29
|
| Rate for Payer: BCN Commercial |
$16.29
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$14.72
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$10.36
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC ACHR GANGLIONIC NEURONAL AB
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.37 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health SBD |
$56.37
|
|
|
HC ACHR GANGLIONIC NEURONAL AB
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$16.29
|
| Rate for Payer: BCN Commercial |
$16.29
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$14.72
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$10.36
|
| Rate for Payer: VA VA |
$18.40
|
|
|
HC ACNE SURGERY
|
Facility
|
OP
|
$272.69
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.72 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$231.79
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$48.72
|
| Rate for Payer: BCN Commercial |
$48.72
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cofinity Commercial |
$190.88
|
| Rate for Payer: Cofinity Commercial |
$234.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$245.42
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.79
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$231.79
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$171.79
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.72
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$109.60
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC ACNE SURGERY
|
Facility
|
IP
|
$272.69
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.79 |
| Max. Negotiated Rate |
$245.42 |
| Rate for Payer: Aetna Commercial |
$231.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.25
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cofinity Commercial |
$190.88
|
| Rate for Payer: Cofinity Commercial |
$234.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.15
|
| Rate for Payer: Healthscope Commercial |
$245.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.79
|
| Rate for Payer: PHP Commercial |
$231.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.25
|
| Rate for Payer: Priority Health SBD |
$171.79
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$93.82 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.80
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$104.24
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health SBD |
$93.82
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$57.58
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Cofinity Commercial |
$104.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$93.82
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$110.20
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC ACTIGRAPHY
|
Facility
|
OP
|
$275.56
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$234.23
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$220.45
|
| Rate for Payer: Cash Price |
$220.45
|
| Rate for Payer: Cofinity Commercial |
$236.98
|
| Rate for Payer: Cofinity Commercial |
$192.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.23
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$234.23
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$173.60
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$203.91
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$32.77
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC ACTIGRAPHY
|
Facility
|
IP
|
$275.56
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$234.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.11
|
| Rate for Payer: Cash Price |
$220.45
|
| Rate for Payer: Cofinity Commercial |
$192.89
|
| Rate for Payer: Cofinity Commercial |
$236.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.45
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.23
|
| Rate for Payer: PHP Commercial |
$234.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.11
|
| Rate for Payer: Priority Health SBD |
$173.60
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health SBD |
$58.34
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.62
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$13.56
|
| Rate for Payer: BCN Commercial |
$13.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Mclaren Medicaid |
$8.21
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$8.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.77
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.62
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.32
|
| Rate for Payer: UHC Medicare Advantage |
$15.32
|
| Rate for Payer: UHCCP Medicaid |
$8.63
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.95 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health SBD |
$41.95
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.62
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$13.56
|
| Rate for Payer: BCN Commercial |
$13.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Cofinity Commercial |
$46.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Mclaren Medicaid |
$8.21
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$8.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.77
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.62
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.32
|
| Rate for Payer: UHC Medicare Advantage |
$15.32
|
| Rate for Payer: UHCCP Medicaid |
$8.63
|
| Rate for Payer: VA VA |
$15.32
|
|
|
HC ACUNAV CATHETER
|
Facility
|
IP
|
$5,722.20
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,604.99 |
| Max. Negotiated Rate |
$5,149.98 |
| Rate for Payer: Aetna Commercial |
$4,863.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,719.43
|
| Rate for Payer: Cash Price |
$4,577.76
|
| Rate for Payer: Cofinity Commercial |
$4,005.54
|
| Rate for Payer: Cofinity Commercial |
$4,921.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,005.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,577.76
|
| Rate for Payer: Healthscope Commercial |
$5,149.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,863.87
|
| Rate for Payer: PHP Commercial |
$4,863.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,719.43
|
| Rate for Payer: Priority Health SBD |
$3,604.99
|
|
|
HC ACUNAV CATHETER
|
Facility
|
OP
|
$5,722.20
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,149.98 |
| Rate for Payer: Aetna Commercial |
$4,863.87
|
| Rate for Payer: Aetna Medicare |
$2,861.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,719.43
|
| Rate for Payer: BCBS Complete |
$2,288.88
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,577.76
|
| Rate for Payer: Cash Price |
$4,577.76
|
| Rate for Payer: Cofinity Commercial |
$4,005.54
|
| Rate for Payer: Cofinity Commercial |
$4,921.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,005.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,577.76
|
| Rate for Payer: Healthscope Commercial |
$5,149.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,863.87
|
| Rate for Payer: PHP Commercial |
$4,863.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,719.43
|
| Rate for Payer: Priority Health SBD |
$3,604.99
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$108.07
|
| Rate for Payer: BCN Commercial |
$108.07
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UHC Core |
$107.36
|
| Rate for Payer: UHC Exchange |
$107.36
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
OP
|
$137.02
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$54.81 |
| Max. Negotiated Rate |
$123.32 |
| Rate for Payer: Aetna Commercial |
$116.47
|
| Rate for Payer: Aetna Medicare |
$68.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.06
|
| Rate for Payer: BCBS Complete |
$54.81
|
| Rate for Payer: Cash Price |
$109.62
|
| Rate for Payer: Cofinity Commercial |
$117.84
|
| Rate for Payer: Cofinity Commercial |
$95.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.62
|
| Rate for Payer: Healthscope Commercial |
$123.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.47
|
| Rate for Payer: PHP Commercial |
$116.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.06
|
| Rate for Payer: Priority Health SBD |
$86.32
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
IP
|
$137.02
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$86.32 |
| Max. Negotiated Rate |
$123.32 |
| Rate for Payer: Aetna Commercial |
$116.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.06
|
| Rate for Payer: Cash Price |
$109.62
|
| Rate for Payer: Cofinity Commercial |
$117.84
|
| Rate for Payer: Cofinity Commercial |
$95.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.62
|
| Rate for Payer: Healthscope Commercial |
$123.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.47
|
| Rate for Payer: PHP Commercial |
$116.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.06
|
| Rate for Payer: Priority Health SBD |
$86.32
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$23.78 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.53
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$26.42
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health SBD |
$23.78
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$18.97
|
| Rate for Payer: BCN Commercial |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$26.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$17.14
|
| Rate for Payer: Priority Health SBD |
$23.78
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$12.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$18.97
|
| Rate for Payer: BCN Commercial |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$17.14
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$12.06
|
| Rate for Payer: VA VA |
$21.42
|
|
