|
HC BIRCH IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$2,079.46
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$817.23 |
| Max. Negotiated Rate |
$1,871.51 |
| Rate for Payer: Aetna Commercial |
$1,767.54
|
| Rate for Payer: Aetna Medicare |
$1,039.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.65
|
| Rate for Payer: BCBS Complete |
$831.78
|
| Rate for Payer: Cash Price |
$1,663.57
|
| Rate for Payer: Cofinity Advantage |
$1,455.62
|
| Rate for Payer: Cofinity Commercial |
$1,788.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.57
|
| Rate for Payer: Healthscope Commercial |
$1,871.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,663.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.60
|
| Rate for Payer: PHP Commercial |
$1,767.54
|
| Rate for Payer: Priority Health SBD |
$1,310.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,351.65
|
| Rate for Payer: UHC Core |
$1,083.40
|
| Rate for Payer: UHC Exchange |
$817.23
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$2,079.46
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,310.06 |
| Max. Negotiated Rate |
$1,871.51 |
| Rate for Payer: Aetna Commercial |
$1,767.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.65
|
| Rate for Payer: Cash Price |
$1,663.57
|
| Rate for Payer: Cofinity Advantage |
$1,455.62
|
| Rate for Payer: Cofinity Commercial |
$1,788.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.57
|
| Rate for Payer: Healthscope Commercial |
$1,871.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.60
|
| Rate for Payer: PHP Commercial |
$1,767.54
|
| Rate for Payer: Priority Health SBD |
$1,310.06
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$28,495.15
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$17,951.94 |
| Max. Negotiated Rate |
$25,645.63 |
| Rate for Payer: Aetna Commercial |
$24,220.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,521.85
|
| Rate for Payer: Cash Price |
$22,796.12
|
| Rate for Payer: Cofinity Advantage |
$19,946.60
|
| Rate for Payer: Cofinity Commercial |
$24,505.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,796.12
|
| Rate for Payer: Healthscope Commercial |
$25,645.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,220.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,371.36
|
| Rate for Payer: PHP Commercial |
$24,220.88
|
| Rate for Payer: Priority Health SBD |
$17,951.94
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$28,495.15
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,198.59 |
| Max. Negotiated Rate |
$25,645.63 |
| Rate for Payer: Aetna Commercial |
$24,220.88
|
| Rate for Payer: Aetna Medicare |
$14,247.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,521.85
|
| Rate for Payer: BCBS Complete |
$11,398.06
|
| Rate for Payer: Cash Price |
$22,796.12
|
| Rate for Payer: Cofinity Advantage |
$19,946.60
|
| Rate for Payer: Cofinity Commercial |
$24,505.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,796.12
|
| Rate for Payer: Healthscope Commercial |
$25,645.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,796.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,220.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,371.36
|
| Rate for Payer: PHP Commercial |
$24,220.88
|
| Rate for Payer: Priority Health SBD |
$17,951.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,521.85
|
| Rate for Payer: UHC Core |
$14,845.97
|
| Rate for Payer: UHC Exchange |
$11,198.59
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$115.67
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.87 |
| Max. Negotiated Rate |
$104.10 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.19
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cofinity Advantage |
$80.97
|
| Rate for Payer: Cofinity Commercial |
$99.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$104.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.75
|
| Rate for Payer: PHP Commercial |
$98.32
|
| Rate for Payer: Priority Health SBD |
$72.87
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$115.67
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$104.10 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$23.53
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$45.68
|
| Rate for Payer: BCN Commercial |
$45.68
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cofinity Advantage |
$80.97
|
| Rate for Payer: Cofinity Commercial |
$99.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$104.10
|
| Rate for Payer: Mclaren Medicaid |
$22.41
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.32
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.75
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$98.32
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.41
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$72.87
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.26
|
| Rate for Payer: UHC Core |
$64.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.84
|
| Rate for Payer: UHC Exchange |
$64.26
|
| Rate for Payer: UHC Medicaid |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$22.41
|
| Rate for Payer: VA VA |
$42.84
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$285.45
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$179.83 |
| Max. Negotiated Rate |
$256.90 |
| Rate for Payer: Aetna Commercial |
$242.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.54
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cofinity Advantage |
$199.81
|
| Rate for Payer: Cofinity Commercial |
$245.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.36
|
| Rate for Payer: Healthscope Commercial |
$256.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.09
|
| Rate for Payer: PHP Commercial |
$242.63
|
| Rate for Payer: Priority Health SBD |
$179.83
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$285.45
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$114.18 |
| Max. Negotiated Rate |
$256.90 |
| Rate for Payer: Aetna Commercial |
$242.63
|
| Rate for Payer: Aetna Medicare |
$142.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.54
|
| Rate for Payer: BCBS Complete |
$114.18
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cofinity Advantage |
$199.81
|
| Rate for Payer: Cofinity Commercial |
$245.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.36
|
| Rate for Payer: Healthscope Commercial |
$256.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.09
|
| Rate for Payer: PHP Commercial |
$242.63
|
| Rate for Payer: Priority Health SBD |
$179.83
|
| Rate for Payer: UHCCP Medicaid |
$144.00
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$156.20
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$140.58 |
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.53
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cofinity Advantage |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$134.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.96
|
| Rate for Payer: Healthscope Commercial |
$140.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.15
|
| Rate for Payer: PHP Commercial |
$132.77
|
| Rate for Payer: Priority Health SBD |
$98.41
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$156.20
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$91.73
|
| Rate for Payer: BCN Commercial |
$91.73
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cofinity Advantage |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$134.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$140.58
|
| Rate for Payer: Mclaren Medicaid |
$30.74
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.77
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.15
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$132.77
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$98.41
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.53
|
| Rate for Payer: UHC Core |
$81.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$61.39
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: VA VA |
$58.78
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$13.76
|
| Rate for Payer: BCN Commercial |
$13.76
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.90
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$10.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.35
|
| Rate for Payer: UHC Core |
$19.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.90
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicaid |
$6.75
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: VA VA |
$12.90
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.16 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$127.01
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.02 |
| Max. Negotiated Rate |
$114.31 |
| Rate for Payer: Aetna Commercial |
$107.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.56
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cofinity Advantage |
$88.91
|
| Rate for Payer: Cofinity Commercial |
$109.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.61
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.26
|
| Rate for Payer: PHP Commercial |
$107.96
|
| Rate for Payer: Priority Health SBD |
$80.02
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$127.01
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.91 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$107.96
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$50.54
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cofinity Advantage |
$88.91
|
| Rate for Payer: Cofinity Commercial |
$109.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.96
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.26
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$107.96
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$80.02
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.56
|
| Rate for Payer: UHC Core |
$66.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$49.91
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$5.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.03
|
| Rate for Payer: BCBS Complete |
$2.65
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$5.15
|
| Rate for Payer: BCN Commercial |
$5.15
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Mclaren Medicaid |
$2.52
|
| Rate for Payer: Mclaren Medicare |
$4.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: Meridian Medicaid |
$5.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$7.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.82
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Priority Health Tiered Network |
$3.86
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.23
|
| Rate for Payer: UHC Core |
$7.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.82
|
| Rate for Payer: UHC Exchange |
$7.23
|
| Rate for Payer: UHC Medicaid |
$2.52
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: VA VA |
$4.82
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
|
|
HC BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Facility
|
IP
|
$943.50
|
|
|
Service Code
|
CPT 67700
|
| Hospital Charge Code |
76100532
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$594.40 |
| Max. Negotiated Rate |
$849.15 |
| Rate for Payer: Aetna Commercial |
$801.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.27
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cofinity Advantage |
$660.45
|
| Rate for Payer: Cofinity Commercial |
$811.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.80
|
| Rate for Payer: Healthscope Commercial |
$849.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.62
|
| Rate for Payer: PHP Commercial |
$801.98
|
| Rate for Payer: Priority Health SBD |
$594.40
|
|
|
HC BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Facility
|
OP
|
$943.50
|
|
|
Service Code
|
CPT 67700
|
| Hospital Charge Code |
76100532
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.40 |
| Max. Negotiated Rate |
$1,022.76 |
| Rate for Payer: Aetna Commercial |
$801.98
|
| Rate for Payer: Aetna Medicare |
$328.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$395.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$395.32
|
| Rate for Payer: BCBS Complete |
$173.69
|
| Rate for Payer: BCBS MAPPO |
$316.26
|
| Rate for Payer: BCBS Trust/PPO |
$218.25
|
| Rate for Payer: BCN Commercial |
$218.25
|
| Rate for Payer: BCN Medicare Advantage |
$316.26
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cash Price |
$754.80
|
| Rate for Payer: Cofinity Advantage |
$660.45
|
| Rate for Payer: Cofinity Commercial |
$811.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.26
|
| Rate for Payer: Healthscope Commercial |
$849.15
|
| Rate for Payer: Mclaren Medicaid |
$165.40
|
| Rate for Payer: Mclaren Medicare |
$316.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.07
|
| Rate for Payer: Meridian Medicaid |
$332.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$363.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$347.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.98
|
| Rate for Payer: Nomi Health Commercial |
$948.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.62
|
| Rate for Payer: PACE Medicare |
$300.45
|
| Rate for Payer: PACE SWMI |
$316.26
|
| Rate for Payer: PHP Commercial |
$801.98
|
| Rate for Payer: PHP Medicare Advantage |
$316.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,022.76
|
| Rate for Payer: Priority Health Medicare |
$316.26
|
| Rate for Payer: Priority Health SBD |
$594.40
|
| Rate for Payer: Priority Health Tiered Network |
$818.21
|
| Rate for Payer: Railroad Medicare Medicare |
$316.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.27
|
| Rate for Payer: UHC Core |
$491.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$316.26
|
| Rate for Payer: UHC Exchange |
$370.80
|
| Rate for Payer: UHC Medicaid |
$165.40
|
| Rate for Payer: UHCCP Medicaid |
$165.40
|
| Rate for Payer: VA VA |
$316.26
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$99.65
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$89.69 |
| Rate for Payer: Aetna Commercial |
$84.70
|
| Rate for Payer: Aetna Medicare |
$10.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: BCBS Complete |
$5.67
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$11.00
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$79.72
|
| Rate for Payer: Cash Price |
$79.72
|
| Rate for Payer: Cofinity Advantage |
$69.75
|
| Rate for Payer: Cofinity Commercial |
$85.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$89.69
|
| Rate for Payer: Mclaren Medicaid |
$5.40
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.70
|
| Rate for Payer: Nomi Health Commercial |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.74
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$84.70
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.32
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health SBD |
$62.78
|
| Rate for Payer: Priority Health Tiered Network |
$8.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.48
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.32
|
| Rate for Payer: UHC Exchange |
$15.48
|
| Rate for Payer: UHC Medicaid |
$5.40
|
| Rate for Payer: UHCCP Medicaid |
$5.40
|
| Rate for Payer: VA VA |
$10.32
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$99.65
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.78 |
| Max. Negotiated Rate |
$89.69 |
| Rate for Payer: Aetna Commercial |
$84.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.77
|
| Rate for Payer: Cash Price |
$79.72
|
| Rate for Payer: Cofinity Advantage |
$69.75
|
| Rate for Payer: Cofinity Commercial |
$85.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.72
|
| Rate for Payer: Healthscope Commercial |
$89.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.74
|
| Rate for Payer: PHP Commercial |
$84.70
|
| Rate for Payer: Priority Health SBD |
$62.78
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$171.13
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.81 |
| Max. Negotiated Rate |
$154.02 |
| Rate for Payer: Aetna Commercial |
$145.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.23
|
| Rate for Payer: Cash Price |
$136.90
|
| Rate for Payer: Cofinity Advantage |
$119.79
|
| Rate for Payer: Cofinity Commercial |
$147.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.90
|
| Rate for Payer: Healthscope Commercial |
$154.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.35
|
| Rate for Payer: PHP Commercial |
$145.46
|
| Rate for Payer: Priority Health SBD |
$107.81
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$171.13
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.14 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna Commercial |
$145.46
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$47.14
|
| Rate for Payer: BCN Commercial |
$47.14
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$136.90
|
| Rate for Payer: Cash Price |
$136.90
|
| Rate for Payer: Cofinity Advantage |
$119.79
|
| Rate for Payer: Cofinity Commercial |
$147.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$154.02
|
| Rate for Payer: Mclaren Medicaid |
$69.33
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.46
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.35
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.46
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$107.81
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.23
|
| Rate for Payer: UHC Core |
$89.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$67.25
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$180.51
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$113.72 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.33
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Advantage |
$126.36
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: Priority Health SBD |
$113.72
|
|
