|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
OP
|
$1,412.70
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$1,271.43 |
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cofinity Commercial |
$988.89
|
| Rate for Payer: Cofinity Commercial |
$1,214.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$988.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$1,271.43
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.25
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$890.00
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,412.70
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$890.00 |
| Max. Negotiated Rate |
$1,271.43 |
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.25
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cofinity Commercial |
$1,214.92
|
| Rate for Payer: Cofinity Commercial |
$988.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$988.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.16
|
| Rate for Payer: Healthscope Commercial |
$1,271.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.25
|
| Rate for Payer: Priority Health SBD |
$890.00
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$196.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$176.44 |
| Rate for Payer: Aetna Commercial |
$166.63
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cofinity Commercial |
$168.59
|
| Rate for Payer: Cofinity Commercial |
$137.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$176.44
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.63
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$166.63
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.43
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$123.51
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.68
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$196.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$123.51 |
| Max. Negotiated Rate |
$176.44 |
| Rate for Payer: Aetna Commercial |
$166.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.43
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cofinity Commercial |
$137.23
|
| Rate for Payer: Cofinity Commercial |
$168.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.83
|
| Rate for Payer: Healthscope Commercial |
$176.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.63
|
| Rate for Payer: PHP Commercial |
$166.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.43
|
| Rate for Payer: Priority Health SBD |
$123.51
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$114.24
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.97 |
| Max. Negotiated Rate |
$102.82 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.26
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.39
|
| Rate for Payer: Healthscope Commercial |
$102.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.10
|
| Rate for Payer: PHP Commercial |
$97.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.26
|
| Rate for Payer: Priority Health SBD |
$71.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$114.24
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$102.82 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Cofinity Commercial |
$79.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$102.82
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.10
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$97.10
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.26
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$71.97
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.68
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$65.28
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Cofinity Commercial |
$45.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$41.13
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.68
|
| Rate for Payer: VA VA |
$18.97
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$65.28
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.13 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.43
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$45.70
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: Priority Health SBD |
$41.13
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$452.71
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$285.21 |
| Max. Negotiated Rate |
$407.44 |
| Rate for Payer: Aetna Commercial |
$384.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.26
|
| Rate for Payer: Cash Price |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$316.90
|
| Rate for Payer: Cofinity Commercial |
$389.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$316.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.17
|
| Rate for Payer: Healthscope Commercial |
$407.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: PHP Commercial |
$384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.26
|
| Rate for Payer: Priority Health SBD |
$285.21
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$452.71
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.08 |
| Max. Negotiated Rate |
$407.44 |
| Rate for Payer: Aetna Commercial |
$384.80
|
| Rate for Payer: Aetna Medicare |
$226.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.26
|
| Rate for Payer: BCBS Complete |
$181.08
|
| Rate for Payer: Cash Price |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$316.90
|
| Rate for Payer: Cofinity Commercial |
$389.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$316.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.17
|
| Rate for Payer: Healthscope Commercial |
$407.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: PHP Commercial |
$384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.26
|
| Rate for Payer: Priority Health SBD |
$285.21
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,429.30 |
| Rate for Payer: Aetna Commercial |
$1,349.89
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,032.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,365.77
|
| Rate for Payer: Cofinity Commercial |
$1,111.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,111.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,429.30
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,349.89
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,000.51
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$1,175.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$1,175.20
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,000.51 |
| Max. Negotiated Rate |
$1,429.30 |
| Rate for Payer: Aetna Commercial |
$1,349.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,032.27
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,111.68
|
| Rate for Payer: Cofinity Commercial |
$1,365.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,111.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Healthscope Commercial |
$1,429.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: PHP Commercial |
$1,349.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: Priority Health SBD |
$1,000.51
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,178.00 |
| Rate for Payer: Aetna Commercial |
$1,112.56
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$916.22
|
| Rate for Payer: Cofinity Commercial |
$1,125.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$916.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,178.00
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,112.56
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$824.60
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$968.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$968.58
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$132.72
|
| Rate for Payer: VA VA |
$235.74
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$824.60 |
| Max. Negotiated Rate |
$1,178.00 |
| Rate for Payer: Aetna Commercial |
$1,112.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.78
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,125.65
|
| Rate for Payer: Cofinity Commercial |
$916.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$916.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Healthscope Commercial |
$1,178.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: PHP Commercial |
$1,112.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: Priority Health SBD |
$824.60
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna Commercial |
$112.21
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$92.41
|
| Rate for Payer: Cofinity Commercial |
$113.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$118.81
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$112.21
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$83.17
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$83.17 |
| Max. Negotiated Rate |
$118.81 |
| Rate for Payer: Aetna Commercial |
$112.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.81
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$113.53
|
| Rate for Payer: Cofinity Commercial |
$92.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Healthscope Commercial |
$118.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: PHP Commercial |
$112.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: Priority Health SBD |
$83.17
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna Commercial |
$4,342.64
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,320.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,393.73
|
| Rate for Payer: Cofinity Commercial |
$3,576.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,576.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$4,598.09
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$4,342.64
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$3,218.66
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,968.18
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,218.66 |
| Max. Negotiated Rate |
$4,598.09 |
| Rate for Payer: Aetna Commercial |
$4,342.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,320.84
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$3,576.29
|
| Rate for Payer: Cofinity Commercial |
$4,393.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,576.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Healthscope Commercial |
$4,598.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: PHP Commercial |
$4,342.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: Priority Health SBD |
$3,218.66
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$544.29 |
| Max. Negotiated Rate |
$777.56 |
| Rate for Payer: Aetna Commercial |
$734.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$561.57
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$604.77
|
| Rate for Payer: Cofinity Commercial |
$743.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$604.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Healthscope Commercial |
$777.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: PHP Commercial |
$734.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: Priority Health SBD |
$544.29
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$777.56 |
| Rate for Payer: Aetna Commercial |
$734.37
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$561.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$743.01
|
| Rate for Payer: Cofinity Commercial |
$604.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$604.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$777.56
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$734.37
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$544.29
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$639.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$639.33
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$652.14 |
| Rate for Payer: Aetna Commercial |
$615.91
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$623.16
|
| Rate for Payer: Cofinity Commercial |
$507.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$507.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$652.14
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$615.91
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$456.50
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$536.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$536.20
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$456.50 |
| Max. Negotiated Rate |
$652.14 |
| Rate for Payer: Aetna Commercial |
$615.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.99
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$507.22
|
| Rate for Payer: Cofinity Commercial |
$623.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$507.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Healthscope Commercial |
$652.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: PHP Commercial |
$615.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: Priority Health SBD |
$456.50
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$801.12
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$810.55
|
| Rate for Payer: Cofinity Commercial |
$659.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$659.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$848.25
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$801.12
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$593.77
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$697.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$697.45
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$85.91
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$593.77 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$801.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.62
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$659.75
|
| Rate for Payer: Cofinity Commercial |
$810.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$659.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Healthscope Commercial |
$848.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: PHP Commercial |
$801.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: Priority Health SBD |
$593.77
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$498.00 |
| Max. Negotiated Rate |
$711.42 |
| Rate for Payer: Aetna Commercial |
$671.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.81
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$679.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$553.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Healthscope Commercial |
$711.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: PHP Commercial |
$671.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: Priority Health SBD |
$498.00
|
|
