|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,010.46
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,416.59 |
| Max. Negotiated Rate |
$6,309.41 |
| Rate for Payer: Aetna Commercial |
$5,958.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,556.80
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cofinity Commercial |
$6,029.00
|
| Rate for Payer: Cofinity Commercial |
$4,907.32
|
| Rate for Payer: Healthscope Commercial |
$6,309.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,958.89
|
| Rate for Payer: PHP Commercial |
$5,958.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.32
|
| Rate for Payer: Priority Health SBD |
$4,416.59
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,010.46
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.05 |
| Max. Negotiated Rate |
$7,382.58 |
| Rate for Payer: Aetna Commercial |
$5,958.89
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,556.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$895.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cofinity Commercial |
$4,907.32
|
| Rate for Payer: Cofinity Commercial |
$6,029.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$6,309.41
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,958.89
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$5,958.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,382.58
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health Narrow Network |
$5,906.06
|
| Rate for Payer: Priority Health SBD |
$4,416.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$312.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,512.69
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,582.99 |
| Max. Negotiated Rate |
$2,261.42 |
| Rate for Payer: Aetna Commercial |
$2,135.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.25
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cofinity Commercial |
$1,758.88
|
| Rate for Payer: Cofinity Commercial |
$2,160.91
|
| Rate for Payer: Healthscope Commercial |
$2,261.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,135.79
|
| Rate for Payer: PHP Commercial |
$2,135.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.88
|
| Rate for Payer: Priority Health SBD |
$1,582.99
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,512.69
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$67.45 |
| Max. Negotiated Rate |
$5,222.22 |
| Rate for Payer: Aetna Commercial |
$2,135.79
|
| Rate for Payer: Aetna Medicare |
$1,760.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,633.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,116.40
|
| Rate for Payer: BCBS Complete |
$972.53
|
| Rate for Payer: BCBS MAPPO |
$1,693.12
|
| Rate for Payer: BCBS Trust/PPO |
$619.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,693.12
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cofinity Commercial |
$2,160.91
|
| Rate for Payer: Cofinity Commercial |
$1,758.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,693.12
|
| Rate for Payer: Healthscope Commercial |
$2,261.42
|
| Rate for Payer: Mclaren Medicaid |
$926.14
|
| Rate for Payer: Mclaren Medicare |
$1,693.12
|
| Rate for Payer: Meridian Medicaid |
$972.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,777.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,947.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,135.79
|
| Rate for Payer: PACE Medicare |
$1,608.46
|
| Rate for Payer: PACE SWMI |
$1,693.12
|
| Rate for Payer: PHP Commercial |
$2,135.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,693.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$926.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,222.22
|
| Rate for Payer: Priority Health Medicare |
$1,693.12
|
| Rate for Payer: Priority Health Narrow Network |
$4,177.77
|
| Rate for Payer: Priority Health SBD |
$1,582.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,693.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.20
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,693.12
|
| Rate for Payer: UHC Exchange |
$67.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,743.91
|
| Rate for Payer: VA VA |
$1,693.12
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$3,971.90
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.41 |
| Max. Negotiated Rate |
$5,427.00 |
| Rate for Payer: Aetna Commercial |
$3,376.12
|
| Rate for Payer: Aetna Medicare |
$3,201.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,581.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,847.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,847.99
|
| Rate for Payer: BCBS Complete |
$1,768.23
|
| Rate for Payer: BCBS MAPPO |
$3,078.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.70
|
| Rate for Payer: BCN Medicare Advantage |
$3,078.39
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cofinity Commercial |
$2,780.33
|
| Rate for Payer: Cofinity Commercial |
$3,415.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,078.39
|
| Rate for Payer: Healthscope Commercial |
$3,574.71
|
| Rate for Payer: Mclaren Medicaid |
$1,683.88
|
| Rate for Payer: Mclaren Medicare |
$3,078.39
|
| Rate for Payer: Meridian Medicaid |
$1,768.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,232.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,540.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,376.12
|
| Rate for Payer: PACE Medicare |
$2,924.47
|
| Rate for Payer: PACE SWMI |
$3,078.39
|
| Rate for Payer: PHP Commercial |
$3,376.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,078.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,683.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.33
|
| Rate for Payer: Priority Health Medicare |
$3,078.39
|
| Rate for Payer: Priority Health SBD |
$2,502.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,078.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.95
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,078.39
|
| Rate for Payer: UHC Exchange |
$125.41
|
| Rate for Payer: UHC Medicare Advantage |
$3,170.74
|
| Rate for Payer: VA VA |
$3,078.39
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$3,971.90
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.30 |
| Max. Negotiated Rate |
$3,574.71 |
| Rate for Payer: Aetna Commercial |
$3,376.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,581.74
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cofinity Commercial |
$3,415.83
|
| Rate for Payer: Cofinity Commercial |
$2,780.33
|
| Rate for Payer: Healthscope Commercial |
$3,574.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,376.12
|
| Rate for Payer: PHP Commercial |
$3,376.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.33
|
| Rate for Payer: Priority Health SBD |
$2,502.30
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$2,951.94
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,859.72 |
| Max. Negotiated Rate |
$2,656.75 |
| Rate for Payer: Aetna Commercial |
$2,509.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,918.76
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cofinity Commercial |
$2,066.36
|
| Rate for Payer: Cofinity Commercial |
$2,538.67
|
| Rate for Payer: Healthscope Commercial |
$2,656.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,509.15
|
| Rate for Payer: PHP Commercial |
$2,509.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,066.36
|
| Rate for Payer: Priority Health SBD |
$1,859.72
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$2,951.94
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.61 |
| Max. Negotiated Rate |
$5,575.00 |
| Rate for Payer: Aetna Commercial |
$2,509.15
|
| Rate for Payer: Aetna Medicare |
$1,884.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,918.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,265.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,265.42
|
| Rate for Payer: BCBS Complete |
$1,041.01
|
| Rate for Payer: BCBS MAPPO |
$1,812.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,936.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,812.34
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cofinity Commercial |
$2,538.67
|
| Rate for Payer: Cofinity Commercial |
$2,066.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,812.34
|
| Rate for Payer: Healthscope Commercial |
$2,656.75
|
| Rate for Payer: Mclaren Medicaid |
$991.35
|
| Rate for Payer: Mclaren Medicare |
$1,812.34
|
| Rate for Payer: Meridian Medicaid |
$1,041.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,902.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,084.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,509.15
|
| Rate for Payer: PACE Medicare |
$1,721.72
|
| Rate for Payer: PACE SWMI |
$1,812.34
|
| Rate for Payer: PHP Commercial |
$2,509.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,812.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,066.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,575.00
|
| Rate for Payer: Priority Health Medicare |
$1,812.34
|
| Rate for Payer: Priority Health Narrow Network |
$4,460.00
|
| Rate for Payer: Priority Health SBD |
$1,859.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,812.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.17
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,812.34
|
| Rate for Payer: UHC Exchange |
$95.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,866.71
|
| Rate for Payer: VA VA |
$1,812.34
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,494.17
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$941.33 |
| Max. Negotiated Rate |
$1,344.75 |
| Rate for Payer: Aetna Commercial |
$1,270.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.21
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cofinity Commercial |
$1,045.92
|
| Rate for Payer: Cofinity Commercial |
$1,284.99
|
| Rate for Payer: Healthscope Commercial |
$1,344.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,270.04
|
| Rate for Payer: PHP Commercial |
$1,270.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.92
|
| Rate for Payer: Priority Health SBD |
$941.33
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,494.17
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$1,344.75 |
| Rate for Payer: Aetna Commercial |
$1,270.04
|
| Rate for Payer: Aetna Medicare |
$401.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.82
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCBS MAPPO |
$386.26
|
| Rate for Payer: BCBS Trust/PPO |
$104.37
|
| Rate for Payer: BCN Medicare Advantage |
$386.26
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cofinity Commercial |
$1,284.99
|
| Rate for Payer: Cofinity Commercial |
$1,045.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.26
|
| Rate for Payer: Healthscope Commercial |
$1,344.75
|
| Rate for Payer: Mclaren Medicaid |
$211.28
|
| Rate for Payer: Mclaren Medicare |
$386.26
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$405.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$444.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,270.04
|
| Rate for Payer: PACE Medicare |
$366.95
|
| Rate for Payer: PACE SWMI |
$386.26
|
| Rate for Payer: PHP Commercial |
$1,270.04
|
| Rate for Payer: PHP Medicare Advantage |
$386.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,222.66
|
| Rate for Payer: Priority Health Medicare |
$386.26
|
| Rate for Payer: Priority Health Narrow Network |
$978.13
|
| Rate for Payer: Priority Health SBD |
$941.33
|
| Rate for Payer: Railroad Medicare Medicare |
$386.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.26
|
| Rate for Payer: UHC Exchange |
$120.83
|
| Rate for Payer: UHC Medicare Advantage |
$397.85
|
| Rate for Payer: VA VA |
$386.26
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$539.47
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$339.87 |
| Max. Negotiated Rate |
$485.52 |
| Rate for Payer: Aetna Commercial |
$458.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.66
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Cofinity Commercial |
$377.63
|
| Rate for Payer: Cofinity Commercial |
$463.94
|
| Rate for Payer: Healthscope Commercial |
$485.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.55
|
| Rate for Payer: PHP Commercial |
$458.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.63
|
| Rate for Payer: Priority Health SBD |
$339.87
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$539.47
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$215.79 |
| Max. Negotiated Rate |
$485.52 |
| Rate for Payer: Aetna Commercial |
$458.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.66
|
| Rate for Payer: BCBS Complete |
$215.79
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Cofinity Commercial |
$377.63
|
| Rate for Payer: Cofinity Commercial |
$463.94
|
| Rate for Payer: Healthscope Commercial |
$485.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.55
|
| Rate for Payer: PHP Commercial |
$458.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.63
|
| Rate for Payer: Priority Health SBD |
$339.87
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,977.00 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$409.30 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,979.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,580.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,580.99
|
| Rate for Payer: BCBS Complete |
$1,645.54
|
| Rate for Payer: BCBS MAPPO |
$2,864.79
|
| Rate for Payer: BCBS Trust/PPO |
$952.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,864.79
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,864.79
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,567.04
|
| Rate for Payer: Mclaren Medicare |
$2,864.79
|
| Rate for Payer: Meridian Medicaid |
$1,645.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,008.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,294.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,721.55
|
| Rate for Payer: PACE SWMI |
$2,864.79
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,864.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,567.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health Medicare |
$2,864.79
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,864.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,864.79
|
| Rate for Payer: UHC Exchange |
$409.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,950.73
|
| Rate for Payer: VA VA |
$2,864.79
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.21 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$937.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$81.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$726.38 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$726.38 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.73 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.55
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$626.04
|
| Rate for Payer: BCBS Trust/PPO |
$405.67
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$342.44
|
| Rate for Payer: Mclaren Medicare |
$626.04
|
| Rate for Payer: Meridian Medicaid |
$359.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$626.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,937.58
|
| Rate for Payer: Priority Health Medicare |
$626.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.06
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$107.73
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$134.25 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$937.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$134.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$726.38 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$726.38 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.21 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$937.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$155.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,199.64 |
| Max. Negotiated Rate |
$1,713.77 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.72
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,332.93
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health SBD |
$1,199.64
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,904.19
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
76100099
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$178.78 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Cofinity Commercial |
$1,332.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,199.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$178.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,199.64 |
| Max. Negotiated Rate |
$1,713.77 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.72
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,332.93
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health SBD |
$1,199.64
|
|
