|
HC CVC INSERT
|
Facility
|
IP
|
$2,596.45
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,635.76 |
| Max. Negotiated Rate |
$2,336.80 |
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
|
|
HC CVC INSERT
|
Facility
|
OP
|
$2,596.45
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,038.58 |
| Max. Negotiated Rate |
$2,336.80 |
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna Medicare |
$1,298.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: BCBS Complete |
$1,038.58
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,077.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$524.71 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health SBD |
$524.71
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$374.02
|
| Rate for Payer: BCN Commercial |
$374.02
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Mclaren Medicaid |
$112.52
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: VA VA |
$215.15
|
|
|
HC CVVHD INSERTION
|
Facility
|
IP
|
$425.18
|
|
| Hospital Charge Code |
27000053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$267.86 |
| Max. Negotiated Rate |
$382.66 |
| Rate for Payer: Aetna Commercial |
$361.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.37
|
| Rate for Payer: Cash Price |
$340.14
|
| Rate for Payer: Cofinity Advantage |
$297.63
|
| Rate for Payer: Cofinity Commercial |
$365.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$382.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.88
|
| Rate for Payer: PHP Commercial |
$361.40
|
| Rate for Payer: Priority Health SBD |
$267.86
|
|
|
HC CVVHD INSERTION
|
Facility
|
OP
|
$425.18
|
|
| Hospital Charge Code |
27000053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$167.10 |
| Max. Negotiated Rate |
$382.66 |
| Rate for Payer: Aetna Commercial |
$361.40
|
| Rate for Payer: Aetna Medicare |
$212.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.37
|
| Rate for Payer: BCBS Complete |
$170.07
|
| Rate for Payer: Cash Price |
$340.14
|
| Rate for Payer: Cofinity Advantage |
$297.63
|
| Rate for Payer: Cofinity Commercial |
$365.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$382.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.88
|
| Rate for Payer: PHP Commercial |
$361.40
|
| Rate for Payer: Priority Health SBD |
$267.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.37
|
| Rate for Payer: UHC Core |
$221.52
|
| Rate for Payer: UHC Exchange |
$167.10
|
|
|
HC CVVH SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$644.08
|
|
| Hospital Charge Code |
27000611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$579.67 |
| Rate for Payer: Aetna Commercial |
$547.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.65
|
| Rate for Payer: Cash Price |
$515.26
|
| Rate for Payer: Cofinity Advantage |
$450.86
|
| Rate for Payer: Cofinity Commercial |
$553.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.26
|
| Rate for Payer: Healthscope Commercial |
$579.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.06
|
| Rate for Payer: PHP Commercial |
$547.47
|
| Rate for Payer: Priority Health SBD |
$405.77
|
|
|
HC CVVH SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$644.08
|
|
| Hospital Charge Code |
27000611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$253.12 |
| Max. Negotiated Rate |
$579.67 |
| Rate for Payer: Aetna Commercial |
$547.47
|
| Rate for Payer: Aetna Medicare |
$322.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.65
|
| Rate for Payer: BCBS Complete |
$257.63
|
| Rate for Payer: Cash Price |
$515.26
|
| Rate for Payer: Cofinity Advantage |
$450.86
|
| Rate for Payer: Cofinity Commercial |
$553.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.26
|
| Rate for Payer: Healthscope Commercial |
$579.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$515.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.06
|
| Rate for Payer: PHP Commercial |
$547.47
|
| Rate for Payer: Priority Health SBD |
$405.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.65
|
| Rate for Payer: UHC Core |
$335.57
|
| Rate for Payer: UHC Exchange |
$253.12
|
|
|
HC CX ID BY PCR AMP, ENTEROBACTERIACEA
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMP, ENTEROBACTERIACEA
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFED, C GLA
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600248
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFED, C GLA
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600248
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, ACIN
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600236
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFIED, ACIN
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600236
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, BSA
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600235
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, BSA
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600235
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFIED, BSB
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600234
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, BSB
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600234
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFIED, C ALB
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600247
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, C ALB
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600247
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFIED, C KRU
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600249
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFIED, C KRU
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600249
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, C PARA
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600250
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.94
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CX ID BY PCR AMPLIFIED, C PARA
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600250
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
|
HC CX ID BY PCR AMPLIFIED, C TROP
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600251
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.11
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Advantage |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.97
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health SBD |
$36.94
|
|
