|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$14.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.28
|
| Rate for Payer: BCBS Complete |
$7.78
|
| Rate for Payer: BCBS MAPPO |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$12.24
|
| Rate for Payer: BCN Commercial |
$12.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$7.41
|
| Rate for Payer: Mclaren Medicare |
$13.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.51
|
| Rate for Payer: Meridian Medicaid |
$7.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$20.73
|
| Rate for Payer: PACE Medicare |
$13.13
|
| Rate for Payer: PACE SWMI |
$13.82
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$13.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.82
|
| Rate for Payer: Priority Health Medicare |
$13.82
|
| Rate for Payer: Priority Health Narrow Network |
$11.06
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: Railroad Medicare Medicare |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.82
|
| Rate for Payer: UHC Medicare Advantage |
$13.82
|
| Rate for Payer: UHCCP Medicaid |
$7.78
|
| Rate for Payer: VA VA |
$13.82
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.84 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health SBD |
$28.84
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$7.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.16
|
| Rate for Payer: BCBS Complete |
$4.13
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$4.86
|
| Rate for Payer: BCN Commercial |
$4.86
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Cofinity Commercial |
$33.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$3.93
|
| Rate for Payer: Mclaren Medicare |
$7.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Meridian Medicaid |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$11.00
|
| Rate for Payer: PACE Medicare |
$6.96
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.33
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$5.86
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.33
|
| Rate for Payer: UHCCP Medicaid |
$4.13
|
| Rate for Payer: VA VA |
$7.33
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.71
|
| Rate for Payer: Priority Health SBD |
$29.76
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$2,996.16
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,198.46 |
| Max. Negotiated Rate |
$2,696.54 |
| Rate for Payer: Aetna Commercial |
$2,546.74
|
| Rate for Payer: Aetna Medicare |
$1,498.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.50
|
| Rate for Payer: BCBS Complete |
$1,198.46
|
| Rate for Payer: Cash Price |
$2,396.93
|
| Rate for Payer: Cofinity Commercial |
$2,097.31
|
| Rate for Payer: Cofinity Commercial |
$2,576.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,097.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,396.93
|
| Rate for Payer: Healthscope Commercial |
$2,696.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,546.74
|
| Rate for Payer: PHP Commercial |
$2,546.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.50
|
| Rate for Payer: Priority Health SBD |
$1,887.58
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$2,996.16
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,887.58 |
| Max. Negotiated Rate |
$2,696.54 |
| Rate for Payer: Aetna Commercial |
$2,546.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,947.50
|
| Rate for Payer: Cash Price |
$2,396.93
|
| Rate for Payer: Cofinity Commercial |
$2,097.31
|
| Rate for Payer: Cofinity Commercial |
$2,576.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,097.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,396.93
|
| Rate for Payer: Healthscope Commercial |
$2,696.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,546.74
|
| Rate for Payer: PHP Commercial |
$2,546.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.50
|
| Rate for Payer: Priority Health SBD |
$1,887.58
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,679.58
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,318.14 |
| Max. Negotiated Rate |
$3,311.62 |
| Rate for Payer: Aetna Commercial |
$3,127.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.73
|
| Rate for Payer: Cash Price |
$2,943.66
|
| Rate for Payer: Cofinity Commercial |
$2,575.71
|
| Rate for Payer: Cofinity Commercial |
$3,164.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,575.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.66
|
| Rate for Payer: Healthscope Commercial |
$3,311.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,127.64
|
| Rate for Payer: PHP Commercial |
$3,127.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.73
|
| Rate for Payer: Priority Health SBD |
$2,318.14
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,679.58
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,471.83 |
| Max. Negotiated Rate |
$3,311.62 |
| Rate for Payer: Aetna Commercial |
$3,127.64
|
| Rate for Payer: Aetna Medicare |
$1,839.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.73
|
| Rate for Payer: BCBS Complete |
$1,471.83
|
| Rate for Payer: Cash Price |
$2,943.66
|
| Rate for Payer: Cofinity Commercial |
$2,575.71
|
| Rate for Payer: Cofinity Commercial |
$3,164.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,575.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.66
|
| Rate for Payer: Healthscope Commercial |
$3,311.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,127.64
|
| Rate for Payer: PHP Commercial |
$3,127.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.73
|
| Rate for Payer: Priority Health SBD |
$2,318.14
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$10.25
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Mclaren Medicaid |
$6.20
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.36
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.57
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health Narrow Network |
$9.26
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.57
|
| Rate for Payer: UHCCP Medicaid |
$6.51
|
| Rate for Payer: VA VA |
$11.57
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$15.30
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health SBD |
$13.77
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$58.03 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS Trust/PPO |
$108.07
|
| Rate for Payer: BCN Commercial |
$108.07
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UHC Core |
$107.36
|
| Rate for Payer: UHC Exchange |
$107.36
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,308.69
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$4,604.47 |
| Max. Negotiated Rate |
$6,577.82 |
| Rate for Payer: Aetna Commercial |
$6,212.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,750.65
|
| Rate for Payer: Cash Price |
$5,846.95
|
| Rate for Payer: Cofinity Commercial |
$5,116.08
|
| Rate for Payer: Cofinity Commercial |
$6,285.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,116.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,846.95
|
| Rate for Payer: Healthscope Commercial |
$6,577.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,212.39
|
| Rate for Payer: PHP Commercial |
$6,212.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,750.65
|
| Rate for Payer: Priority Health SBD |
$4,604.47
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,709.64
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,337.07 |
| Max. Negotiated Rate |
$3,338.68 |
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,411.27
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cofinity Commercial |
$2,596.75
|
| Rate for Payer: Cofinity Commercial |
$3,190.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,596.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,967.71
|
| Rate for Payer: Healthscope Commercial |
$3,338.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,153.19
|
| Rate for Payer: PHP Commercial |
$3,153.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,411.27
|
| Rate for Payer: Priority Health SBD |
$2,337.07
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,709.64
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,338.68 |
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,411.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$426.84
|
| Rate for Payer: BCN Commercial |
$426.84
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cofinity Commercial |
$3,190.29
|
| Rate for Payer: Cofinity Commercial |
$2,596.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,596.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,967.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,338.68
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,153.19
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$3,153.19
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,411.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$2,337.07
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$2,745.13
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,502.26
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,252.03 |
| Rate for Payer: Aetna Commercial |
$2,126.92
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$200.53
|
| Rate for Payer: BCN Commercial |
$200.53
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cofinity Commercial |
$2,151.94
|
| Rate for Payer: Cofinity Commercial |
$1,751.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,751.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$2,252.03
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,126.92
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$2,126.92
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$1,576.42
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$1,851.67
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$133.34
|
| Rate for Payer: VA VA |
$236.83
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,502.26
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,576.42 |
| Max. Negotiated Rate |
$2,252.03 |
| Rate for Payer: Aetna Commercial |
$2,126.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,626.47
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cofinity Commercial |
$1,751.58
|
| Rate for Payer: Cofinity Commercial |
$2,151.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,751.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.81
|
| Rate for Payer: Healthscope Commercial |
$2,252.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,126.92
|
| Rate for Payer: PHP Commercial |
$2,126.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.47
|
| Rate for Payer: Priority Health SBD |
$1,576.42
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,433.63
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,793.19 |
| Max. Negotiated Rate |
$3,990.27 |
| Rate for Payer: Aetna Commercial |
$3,768.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,881.86
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cofinity Commercial |
$3,103.54
|
| Rate for Payer: Cofinity Commercial |
$3,812.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,103.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.90
|
| Rate for Payer: Healthscope Commercial |
$3,990.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.59
|
| Rate for Payer: PHP Commercial |
$3,768.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.86
|
| Rate for Payer: Priority Health SBD |
$2,793.19
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,433.63
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,990.27 |
| Rate for Payer: Aetna Commercial |
$3,768.59
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,881.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$482.15
|
| Rate for Payer: BCN Commercial |
$482.15
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cofinity Commercial |
$3,812.92
|
| Rate for Payer: Cofinity Commercial |
$3,103.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,103.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,990.27
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.59
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$3,768.59
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$2,793.19
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$3,280.89
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$197.00
|
| Rate for Payer: VA VA |
$349.91
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,097.42
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$691.37 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.32
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$768.19
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health SBD |
$691.37
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,097.42
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$431.87
|
| Rate for Payer: BCN Commercial |
$431.87
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Cofinity Commercial |
$768.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$768.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$691.37
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$812.09
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$98.20
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
IP
|
$1,959.75
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,234.64 |
| Max. Negotiated Rate |
$1,763.78 |
| Rate for Payer: Aetna Commercial |
$1,665.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.84
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cofinity Commercial |
$1,371.82
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,371.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.80
|
| Rate for Payer: Healthscope Commercial |
$1,763.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.79
|
| Rate for Payer: PHP Commercial |
$1,665.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.84
|
| Rate for Payer: Priority Health SBD |
$1,234.64
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
OP
|
$1,959.75
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.49 |
| Max. Negotiated Rate |
$1,763.78 |
| Rate for Payer: Aetna Commercial |
$1,665.79
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$338.83
|
| Rate for Payer: BCN Commercial |
$338.83
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Cofinity Commercial |
$1,371.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,371.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$1,763.78
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.79
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$1,665.79
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$1,234.64
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$1,450.22
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$98.20
|
| Rate for Payer: VA VA |
$174.42
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,606.90
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$1,446.21 |
| Rate for Payer: Aetna Commercial |
$1,365.86
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$159.05
|
| Rate for Payer: BCN Commercial |
$159.05
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cofinity Commercial |
$1,381.93
|
| Rate for Payer: Cofinity Commercial |
$1,124.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,124.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$1,446.21
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.86
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$1,365.86
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$1,012.35
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$1,189.11
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$58.66
|
| Rate for Payer: VA VA |
$104.19
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
IP
|
$1,606.90
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,012.35 |
| Max. Negotiated Rate |
$1,446.21 |
| Rate for Payer: Aetna Commercial |
$1,365.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.48
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cofinity Commercial |
$1,124.83
|
| Rate for Payer: Cofinity Commercial |
$1,381.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,124.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.52
|
| Rate for Payer: Healthscope Commercial |
$1,446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.86
|
| Rate for Payer: PHP Commercial |
$1,365.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.48
|
| Rate for Payer: Priority Health SBD |
$1,012.35
|
|
