|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$975.83 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna Commercial |
$4,466.17
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,415.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$5,227.56
|
| Rate for Payer: BCN Commercial |
$5,227.56
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$3,678.02
|
| Rate for Payer: Cofinity Commercial |
$4,518.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,678.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$4,728.89
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$4,466.17
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$3,310.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$975.83
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$9,445.00
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$6,255.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$270.12 |
| Max. Negotiated Rate |
$385.88 |
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.69
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$300.13
|
| Rate for Payer: Cofinity Commercial |
$368.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$385.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: PHP Commercial |
$364.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health SBD |
$270.12
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.50 |
| Max. Negotiated Rate |
$7,304.83 |
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna Medicare |
$214.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.69
|
| Rate for Payer: BCBS Complete |
$171.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,304.83
|
| Rate for Payer: BCN Commercial |
$7,304.83
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$300.13
|
| Rate for Payer: Cofinity Commercial |
$368.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$385.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: PHP Commercial |
$364.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health SBD |
$270.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.19
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Exchange |
$940.00
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,580.75 |
| Max. Negotiated Rate |
$19,401.07 |
| Rate for Payer: Aetna Commercial |
$18,323.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,011.88
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$15,089.72
|
| Rate for Payer: Cofinity Commercial |
$18,538.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,089.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Healthscope Commercial |
$19,401.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: PHP Commercial |
$18,323.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health SBD |
$13,580.75
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$448.08 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna Commercial |
$18,323.23
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,011.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,714.77
|
| Rate for Payer: BCN Commercial |
$6,714.77
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$15,089.72
|
| Rate for Payer: Cofinity Commercial |
$18,538.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,089.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$19,401.07
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$18,323.23
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$13,580.75
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.08
|
| Rate for Payer: UHC Core |
$8,819.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$9,445.00
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$6,255.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,718.52 |
| Max. Negotiated Rate |
$5,312.17 |
| Rate for Payer: Aetna Commercial |
$5,017.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,836.57
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$4,131.69
|
| Rate for Payer: Cofinity Commercial |
$5,076.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,131.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: PHP Commercial |
$5,017.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health SBD |
$3,718.52
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,360.96 |
| Max. Negotiated Rate |
$5,312.17 |
| Rate for Payer: Aetna Commercial |
$5,017.05
|
| Rate for Payer: Aetna Medicare |
$2,951.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,836.57
|
| Rate for Payer: BCBS Complete |
$2,360.96
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$4,131.69
|
| Rate for Payer: Cofinity Commercial |
$5,076.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,131.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: PHP Commercial |
$5,017.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health SBD |
$3,718.52
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$56.39 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna Medicare |
$70.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.63
|
| Rate for Payer: BCBS Complete |
$56.39
|
| Rate for Payer: BCBS Trust/PPO |
$108.07
|
| Rate for Payer: BCN Commercial |
$108.07
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: PHP Commercial |
$119.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health SBD |
$88.81
|
| Rate for Payer: UHC Core |
$104.32
|
| Rate for Payer: UHC Exchange |
$104.32
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$88.81 |
| Max. Negotiated Rate |
$126.87 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.63
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: PHP Commercial |
$119.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health SBD |
$88.81
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$221.16 |
| Max. Negotiated Rate |
$315.94 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.18
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$245.73
|
| Rate for Payer: Cofinity Commercial |
$301.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Healthscope Commercial |
$315.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: PHP Commercial |
$298.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health SBD |
$221.16
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna Medicare |
$247.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$104.35
|
| Rate for Payer: BCN Commercial |
$104.35
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$301.89
|
| Rate for Payer: Cofinity Commercial |
$245.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$315.94
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$500.41
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$298.38
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.94
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$599.15
|
| Rate for Payer: Priority Health SBD |
$221.16
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.22
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$259.77
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$134.16
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$23.97 |
| Max. Negotiated Rate |
$878.00 |
| Rate for Payer: Aetna Commercial |
$310.35
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$23.97
|
| Rate for Payer: BCN Commercial |
$23.97
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$314.00
|
| Rate for Payer: Cofinity Commercial |
$255.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$328.61
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$310.35
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$230.03
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.48
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$270.19
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$230.03 |
| Max. Negotiated Rate |
$328.61 |
| Rate for Payer: Aetna Commercial |
$310.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.33
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$255.58
|
| Rate for Payer: Cofinity Commercial |
$314.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Healthscope Commercial |
$328.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: PHP Commercial |
$310.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health SBD |
$230.03
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$228.87 |
| Rate for Payer: Aetna Commercial |
$209.41
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$228.87
|
| Rate for Payer: BCN Commercial |
$228.87
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$211.88
|
| Rate for Payer: Cofinity Commercial |
$172.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$221.73
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$209.41
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$155.21
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$182.31
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$32.77
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$155.21 |
| Max. Negotiated Rate |
$221.73 |
| Rate for Payer: Aetna Commercial |
$209.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.14
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$172.46
|
| Rate for Payer: Cofinity Commercial |
$211.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$221.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: PHP Commercial |
$209.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health SBD |
$155.21
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$385.59 |
| Max. Negotiated Rate |
$550.84 |
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.83
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$428.44
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$550.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health SBD |
$385.59
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$550.84 |
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: Aetna Medicare |
$306.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.83
|
| Rate for Payer: BCBS Complete |
$244.82
|
| Rate for Payer: BCBS Trust/PPO |
$206.72
|
| Rate for Payer: BCN Commercial |
$206.72
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$428.44
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$550.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health SBD |
$385.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.93
|
| Rate for Payer: UHC Exchange |
$452.92
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$118.05 |
| Max. Negotiated Rate |
$168.64 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.80
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health SBD |
$118.05
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$74.95 |
| Max. Negotiated Rate |
$252.49 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna Medicare |
$93.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.80
|
| Rate for Payer: BCBS Complete |
$74.95
|
| Rate for Payer: BCBS Trust/PPO |
$252.49
|
| Rate for Payer: BCN Commercial |
$252.49
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Cofinity Commercial |
$131.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health SBD |
$118.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.10
|
| Rate for Payer: UHC Exchange |
$138.66
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$277.61
|
| Rate for Payer: BCN Commercial |
$277.61
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Cofinity Commercial |
$418.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$418.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$376.22
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$441.91
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$71.10
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$376.22 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$418.03
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$418.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health SBD |
$376.22
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$354.38
|
| Rate for Payer: BCN Commercial |
$354.38
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Cofinity Commercial |
$493.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$443.90
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$521.40
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$71.10
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$443.90 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.99
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$493.22
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health SBD |
$443.90
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$410.21 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.23
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health SBD |
$410.21
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$488.76
|
| Rate for Payer: BCN Commercial |
$488.76
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$455.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$410.21
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$481.84
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$86.31
|
| Rate for Payer: VA VA |
$153.30
|
|
