|
HC MUMPS AB IGG
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.22
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Cofinity Commercial |
$55.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Mclaren Medicaid |
$7.14
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Medicaid |
$7.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health SBD |
$49.77
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.66
|
| Rate for Payer: UHC Core |
$22.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.05
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: VA VA |
$13.05
|
|
|
HC MUMPS AB IGG
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.35
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Cofinity Commercial |
$55.30
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health SBD |
$49.77
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.88 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna Commercial |
$64.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.40
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$65.36
|
| Rate for Payer: Cofinity Commercial |
$53.20
|
| Rate for Payer: Healthscope Commercial |
$68.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.60
|
| Rate for Payer: PHP Commercial |
$64.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health SBD |
$47.88
|
|
|
HC MUMPS IGM ANTIBODY
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200306
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna Commercial |
$64.60
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.22
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$65.36
|
| Rate for Payer: Cofinity Commercial |
$53.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$68.40
|
| Rate for Payer: Mclaren Medicaid |
$7.14
|
| Rate for Payer: Mclaren Medicare |
$13.05
|
| Rate for Payer: Meridian Medicaid |
$7.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.60
|
| Rate for Payer: PACE Medicare |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$64.60
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health Medicare |
$13.05
|
| Rate for Payer: Priority Health SBD |
$47.88
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.66
|
| Rate for Payer: UHC Core |
$22.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.05
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: VA VA |
$13.05
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$14.14
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$9.87
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Core |
$29.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Exchange |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: VA VA |
$18.05
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$22.51 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Core |
$22.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.49
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
OP
|
$20.33
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$22.51 |
| Rate for Payer: Aetna Commercial |
$17.28
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$14.23
|
| Rate for Payer: Cofinity Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$18.30
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.28
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$17.28
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.23
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$12.81
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Core |
$22.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
IP
|
$20.33
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.81 |
| Max. Negotiated Rate |
$18.30 |
| Rate for Payer: Aetna Commercial |
$17.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.21
|
| Rate for Payer: Cash Price |
$16.26
|
| Rate for Payer: Cofinity Commercial |
$14.23
|
| Rate for Payer: Cofinity Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$18.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.28
|
| Rate for Payer: PHP Commercial |
$17.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.23
|
| Rate for Payer: Priority Health SBD |
$12.81
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna Medicare |
$16.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.24
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$15.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$15.39
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Cofinity Commercial |
$75.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Mclaren Medicare |
$15.39
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Medicare |
$14.62
|
| Rate for Payer: PACE SWMI |
$15.39
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health Medicare |
$15.39
|
| Rate for Payer: Priority Health SBD |
$67.79
|
| Rate for Payer: Railroad Medicare Medicare |
$15.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.47
|
| Rate for Payer: UHC Core |
$26.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.39
|
| Rate for Payer: UHC Exchange |
$15.39
|
| Rate for Payer: UHC Medicare Advantage |
$15.85
|
| Rate for Payer: VA VA |
$15.39
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.79 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.94
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Cofinity Commercial |
$75.32
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health SBD |
$67.79
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$42.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health SBD |
$37.80
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.00
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$42.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$37.80
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.13 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.99
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$100.14
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health SBD |
$90.13
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.99
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Cofinity Commercial |
$100.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$90.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.99
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Cofinity Commercial |
$100.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$90.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.13 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.99
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$100.14
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health SBD |
$90.13
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.13 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.99
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$100.14
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health SBD |
$90.13
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.99
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Cofinity Commercial |
$100.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$90.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.49
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$22.51 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Core |
$22.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$216.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$136.08 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.40
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$185.76
|
| Rate for Payer: Cofinity Commercial |
$151.20
|
| Rate for Payer: Healthscope Commercial |
$194.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.60
|
| Rate for Payer: PHP Commercial |
$183.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: Priority Health SBD |
$136.08
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$216.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.40
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$185.76
|
| Rate for Payer: Cofinity Commercial |
$151.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$194.40
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.60
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$183.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$136.08
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$59.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$632.40
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$95.94 |
| Max. Negotiated Rate |
$569.16 |
| Rate for Payer: Aetna Commercial |
$537.54
|
| Rate for Payer: Aetna Medicare |
$182.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: BCBS Complete |
$100.75
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCBS Trust/PPO |
$137.35
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cofinity Commercial |
$543.86
|
| Rate for Payer: Cofinity Commercial |
$442.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$569.16
|
| Rate for Payer: Mclaren Medicaid |
$95.94
|
| Rate for Payer: Mclaren Medicare |
$175.40
|
| Rate for Payer: Meridian Medicaid |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.54
|
| Rate for Payer: PACE Medicare |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$537.54
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.68
|
| Rate for Payer: Priority Health Medicare |
$175.40
|
| Rate for Payer: Priority Health SBD |
$398.41
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.48
|
| Rate for Payer: UHC Core |
$210.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.40
|
| Rate for Payer: UHC Exchange |
$175.40
|
| Rate for Payer: UHC Medicare Advantage |
$180.66
|
| Rate for Payer: VA VA |
$175.40
|
|
