|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
IP
|
$2,507.96
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,580.01 |
| Max. Negotiated Rate |
$2,257.16 |
| Rate for Payer: Aetna Commercial |
$2,131.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.17
|
| Rate for Payer: Cash Price |
$2,006.37
|
| Rate for Payer: Cofinity Advantage |
$1,755.57
|
| Rate for Payer: Cofinity Commercial |
$2,156.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,006.37
|
| Rate for Payer: Healthscope Commercial |
$2,257.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,131.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,880.97
|
| Rate for Payer: PHP Commercial |
$2,131.77
|
| Rate for Payer: Priority Health SBD |
$1,580.01
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
OP
|
$2,507.96
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$985.63 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Commercial |
$2,131.77
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.62
|
| Rate for Payer: BCN Commercial |
$1,030.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,006.37
|
| Rate for Payer: Cash Price |
$2,006.37
|
| Rate for Payer: Cash Price |
$2,006.37
|
| Rate for Payer: Cofinity Advantage |
$1,755.57
|
| Rate for Payer: Cofinity Commercial |
$2,156.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,006.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$2,257.16
|
| Rate for Payer: Mclaren Medicaid |
$1,075.21
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,131.77
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,880.97
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,131.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$1,580.01
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,630.17
|
| Rate for Payer: UHC Core |
$1,306.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$985.63
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
IP
|
$3,283.73
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,068.75 |
| Max. Negotiated Rate |
$2,955.36 |
| Rate for Payer: Aetna Commercial |
$2,791.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,134.42
|
| Rate for Payer: Cash Price |
$2,626.98
|
| Rate for Payer: Cofinity Advantage |
$2,298.61
|
| Rate for Payer: Cofinity Commercial |
$2,824.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,626.98
|
| Rate for Payer: Healthscope Commercial |
$2,955.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,791.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,462.80
|
| Rate for Payer: PHP Commercial |
$2,791.17
|
| Rate for Payer: Priority Health SBD |
$2,068.75
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
OP
|
$3,283.73
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$752.50 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Commercial |
$2,791.17
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,134.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$752.50
|
| Rate for Payer: BCN Commercial |
$752.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,626.98
|
| Rate for Payer: Cash Price |
$2,626.98
|
| Rate for Payer: Cash Price |
$2,626.98
|
| Rate for Payer: Cofinity Advantage |
$2,298.61
|
| Rate for Payer: Cofinity Commercial |
$2,824.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,626.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$2,955.36
|
| Rate for Payer: Mclaren Medicaid |
$1,075.21
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,791.17
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,462.80
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,791.17
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$2,068.75
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,134.42
|
| Rate for Payer: UHC Core |
$1,710.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$1,290.51
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
HC GRAM STAIN
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.97 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.02
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Advantage |
$36.64
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: Priority Health SBD |
$32.97
|
|
|
HC GRAM STAIN
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.55
|
| Rate for Payer: BCN Commercial |
$4.55
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Advantage |
$36.64
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Mclaren Medicaid |
$2.23
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$6.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.27
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$32.97
|
| Rate for Payer: Priority Health Tiered Network |
$3.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.41
|
| Rate for Payer: UHC Core |
$6.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.41
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC GRANULOCYTES
|
Facility
|
OP
|
$1,964.28
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$771.96 |
| Max. Negotiated Rate |
$4,220.92 |
| Rate for Payer: Aetna Commercial |
$1,669.64
|
| Rate for Payer: Aetna Medicare |
$982.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,276.78
|
| Rate for Payer: BCBS Complete |
$785.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,220.92
|
| Rate for Payer: BCN Commercial |
$4,220.92
|
| Rate for Payer: Cash Price |
$1,571.42
|
| Rate for Payer: Cash Price |
$1,571.42
|
| Rate for Payer: Cofinity Advantage |
$1,375.00
|
| Rate for Payer: Cofinity Commercial |
$1,689.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.42
|
| Rate for Payer: Healthscope Commercial |
$1,767.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,571.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,473.21
|
| Rate for Payer: PHP Commercial |
$1,669.64
|
| Rate for Payer: Priority Health SBD |
$1,237.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,276.78
|
| Rate for Payer: UHC Core |
$1,023.39
|
| Rate for Payer: UHC Exchange |
$771.96
|
|
|
HC GRANULOCYTES
|
Facility
|
IP
|
$1,964.28
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,237.50 |
| Max. Negotiated Rate |
$1,767.85 |
| Rate for Payer: Aetna Commercial |
$1,669.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,276.78
|
| Rate for Payer: Cash Price |
$1,571.42
|
| Rate for Payer: Cofinity Advantage |
$1,375.00
|
| Rate for Payer: Cofinity Commercial |
$1,689.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.42
|
| Rate for Payer: Healthscope Commercial |
$1,767.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,473.21
|
| Rate for Payer: PHP Commercial |
$1,669.64
|
| Rate for Payer: Priority Health SBD |
$1,237.50
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.57
|
| Rate for Payer: BCN Commercial |
$5.57
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$2.73
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.32 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Advantage |
$14.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: Priority Health SBD |
$12.60
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Advantage |
$14.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: Priority Health SBD |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.00
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: UHC Exchange |
$7.86
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
IP
|
$1,472.60
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$927.74 |
| Max. Negotiated Rate |
$1,325.34 |
| Rate for Payer: Aetna Commercial |
$1,251.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.19
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cofinity Advantage |
$1,030.82
|
| Rate for Payer: Cofinity Commercial |
$1,266.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,178.08
|
| Rate for Payer: Healthscope Commercial |
$1,325.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,251.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,104.45
|
| Rate for Payer: PHP Commercial |
$1,251.71
|
| Rate for Payer: Priority Health SBD |
$927.74
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
OP
|
$1,472.60
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,325.34 |
| Rate for Payer: Aetna Commercial |
$1,251.71
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$885.31
|
| Rate for Payer: BCN Commercial |
$885.31
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cofinity Advantage |
$1,030.82
|
| Rate for Payer: Cofinity Commercial |
$1,266.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,178.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,325.34
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,251.71
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,104.45
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,251.71
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$927.74
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.19
|
| Rate for Payer: UHC Core |
$767.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$578.73
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
IP
|
$940.65
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$592.61 |
| Max. Negotiated Rate |
$846.59 |
| Rate for Payer: Aetna Commercial |
$799.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.42
|
| Rate for Payer: Cash Price |
$752.52
|
| Rate for Payer: Cofinity Advantage |
$658.46
|
| Rate for Payer: Cofinity Commercial |
$808.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.52
|
| Rate for Payer: Healthscope Commercial |
$846.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.49
|
| Rate for Payer: PHP Commercial |
$799.55
|
| Rate for Payer: Priority Health SBD |
$592.61
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
OP
|
$940.65
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$846.59 |
| Rate for Payer: Aetna Commercial |
$799.55
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$530.01
|
| Rate for Payer: BCN Commercial |
$530.01
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$752.52
|
| Rate for Payer: Cash Price |
$752.52
|
| Rate for Payer: Cofinity Advantage |
$658.46
|
| Rate for Payer: Cofinity Commercial |
$808.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$846.59
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$799.55
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.49
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$799.55
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$592.61
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.42
|
| Rate for Payer: UHC Core |
$490.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$369.68
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
IP
|
$473.46
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$298.28 |
| Max. Negotiated Rate |
$426.11 |
| Rate for Payer: Aetna Commercial |
$402.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.75
|
| Rate for Payer: Cash Price |
$378.77
|
| Rate for Payer: Cofinity Advantage |
$331.42
|
| Rate for Payer: Cofinity Commercial |
$407.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.77
|
| Rate for Payer: Healthscope Commercial |
$426.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.10
|
| Rate for Payer: PHP Commercial |
$402.44
|
| Rate for Payer: Priority Health SBD |
$298.28
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
OP
|
$473.46
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$186.07 |
| Max. Negotiated Rate |
$426.11 |
| Rate for Payer: Aetna Commercial |
$402.44
|
| Rate for Payer: Aetna Medicare |
$236.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.75
|
| Rate for Payer: BCBS Complete |
$189.38
|
| Rate for Payer: Cash Price |
$378.77
|
| Rate for Payer: Cofinity Advantage |
$331.42
|
| Rate for Payer: Cofinity Commercial |
$407.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.77
|
| Rate for Payer: Healthscope Commercial |
$426.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.10
|
| Rate for Payer: PHP Commercial |
$402.44
|
| Rate for Payer: Priority Health SBD |
$298.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.75
|
| Rate for Payer: UHC Core |
$246.67
|
| Rate for Payer: UHC Exchange |
$186.07
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$37.42
|
| Rate for Payer: BCN Commercial |
$37.42
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$18.35
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health SBD |
$66.86
|
|
|
HC GROUP PSYCHOTHERAPY
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$327.36 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$23.35
|
| Rate for Payer: BCN Commercial |
$23.35
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Mclaren Medicaid |
$52.94
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: VA VA |
$101.22
|
|
|
HC GROUP PSYCHOTHERAPY
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$63.52 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health SBD |
$63.52
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
OP
|
$64.35
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.91 |
| Rate for Payer: Aetna Commercial |
$54.70
|
| Rate for Payer: Aetna Medicare |
$32.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.83
|
| Rate for Payer: BCBS Complete |
$25.74
|
| Rate for Payer: BCBS Trust/PPO |
$31.08
|
| Rate for Payer: BCN Commercial |
$31.08
|
| Rate for Payer: Cash Price |
$51.48
|
| Rate for Payer: Cash Price |
$51.48
|
| Rate for Payer: Cofinity Advantage |
$45.05
|
| Rate for Payer: Cofinity Commercial |
$55.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.48
|
| Rate for Payer: Healthscope Commercial |
$57.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.26
|
| Rate for Payer: PHP Commercial |
$54.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.00
|
| Rate for Payer: Priority Health SBD |
$40.54
|
| Rate for Payer: Priority Health Tiered Network |
$12.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.83
|
| Rate for Payer: UHC Core |
$33.53
|
| Rate for Payer: UHC Exchange |
$25.29
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
IP
|
$64.35
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$40.54 |
| Max. Negotiated Rate |
$57.91 |
| Rate for Payer: Aetna Commercial |
$54.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.83
|
| Rate for Payer: Cash Price |
$51.48
|
| Rate for Payer: Cofinity Advantage |
$45.05
|
| Rate for Payer: Cofinity Commercial |
$55.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.48
|
| Rate for Payer: Healthscope Commercial |
$57.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.26
|
| Rate for Payer: PHP Commercial |
$54.70
|
| Rate for Payer: Priority Health SBD |
$40.54
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
OP
|
$109.35
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$92.95
|
| Rate for Payer: Aetna Medicare |
$54.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.08
|
| Rate for Payer: BCBS Complete |
$43.74
|
| Rate for Payer: BCBS Trust/PPO |
$16.45
|
| Rate for Payer: BCN Commercial |
$16.45
|
| Rate for Payer: Cash Price |
$87.48
|
| Rate for Payer: Cash Price |
$87.48
|
| Rate for Payer: Cash Price |
$87.48
|
| Rate for Payer: Cofinity Advantage |
$76.55
|
| Rate for Payer: Cofinity Commercial |
$94.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.48
|
| Rate for Payer: Healthscope Commercial |
$98.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.95
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.01
|
| Rate for Payer: PHP Commercial |
$92.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.00
|
| Rate for Payer: Priority Health SBD |
$68.89
|
| Rate for Payer: Priority Health Tiered Network |
$14.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.08
|
| Rate for Payer: UHC Core |
$56.97
|
| Rate for Payer: UHC Exchange |
$42.97
|
|
