|
HC NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Facility
|
OP
|
$4,800.00
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
76100402
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.71 |
| Max. Negotiated Rate |
$5,175.07 |
| Rate for Payer: Aetna Commercial |
$4,080.00
|
| Rate for Payer: Aetna Medicare |
$1,687.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,120.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,028.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,028.30
|
| Rate for Payer: BCBS Complete |
$932.04
|
| Rate for Payer: BCBS MAPPO |
$1,622.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,622.64
|
| Rate for Payer: Cash Price |
$3,840.00
|
| Rate for Payer: Cash Price |
$3,840.00
|
| Rate for Payer: Cofinity Commercial |
$4,128.00
|
| Rate for Payer: Cofinity Commercial |
$3,360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,622.64
|
| Rate for Payer: Healthscope Commercial |
$4,320.00
|
| Rate for Payer: Mclaren Medicaid |
$887.58
|
| Rate for Payer: Mclaren Medicare |
$1,622.64
|
| Rate for Payer: Meridian Medicaid |
$932.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,703.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,866.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,080.00
|
| Rate for Payer: PACE Medicare |
$1,541.51
|
| Rate for Payer: PACE SWMI |
$1,622.64
|
| Rate for Payer: PHP Commercial |
$4,080.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,622.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$887.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,360.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,175.07
|
| Rate for Payer: Priority Health Medicare |
$1,622.64
|
| Rate for Payer: Priority Health Narrow Network |
$4,140.06
|
| Rate for Payer: Priority Health SBD |
$3,024.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,622.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,622.64
|
| Rate for Payer: UHC Exchange |
$145.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,671.32
|
| Rate for Payer: VA VA |
$1,622.64
|
|
|
HC NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Facility
|
IP
|
$4,800.00
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
76100402
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,024.00 |
| Max. Negotiated Rate |
$4,320.00 |
| Rate for Payer: Aetna Commercial |
$4,080.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,120.00
|
| Rate for Payer: Cash Price |
$3,840.00
|
| Rate for Payer: Cofinity Commercial |
$3,360.00
|
| Rate for Payer: Cofinity Commercial |
$4,128.00
|
| Rate for Payer: Healthscope Commercial |
$4,320.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,080.00
|
| Rate for Payer: PHP Commercial |
$4,080.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,360.00
|
| Rate for Payer: Priority Health SBD |
$3,024.00
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
OP
|
$883.99
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$751.39
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$227.26
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$707.19
|
| Rate for Payer: Cash Price |
$707.19
|
| Rate for Payer: Cofinity Commercial |
$760.23
|
| Rate for Payer: Cofinity Commercial |
$618.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$795.59
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$751.39
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$751.39
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$556.91
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$157.50
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
IP
|
$883.99
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$556.91 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$751.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.59
|
| Rate for Payer: Cash Price |
$707.19
|
| Rate for Payer: Cofinity Commercial |
$618.79
|
| Rate for Payer: Cofinity Commercial |
$760.23
|
| Rate for Payer: Healthscope Commercial |
$795.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$751.39
|
| Rate for Payer: PHP Commercial |
$751.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health SBD |
$556.91
|
|
|
HC NM BONE MARROW MULTIPLE AREA
|
Facility
|
OP
|
$1,126.87
|
|
|
Service Code
|
CPT 78103
|
| Hospital Charge Code |
34100010
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$167.98 |
| Max. Negotiated Rate |
$1,014.18 |
| Rate for Payer: Aetna Commercial |
$957.84
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$239.39
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$901.50
|
| Rate for Payer: Cash Price |
$901.50
|
| Rate for Payer: Cofinity Commercial |
$969.11
|
| Rate for Payer: Cofinity Commercial |
$788.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,014.18
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$957.84
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$957.84
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.81
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$709.93
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$167.98
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE MARROW MULTIPLE AREA
|
Facility
|
IP
|
$1,126.87
|
|
|
Service Code
|
CPT 78103
|
| Hospital Charge Code |
34100010
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$709.93 |
| Max. Negotiated Rate |
$1,014.18 |
| Rate for Payer: Aetna Commercial |
$957.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.47
|
| Rate for Payer: Cash Price |
$901.50
|
| Rate for Payer: Cofinity Commercial |
$788.81
|
| Rate for Payer: Cofinity Commercial |
$969.11
|
| Rate for Payer: Healthscope Commercial |
$1,014.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$957.84
|
| Rate for Payer: PHP Commercial |
$957.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.81
|
| Rate for Payer: Priority Health SBD |
$709.93
|
|
|
HC NM BONE MARROW WHOLE BODY
|
Facility
|
IP
|
$1,045.41
|
|
|
Service Code
|
CPT 78104
|
| Hospital Charge Code |
34100011
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$658.61 |
| Max. Negotiated Rate |
$940.87 |
| Rate for Payer: Aetna Commercial |
$888.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.52
|
| Rate for Payer: Cash Price |
$836.33
|
| Rate for Payer: Cofinity Commercial |
$731.79
|
| Rate for Payer: Cofinity Commercial |
$899.05
|
| Rate for Payer: Healthscope Commercial |
$940.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$888.60
|
| Rate for Payer: PHP Commercial |
$888.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.79
|
| Rate for Payer: Priority Health SBD |
$658.61
|
|
|
HC NM BONE MARROW WHOLE BODY
|
Facility
|
OP
|
$1,045.41
|
|
|
Service Code
|
CPT 78104
|
| Hospital Charge Code |
34100011
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$940.87 |
| Rate for Payer: Aetna Commercial |
$888.60
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$326.54
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$836.33
|
| Rate for Payer: Cash Price |
$836.33
|
| Rate for Payer: Cofinity Commercial |
$899.05
|
| Rate for Payer: Cofinity Commercial |
$731.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$940.87
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$888.60
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$888.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.79
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$658.61
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$225.61
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE MULTIPLE AREAS
|
Facility
|
IP
|
$1,270.68
|
|
|
Service Code
|
CPT 78305
|
| Hospital Charge Code |
34100024
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$800.53 |
| Max. Negotiated Rate |
$1,143.61 |
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health SBD |
$800.53
|
|
|
HC NM BONE MULTIPLE AREAS
|
Facility
|
OP
|
$1,270.68
|
|
|
Service Code
|
CPT 78305
|
| Hospital Charge Code |
34100024
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$1,143.61 |
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$361.84
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$800.53
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$244.93
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE SINGLE AREA
|
Facility
|
IP
|
$1,180.85
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
34100023
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$743.94 |
| Max. Negotiated Rate |
$1,062.76 |
| Rate for Payer: Aetna Commercial |
$1,003.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.55
|
| Rate for Payer: Cash Price |
$944.68
|
| Rate for Payer: Cofinity Commercial |
$1,015.53
|
| Rate for Payer: Cofinity Commercial |
$826.60
|
| Rate for Payer: Healthscope Commercial |
$1,062.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.72
|
| Rate for Payer: PHP Commercial |
$1,003.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.60
|
| Rate for Payer: Priority Health SBD |
$743.94
|
|
|
HC NM BONE SINGLE AREA
|
Facility
|
OP
|
$1,180.85
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
34100023
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$1,062.76 |
| Rate for Payer: Aetna Commercial |
$1,003.72
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$301.72
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$944.68
|
| Rate for Payer: Cash Price |
$944.68
|
| Rate for Payer: Cofinity Commercial |
$826.60
|
| Rate for Payer: Cofinity Commercial |
$1,015.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,062.76
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.72
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$1,003.72
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.60
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$743.94
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$203.01
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE TOTAL BODY
|
Facility
|
IP
|
$1,731.32
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
34100025
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,090.73 |
| Max. Negotiated Rate |
$1,558.19 |
| Rate for Payer: Aetna Commercial |
$1,471.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.36
|
| Rate for Payer: Cash Price |
$1,385.06
|
| Rate for Payer: Cofinity Commercial |
$1,211.92
|
| Rate for Payer: Cofinity Commercial |
$1,488.94
|
| Rate for Payer: Healthscope Commercial |
$1,558.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,471.62
|
| Rate for Payer: PHP Commercial |
$1,471.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.92
|
| Rate for Payer: Priority Health SBD |
$1,090.73
|
|
|
HC NM BONE TOTAL BODY
|
Facility
|
OP
|
$1,731.32
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
34100025
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$1,558.19 |
| Rate for Payer: Aetna Commercial |
$1,471.62
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,125.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$389.43
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$1,385.06
|
| Rate for Payer: Cash Price |
$1,385.06
|
| Rate for Payer: Cofinity Commercial |
$1,488.94
|
| Rate for Payer: Cofinity Commercial |
$1,211.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,558.19
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,471.62
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$1,471.62
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.92
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$1,090.73
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$264.57
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE W BLOOD FLOW 3 PHASE
|
Facility
|
OP
|
$1,701.22
|
|
|
Service Code
|
CPT 78315
|
| Hospital Charge Code |
34100026
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$1,531.10 |
| Rate for Payer: Aetna Commercial |
$1,446.04
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$455.07
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$1,360.98
|
| Rate for Payer: Cash Price |
$1,360.98
|
| Rate for Payer: Cofinity Commercial |
$1,463.05
|
| Rate for Payer: Cofinity Commercial |
$1,190.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,531.10
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,446.04
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$1,446.04
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.85
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$1,071.77
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$311.07
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BONE W BLOOD FLOW 3 PHASE
|
Facility
|
IP
|
$1,701.22
|
|
|
Service Code
|
CPT 78315
|
| Hospital Charge Code |
34100026
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,071.77 |
| Max. Negotiated Rate |
$1,531.10 |
| Rate for Payer: Aetna Commercial |
$1,446.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.79
|
| Rate for Payer: Cash Price |
$1,360.98
|
| Rate for Payer: Cofinity Commercial |
$1,190.85
|
| Rate for Payer: Cofinity Commercial |
$1,463.05
|
| Rate for Payer: Healthscope Commercial |
$1,531.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,446.04
|
| Rate for Payer: PHP Commercial |
$1,446.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.85
|
| Rate for Payer: Priority Health SBD |
$1,071.77
|
|
|
HC NM BRAIN <4 STATC VIEW W VAS F
|
Facility
|
IP
|
$1,270.68
|
|
|
Service Code
|
CPT 78601
|
| Hospital Charge Code |
34100038
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$800.53 |
| Max. Negotiated Rate |
$1,143.61 |
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health SBD |
$800.53
|
|
|
HC NM BRAIN <4 STATC VIEW W VAS F
|
Facility
|
OP
|
$1,270.68
|
|
|
Service Code
|
CPT 78601
|
| Hospital Charge Code |
34100038
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$196.79 |
| Max. Negotiated Rate |
$1,143.61 |
| Rate for Payer: Aetna Commercial |
$1,080.08
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$296.21
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cash Price |
$1,016.54
|
| Rate for Payer: Cofinity Commercial |
$1,092.78
|
| Rate for Payer: Cofinity Commercial |
$889.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,143.61
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,080.08
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$1,080.08
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.48
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$800.53
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$196.79
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM BREAST IMAGING BILAT
|
Facility
|
IP
|
$1,160.25
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
34100053
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$730.96 |
| Max. Negotiated Rate |
$1,044.22 |
| Rate for Payer: Aetna Commercial |
$986.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.16
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cofinity Commercial |
$997.82
|
| Rate for Payer: Cofinity Commercial |
$812.18
|
| Rate for Payer: Healthscope Commercial |
$1,044.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$986.21
|
| Rate for Payer: PHP Commercial |
$986.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$812.18
|
| Rate for Payer: Priority Health SBD |
$730.96
|
|
|
HC NM BREAST IMAGING BILAT
|
Facility
|
OP
|
$1,160.25
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
34100053
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$1,044.22 |
| Rate for Payer: Aetna Commercial |
$986.21
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$339.23
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cofinity Commercial |
$997.82
|
| Rate for Payer: Cofinity Commercial |
$812.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,044.22
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$986.21
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$986.21
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$812.18
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$730.96
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$228.23
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM CARDIAC GATED WALL MUGA
|
Facility
|
IP
|
$1,300.78
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
34100030
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$819.49 |
| Max. Negotiated Rate |
$1,170.70 |
| Rate for Payer: Aetna Commercial |
$1,105.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.51
|
| Rate for Payer: Cash Price |
$1,040.62
|
| Rate for Payer: Cofinity Commercial |
$1,118.67
|
| Rate for Payer: Cofinity Commercial |
$910.55
|
| Rate for Payer: Healthscope Commercial |
$1,170.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.66
|
| Rate for Payer: PHP Commercial |
$1,105.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.55
|
| Rate for Payer: Priority Health SBD |
$819.49
|
|
|
HC NM CARDIAC GATED WALL MUGA
|
Facility
|
OP
|
$1,300.78
|
|
|
Service Code
|
CPT 78472
|
| Hospital Charge Code |
34100030
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.74 |
| Max. Negotiated Rate |
$1,170.70 |
| Rate for Payer: Aetna Commercial |
$1,105.66
|
| Rate for Payer: Aetna Medicare |
$381.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.74
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS MAPPO |
$366.99
|
| Rate for Payer: BCBS Trust/PPO |
$276.91
|
| Rate for Payer: BCN Medicare Advantage |
$366.99
|
| Rate for Payer: Cash Price |
$1,040.62
|
| Rate for Payer: Cash Price |
$1,040.62
|
| Rate for Payer: Cofinity Commercial |
$1,118.67
|
| Rate for Payer: Cofinity Commercial |
$910.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.99
|
| Rate for Payer: Healthscope Commercial |
$1,170.70
|
| Rate for Payer: Mclaren Medicaid |
$200.74
|
| Rate for Payer: Mclaren Medicare |
$366.99
|
| Rate for Payer: Meridian Medicaid |
$210.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.66
|
| Rate for Payer: PACE Medicare |
$348.64
|
| Rate for Payer: PACE SWMI |
$366.99
|
| Rate for Payer: PHP Commercial |
$1,105.66
|
| Rate for Payer: PHP Medicare Advantage |
$366.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.55
|
| Rate for Payer: Priority Health Medicare |
$366.99
|
| Rate for Payer: Priority Health SBD |
$819.49
|
| Rate for Payer: Railroad Medicare Medicare |
$366.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.99
|
| Rate for Payer: UHC Exchange |
$206.62
|
| Rate for Payer: UHC Medicare Advantage |
$378.00
|
| Rate for Payer: VA VA |
$366.99
|
|
|
HC NM CEREBRAL SHUNT EVAL
|
Facility
|
OP
|
$857.70
|
|
|
Service Code
|
CPT 78645
|
| Hospital Charge Code |
34100041
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$263.07 |
| Max. Negotiated Rate |
$771.93 |
| Rate for Payer: Aetna Commercial |
$729.04
|
| Rate for Payer: Aetna Medicare |
$500.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.18
|
| Rate for Payer: BCBS Complete |
$276.25
|
| Rate for Payer: BCBS MAPPO |
$480.94
|
| Rate for Payer: BCBS Trust/PPO |
$453.41
|
| Rate for Payer: BCN Medicare Advantage |
$480.94
|
| Rate for Payer: Cash Price |
$686.16
|
| Rate for Payer: Cash Price |
$686.16
|
| Rate for Payer: Cofinity Commercial |
$737.62
|
| Rate for Payer: Cofinity Commercial |
$600.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.94
|
| Rate for Payer: Healthscope Commercial |
$771.93
|
| Rate for Payer: Mclaren Medicaid |
$263.07
|
| Rate for Payer: Mclaren Medicare |
$480.94
|
| Rate for Payer: Meridian Medicaid |
$276.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.04
|
| Rate for Payer: PACE Medicare |
$456.89
|
| Rate for Payer: PACE SWMI |
$480.94
|
| Rate for Payer: PHP Commercial |
$729.04
|
| Rate for Payer: PHP Medicare Advantage |
$480.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.39
|
| Rate for Payer: Priority Health Medicare |
$480.94
|
| Rate for Payer: Priority Health SBD |
$540.35
|
| Rate for Payer: Railroad Medicare Medicare |
$480.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$480.94
|
| Rate for Payer: UHC Exchange |
$290.11
|
| Rate for Payer: UHC Medicare Advantage |
$495.37
|
| Rate for Payer: VA VA |
$480.94
|
|
|
HC NM CEREBRAL SHUNT EVAL
|
Facility
|
IP
|
$857.70
|
|
|
Service Code
|
CPT 78645
|
| Hospital Charge Code |
34100041
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$540.35 |
| Max. Negotiated Rate |
$771.93 |
| Rate for Payer: Aetna Commercial |
$729.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.50
|
| Rate for Payer: Cash Price |
$686.16
|
| Rate for Payer: Cofinity Commercial |
$600.39
|
| Rate for Payer: Cofinity Commercial |
$737.62
|
| Rate for Payer: Healthscope Commercial |
$771.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.04
|
| Rate for Payer: PHP Commercial |
$729.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.39
|
| Rate for Payer: Priority Health SBD |
$540.35
|
|
|
HC NM CISTERNOGRAM
|
Facility
|
OP
|
$1,000.76
|
|
|
Service Code
|
CPT 78630
|
| Hospital Charge Code |
34100040
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$263.07 |
| Max. Negotiated Rate |
$900.68 |
| Rate for Payer: Aetna Commercial |
$850.65
|
| Rate for Payer: Aetna Medicare |
$500.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.18
|
| Rate for Payer: BCBS Complete |
$276.25
|
| Rate for Payer: BCBS MAPPO |
$480.94
|
| Rate for Payer: BCBS Trust/PPO |
$466.10
|
| Rate for Payer: BCN Medicare Advantage |
$480.94
|
| Rate for Payer: Cash Price |
$800.61
|
| Rate for Payer: Cash Price |
$800.61
|
| Rate for Payer: Cofinity Commercial |
$860.65
|
| Rate for Payer: Cofinity Commercial |
$700.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.94
|
| Rate for Payer: Healthscope Commercial |
$900.68
|
| Rate for Payer: Mclaren Medicaid |
$263.07
|
| Rate for Payer: Mclaren Medicare |
$480.94
|
| Rate for Payer: Meridian Medicaid |
$276.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.65
|
| Rate for Payer: PACE Medicare |
$456.89
|
| Rate for Payer: PACE SWMI |
$480.94
|
| Rate for Payer: PHP Commercial |
$850.65
|
| Rate for Payer: PHP Medicare Advantage |
$480.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.53
|
| Rate for Payer: Priority Health Medicare |
$480.94
|
| Rate for Payer: Priority Health SBD |
$630.48
|
| Rate for Payer: Railroad Medicare Medicare |
$480.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$480.94
|
| Rate for Payer: UHC Exchange |
$302.23
|
| Rate for Payer: UHC Medicare Advantage |
$495.37
|
| Rate for Payer: VA VA |
$480.94
|
|
