|
HC HIV DNA BY PCR
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$56.37 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health SBD |
$56.37
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
OP
|
$143.62
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$239.55 |
| Rate for Payer: Aetna Commercial |
$122.08
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cofinity Commercial |
$123.51
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$129.26
|
| Rate for Payer: Mclaren Medicaid |
$45.61
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$47.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.08
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$122.08
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.35
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health SBD |
$90.48
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.10
|
| Rate for Payer: UHCCP Medicaid |
$47.91
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
IP
|
$143.62
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.48 |
| Max. Negotiated Rate |
$129.26 |
| Rate for Payer: Aetna Commercial |
$122.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.35
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Cofinity Commercial |
$123.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.90
|
| Rate for Payer: Healthscope Commercial |
$129.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.08
|
| Rate for Payer: PHP Commercial |
$122.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.35
|
| Rate for Payer: Priority Health SBD |
$90.48
|
|
|
HC HIV RNA BY PCR
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$239.55 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Cofinity Commercial |
$145.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Mclaren Medicaid |
$45.61
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$47.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health SBD |
$131.09
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.10
|
| Rate for Payer: UHCCP Medicaid |
$47.91
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA BY PCR
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$131.09 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.25
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health SBD |
$131.09
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
OP
|
$139.21
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$239.55 |
| Rate for Payer: Aetna Commercial |
$118.33
|
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.38
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS MAPPO |
$85.10
|
| Rate for Payer: BCN Medicare Advantage |
$85.10
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cofinity Commercial |
$97.45
|
| Rate for Payer: Cofinity Commercial |
$119.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$97.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.10
|
| Rate for Payer: Healthscope Commercial |
$125.29
|
| Rate for Payer: Mclaren Medicaid |
$45.61
|
| Rate for Payer: Mclaren Medicare |
$85.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.36
|
| Rate for Payer: Meridian Medicaid |
$47.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.33
|
| Rate for Payer: PACE Medicare |
$80.84
|
| Rate for Payer: PACE SWMI |
$85.10
|
| Rate for Payer: PHP Commercial |
$118.33
|
| Rate for Payer: PHP Medicare Advantage |
$85.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.49
|
| Rate for Payer: Priority Health Medicare |
$85.10
|
| Rate for Payer: Priority Health SBD |
$87.70
|
| Rate for Payer: Railroad Medicare Medicare |
$85.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.10
|
| Rate for Payer: UHCCP Medicaid |
$47.91
|
| Rate for Payer: VA VA |
$85.10
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
IP
|
$139.21
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.70 |
| Max. Negotiated Rate |
$125.29 |
| Rate for Payer: Aetna Commercial |
$118.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.49
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cofinity Commercial |
$119.72
|
| Rate for Payer: Cofinity Commercial |
$97.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$97.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.37
|
| Rate for Payer: Healthscope Commercial |
$125.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.33
|
| Rate for Payer: PHP Commercial |
$118.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.49
|
| Rate for Payer: Priority Health SBD |
$87.70
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.90 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.96
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health SBD |
$64.90
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$64.90
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.89
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.89
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$67.47 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.90
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PACE Medicare |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHCCP Medicaid |
$7.61
|
| Rate for Payer: VA VA |
$13.52
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health SBD |
$48.20
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.89
|
| Rate for Payer: VA VA |
$19.35
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.07 |
| Max. Negotiated Rate |
$478.25 |
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna Medicare |
$176.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.38
|
| Rate for Payer: BCBS Complete |
$95.62
|
| Rate for Payer: BCBS MAPPO |
$169.90
|
| Rate for Payer: BCN Medicare Advantage |
$169.90
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$194.54
|
| Rate for Payer: Cofinity Commercial |
$239.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.90
|
| Rate for Payer: Healthscope Commercial |
$250.13
|
| Rate for Payer: Mclaren Medicaid |
$91.07
|
| Rate for Payer: Mclaren Medicare |
$169.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.40
|
| Rate for Payer: Meridian Medicaid |
$95.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: PACE Medicare |
$161.41
|
| Rate for Payer: PACE SWMI |
$169.90
|
| Rate for Payer: PHP Commercial |
$236.23
|
| Rate for Payer: PHP Medicare Advantage |
$169.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: Priority Health Medicare |
$169.90
|
| Rate for Payer: Priority Health SBD |
$175.09
|
| Rate for Payer: Railroad Medicare Medicare |
$169.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.90
|
| Rate for Payer: UHC Medicare Advantage |
$169.90
|
| Rate for Payer: UHCCP Medicaid |
$95.65
|
| Rate for Payer: VA VA |
$169.90
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$175.09 |
| Max. Negotiated Rate |
$250.13 |
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$194.54
|
| Rate for Payer: Cofinity Commercial |
$239.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Healthscope Commercial |
$250.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: PHP Commercial |
$236.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: Priority Health SBD |
$175.09
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$72.65 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$14.53
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.81
|
| Rate for Payer: UHC Medicare Advantage |
$25.81
|
| Rate for Payer: UHCCP Medicaid |
$14.53
|
| Rate for Payer: VA VA |
$25.81
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.46 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health SBD |
$31.46
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,756.75
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$406.43 |
| Max. Negotiated Rate |
$2,481.07 |
| Rate for Payer: Aetna Commercial |
$2,343.24
|
| Rate for Payer: Aetna Medicare |
$788.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$947.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$947.84
|
| Rate for Payer: BCBS Complete |
$426.75
|
| Rate for Payer: BCBS MAPPO |
$758.27
|
| Rate for Payer: BCN Medicare Advantage |
$758.27
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cofinity Commercial |
$2,370.80
|
| Rate for Payer: Cofinity Commercial |
$1,929.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,205.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.27
|
| Rate for Payer: Healthscope Commercial |
$2,481.07
|
| Rate for Payer: Mclaren Medicaid |
$406.43
|
| Rate for Payer: Mclaren Medicare |
$758.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$796.18
|
| Rate for Payer: Meridian Medicaid |
$426.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$872.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.24
|
| Rate for Payer: PACE Medicare |
$720.36
|
| Rate for Payer: PACE SWMI |
$758.27
|
| Rate for Payer: PHP Commercial |
$2,343.24
|
| Rate for Payer: PHP Medicare Advantage |
$758.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.89
|
| Rate for Payer: Priority Health Medicare |
$758.27
|
| Rate for Payer: Priority Health SBD |
$1,736.75
|
| Rate for Payer: Railroad Medicare Medicare |
$758.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,134.45
|
| Rate for Payer: UHC Core |
$2,039.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$758.27
|
| Rate for Payer: UHC Exchange |
$2,039.99
|
| Rate for Payer: UHC Medicare Advantage |
$758.27
|
| Rate for Payer: UHCCP Medicaid |
$426.91
|
| Rate for Payer: VA VA |
$758.27
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,756.75
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,736.75 |
| Max. Negotiated Rate |
$2,481.07 |
| Rate for Payer: Aetna Commercial |
$2,343.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.89
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cofinity Commercial |
$1,929.72
|
| Rate for Payer: Cofinity Commercial |
$2,370.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,205.40
|
| Rate for Payer: Healthscope Commercial |
$2,481.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.24
|
| Rate for Payer: PHP Commercial |
$2,343.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.89
|
| Rate for Payer: Priority Health SBD |
$1,736.75
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$665.72
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$419.40 |
| Max. Negotiated Rate |
$599.15 |
| Rate for Payer: Aetna Commercial |
$565.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.72
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cofinity Commercial |
$466.00
|
| Rate for Payer: Cofinity Commercial |
$572.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$466.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.58
|
| Rate for Payer: Healthscope Commercial |
$599.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.86
|
| Rate for Payer: PHP Commercial |
$565.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.72
|
| Rate for Payer: Priority Health SBD |
$419.40
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$665.72
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$599.15 |
| Rate for Payer: Aetna Commercial |
$565.86
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cofinity Commercial |
$466.00
|
| Rate for Payer: Cofinity Commercial |
$572.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$466.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$599.15
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.86
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$565.86
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.72
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$419.40
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$492.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$492.63
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,053.67
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$663.81 |
| Max. Negotiated Rate |
$948.30 |
| Rate for Payer: Aetna Commercial |
$895.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.89
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cofinity Commercial |
$737.57
|
| Rate for Payer: Cofinity Commercial |
$906.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.94
|
| Rate for Payer: Healthscope Commercial |
$948.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.62
|
| Rate for Payer: PHP Commercial |
$895.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.89
|
| Rate for Payer: Priority Health SBD |
$663.81
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,053.67
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$948.30 |
| Rate for Payer: Aetna Commercial |
$895.62
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cofinity Commercial |
$906.16
|
| Rate for Payer: Cofinity Commercial |
$737.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$948.30
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.62
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$895.62
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.89
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$663.81
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$779.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$779.72
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$32.61
|
| Rate for Payer: VA VA |
$57.93
|
|
