|
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$103,807.46
|
|
|
Service Code
|
MSDRG 461
|
| Min. Negotiated Rate |
$41,098.90 |
| Max. Negotiated Rate |
$103,807.46 |
| Rate for Payer: Aetna Medicare |
$44,992.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54,077.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54,077.50
|
| Rate for Payer: BCBS MAPPO |
$43,262.00
|
| Rate for Payer: BCBS Trust/PPO |
$103,807.46
|
| Rate for Payer: BCN Commercial |
$103,807.46
|
| Rate for Payer: BCN Medicare Advantage |
$43,262.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43,262.00
|
| Rate for Payer: Mclaren Medicare |
$43,262.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45,425.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49,751.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47,588.20
|
| Rate for Payer: Nomi Health Commercial |
$69,151.74
|
| Rate for Payer: PACE Medicare |
$41,098.90
|
| Rate for Payer: PACE SWMI |
$43,262.00
|
| Rate for Payer: PHP Medicare Advantage |
$43,262.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89,042.58
|
| Rate for Payer: Priority Health Medicare |
$43,262.00
|
| Rate for Payer: Priority Health Tiered Network |
$71,234.05
|
| Rate for Payer: Railroad Medicare Medicare |
$43,262.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87,377.78
|
| Rate for Payer: UHC Core |
$73,102.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43,262.00
|
| Rate for Payer: UHC Exchange |
$59,701.00
|
| Rate for Payer: VA VA |
$43,262.00
|
|
|
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$55,919.37
|
|
|
Service Code
|
MSDRG 462
|
| Min. Negotiated Rate |
$20,079.27 |
| Max. Negotiated Rate |
$55,919.37 |
| Rate for Payer: Aetna Medicare |
$21,981.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,420.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,420.09
|
| Rate for Payer: BCBS MAPPO |
$21,136.07
|
| Rate for Payer: BCBS Trust/PPO |
$55,919.37
|
| Rate for Payer: BCN Commercial |
$55,919.37
|
| Rate for Payer: BCN Medicare Advantage |
$21,136.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,136.07
|
| Rate for Payer: Mclaren Medicare |
$21,136.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,192.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,306.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$23,249.68
|
| Rate for Payer: Nomi Health Commercial |
$34,314.00
|
| Rate for Payer: PACE Medicare |
$20,079.27
|
| Rate for Payer: PACE SWMI |
$21,136.07
|
| Rate for Payer: PHP Medicare Advantage |
$21,136.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42,884.89
|
| Rate for Payer: Priority Health Medicare |
$21,136.07
|
| Rate for Payer: Priority Health Tiered Network |
$34,307.91
|
| Rate for Payer: Railroad Medicare Medicare |
$21,136.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43,358.00
|
| Rate for Payer: UHC Core |
$36,274.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21,136.07
|
| Rate for Payer: UHC Exchange |
$29,624.42
|
| Rate for Payer: VA VA |
$21,136.07
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$55,776.58
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$16,535.39 |
| Max. Negotiated Rate |
$55,776.58 |
| Rate for Payer: Aetna Medicare |
$18,101.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,757.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,757.09
|
| Rate for Payer: BCBS MAPPO |
$17,405.67
|
| Rate for Payer: BCBS Trust/PPO |
$55,776.58
|
| Rate for Payer: BCN Commercial |
$55,776.58
|
| Rate for Payer: BCN Medicare Advantage |
$17,405.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,405.67
|
| Rate for Payer: Mclaren Medicare |
$17,405.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,275.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,016.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,146.24
|
| Rate for Payer: Nomi Health Commercial |
$28,087.17
|
| Rate for Payer: PACE Medicare |
$16,535.39
|
| Rate for Payer: PACE SWMI |
$17,405.67
|
| Rate for Payer: PHP Medicare Advantage |
$17,405.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,102.74
|
| Rate for Payer: Priority Health Medicare |
$17,405.67
|
| Rate for Payer: Priority Health Tiered Network |
$28,082.18
|
| Rate for Payer: Railroad Medicare Medicare |
$17,405.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,489.99
|
| Rate for Payer: UHC Core |
$29,691.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,405.67
|
| Rate for Payer: UHC Exchange |
$24,248.59
|
| Rate for Payer: VA VA |
$17,405.67
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$90,176.98
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$26,728.03 |
| Max. Negotiated Rate |
$90,176.98 |
| Rate for Payer: Aetna Medicare |
$29,260.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,168.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,168.46
|
| Rate for Payer: BCBS MAPPO |
$28,134.77
|
| Rate for Payer: BCBS Trust/PPO |
$90,176.98
|
| Rate for Payer: BCN Commercial |
$90,176.98
|
| Rate for Payer: BCN Medicare Advantage |
$28,134.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,134.77
|
| Rate for Payer: Mclaren Medicare |
$28,134.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,541.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,354.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,948.25
|
| Rate for Payer: Nomi Health Commercial |
$45,996.24
|
| Rate for Payer: PACE Medicare |
$26,728.03
|
| Rate for Payer: PACE SWMI |
$28,134.77
|
| Rate for Payer: PHP Medicare Advantage |
$28,134.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57,485.10
|
| Rate for Payer: Priority Health Medicare |
$28,134.77
|
| Rate for Payer: Priority Health Tiered Network |
$45,988.07
|
| Rate for Payer: Railroad Medicare Medicare |
$28,134.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,119.28
|
| Rate for Payer: UHC Core |
$48,624.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28,134.77
|
| Rate for Payer: UHC Exchange |
$39,710.09
|
| Rate for Payer: VA VA |
$28,134.77
|
|
|
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$35,725.29
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$12,206.65 |
| Max. Negotiated Rate |
$35,725.29 |
| Rate for Payer: Aetna Medicare |
$13,363.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,061.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,061.38
|
| Rate for Payer: BCBS MAPPO |
$12,849.10
|
| Rate for Payer: BCBS Trust/PPO |
$35,725.29
|
| Rate for Payer: BCN Commercial |
$35,725.29
|
| Rate for Payer: BCN Medicare Advantage |
$12,849.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,849.10
|
| Rate for Payer: Mclaren Medicare |
$12,849.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,491.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,776.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,134.01
|
| Rate for Payer: Nomi Health Commercial |
$20,481.33
|
| Rate for Payer: PACE Medicare |
$12,206.65
|
| Rate for Payer: PACE SWMI |
$12,849.10
|
| Rate for Payer: PHP Medicare Advantage |
$12,849.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,597.12
|
| Rate for Payer: Priority Health Medicare |
$12,849.10
|
| Rate for Payer: Priority Health Tiered Network |
$20,477.69
|
| Rate for Payer: Railroad Medicare Medicare |
$12,849.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,879.51
|
| Rate for Payer: UHC Core |
$21,651.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,849.10
|
| Rate for Payer: UHC Exchange |
$17,682.21
|
| Rate for Payer: VA VA |
$12,849.10
|
|
|
BIMATOPROST 0.01 % EYE DROPS
|
Facility
|
IP
|
$876.79
|
|
|
Service Code
|
NDC 00023320503
|
| Hospital Charge Code |
105410
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$552.38 |
| Max. Negotiated Rate |
$789.11 |
| Rate for Payer: Aetna Commercial |
$745.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.91
|
| Rate for Payer: Cash Price |
$701.43
|
| Rate for Payer: Cofinity Advantage |
$613.75
|
| Rate for Payer: Cofinity Commercial |
$754.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.43
|
| Rate for Payer: Healthscope Commercial |
$789.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.59
|
| Rate for Payer: PHP Commercial |
$745.27
|
| Rate for Payer: Priority Health SBD |
$552.38
|
|
|
BIMATOPROST 0.01 % EYE DROPS
|
Facility
|
OP
|
$876.79
|
|
|
Service Code
|
NDC 00023320503
|
| Hospital Charge Code |
105410
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$344.58 |
| Max. Negotiated Rate |
$789.11 |
| Rate for Payer: Aetna Commercial |
$745.27
|
| Rate for Payer: Aetna Medicare |
$438.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.91
|
| Rate for Payer: BCBS Complete |
$350.72
|
| Rate for Payer: Cash Price |
$701.43
|
| Rate for Payer: Cofinity Advantage |
$613.75
|
| Rate for Payer: Cofinity Commercial |
$754.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.43
|
| Rate for Payer: Healthscope Commercial |
$789.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$701.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.59
|
| Rate for Payer: PHP Commercial |
$745.27
|
| Rate for Payer: Priority Health SBD |
$552.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.91
|
| Rate for Payer: UHC Core |
$456.81
|
| Rate for Payer: UHC Exchange |
$344.58
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$40,924.21
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$18,605.03 |
| Max. Negotiated Rate |
$40,924.21 |
| Rate for Payer: Aetna Medicare |
$20,367.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,480.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,480.30
|
| Rate for Payer: BCBS MAPPO |
$19,584.24
|
| Rate for Payer: BCBS Trust/PPO |
$40,924.21
|
| Rate for Payer: BCN Commercial |
$40,924.21
|
| Rate for Payer: BCN Medicare Advantage |
$19,584.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,584.24
|
| Rate for Payer: Mclaren Medicare |
$19,584.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20,563.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,521.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21,542.66
|
| Rate for Payer: Nomi Health Commercial |
$31,723.68
|
| Rate for Payer: PACE Medicare |
$18,605.03
|
| Rate for Payer: PACE SWMI |
$19,584.24
|
| Rate for Payer: PHP Medicare Advantage |
$19,584.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39,647.57
|
| Rate for Payer: Priority Health Medicare |
$19,584.24
|
| Rate for Payer: Priority Health Tiered Network |
$31,718.05
|
| Rate for Payer: Railroad Medicare Medicare |
$19,584.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,084.96
|
| Rate for Payer: UHC Core |
$33,536.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19,584.24
|
| Rate for Payer: UHC Exchange |
$27,388.11
|
| Rate for Payer: VA VA |
$19,584.24
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$56,309.98
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$25,913.10 |
| Max. Negotiated Rate |
$56,309.98 |
| Rate for Payer: Aetna Medicare |
$28,368.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,096.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,096.19
|
| Rate for Payer: BCBS MAPPO |
$27,276.95
|
| Rate for Payer: BCBS Trust/PPO |
$53,936.71
|
| Rate for Payer: BCN Commercial |
$53,936.71
|
| Rate for Payer: BCN Medicare Advantage |
$27,276.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,276.95
|
| Rate for Payer: Mclaren Medicare |
$27,276.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28,640.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,368.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$30,004.65
|
| Rate for Payer: Nomi Health Commercial |
$44,564.34
|
| Rate for Payer: PACE Medicare |
$25,913.10
|
| Rate for Payer: PACE SWMI |
$27,276.95
|
| Rate for Payer: PHP Medicare Advantage |
$27,276.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55,695.54
|
| Rate for Payer: Priority Health Medicare |
$27,276.95
|
| Rate for Payer: Priority Health Tiered Network |
$44,556.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27,276.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,309.98
|
| Rate for Payer: UHC Core |
$47,110.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27,276.95
|
| Rate for Payer: UHC Exchange |
$38,473.88
|
| Rate for Payer: VA VA |
$27,276.95
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$30,300.07
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$14,197.76 |
| Max. Negotiated Rate |
$30,300.07 |
| Rate for Payer: Aetna Medicare |
$15,542.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,681.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,681.26
|
| Rate for Payer: BCBS MAPPO |
$14,945.01
|
| Rate for Payer: BCBS Trust/PPO |
$26,434.65
|
| Rate for Payer: BCN Commercial |
$26,434.65
|
| Rate for Payer: BCN Medicare Advantage |
$14,945.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,945.01
|
| Rate for Payer: Mclaren Medicare |
$14,945.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,692.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,186.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$16,439.51
|
| Rate for Payer: Nomi Health Commercial |
$23,979.81
|
| Rate for Payer: PACE Medicare |
$14,197.76
|
| Rate for Payer: PACE SWMI |
$14,945.01
|
| Rate for Payer: PHP Medicare Advantage |
$14,945.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29,969.45
|
| Rate for Payer: Priority Health Medicare |
$14,945.01
|
| Rate for Payer: Priority Health Tiered Network |
$23,975.55
|
| Rate for Payer: Railroad Medicare Medicare |
$14,945.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,300.07
|
| Rate for Payer: UHC Core |
$25,349.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14,945.01
|
| Rate for Payer: UHC Exchange |
$20,702.57
|
| Rate for Payer: VA VA |
$14,945.01
|
|
|
BIOPSY, BONE, OPEN; SUPERFICIAL (EG, STERNUM, SPINOUS PROCESS, RIB, PATELLA, OLECRANON PROCESS, CALCANEUS, TARSAL, METATARSAL, CARPAL, METACARPAL, PHALANX)
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 20240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,390.46
|
| Rate for Payer: BCN Commercial |
$2,390.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 45100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.15
|
| Rate for Payer: BCN Commercial |
$2,102.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
BIOPSY OF CERVIX, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,967.88
|
|
|
Service Code
|
CPT 57500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$580.01
|
| Rate for Payer: BCN Commercial |
$580.01
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Mclaren Medicaid |
$479.98
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
BIOPSY OF PENIS; (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 54100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$696.41 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$696.41
|
| Rate for Payer: BCN Commercial |
$696.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
|
OP
|
$2,967.88
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$479.98 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$580.01
|
| Rate for Payer: BCN Commercial |
$580.01
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Mclaren Medicaid |
$479.98
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$292.17
|
|
|
Service Code
|
CPT 56606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.17 |
| Max. Negotiated Rate |
$292.17 |
| Rate for Payer: BCBS Trust/PPO |
$292.17
|
| Rate for Payer: BCN Commercial |
$292.17
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,398.09
|
| Rate for Payer: BCN Commercial |
$2,398.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S)
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,985.47
|
| Rate for Payer: BCN Commercial |
$2,985.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INGUINOFEMORAL NODE(S)
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,201.74
|
| Rate for Payer: BCN Commercial |
$2,201.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, SUPERFICIAL
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 38500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,040.41 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,377.78
|
| Rate for Payer: BCN Commercial |
$2,377.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
|
Facility
|
OP
|
$1,141.51
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,141.51 |
| Max. Negotiated Rate |
$1,141.51 |
| Rate for Payer: BCBS Trust/PPO |
$1,141.51
|
| Rate for Payer: BCN Commercial |
$1,141.51
|
|
|
BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 55707
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$12,564.44
|
|
|
Service Code
|
APR-DRG 7534
|
| Min. Negotiated Rate |
$11,966.14 |
| Max. Negotiated Rate |
$12,564.44 |
| Rate for Payer: BCBS Complete |
$12,564.44
|
| Rate for Payer: Mclaren Medicaid |
$11,966.14
|
| Rate for Payer: Meridian Medicaid |
$12,564.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,966.14
|
| Rate for Payer: UHC Medicaid |
$11,966.14
|
| Rate for Payer: UHCCP Medicaid |
$11,966.14
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$2,717.44
|
|
|
Service Code
|
APR-DRG 7531
|
| Min. Negotiated Rate |
$2,588.04 |
| Max. Negotiated Rate |
$2,717.44 |
| Rate for Payer: BCBS Complete |
$2,717.44
|
| Rate for Payer: Mclaren Medicaid |
$2,588.04
|
| Rate for Payer: Meridian Medicaid |
$2,717.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,588.04
|
| Rate for Payer: UHC Medicaid |
$2,588.04
|
| Rate for Payer: UHCCP Medicaid |
$2,588.04
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$3,414.57
|
|
|
Service Code
|
APR-DRG 7532
|
| Min. Negotiated Rate |
$3,251.98 |
| Max. Negotiated Rate |
$3,414.57 |
| Rate for Payer: BCBS Complete |
$3,414.57
|
| Rate for Payer: Mclaren Medicaid |
$3,251.98
|
| Rate for Payer: Meridian Medicaid |
$3,414.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,251.98
|
| Rate for Payer: UHC Medicaid |
$3,251.98
|
| Rate for Payer: UHCCP Medicaid |
$3,251.98
|
|
