|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
OP
|
$131.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$15.28
|
| Rate for Payer: BCN Commercial |
$15.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$82.90
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.72
|
| Rate for Payer: VA VA |
$17.27
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
IP
|
$131.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.90 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health SBD |
$82.90
|
|
|
HC INTERMEDIATE CARE R & B
|
Facility
|
IP
|
$4,896.09
|
|
| Hospital Charge Code |
20600001
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$3,084.54 |
| Max. Negotiated Rate |
$4,406.48 |
| Rate for Payer: Aetna Commercial |
$4,161.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,182.46
|
| Rate for Payer: Cash Price |
$3,916.87
|
| Rate for Payer: Cofinity Commercial |
$3,427.26
|
| Rate for Payer: Cofinity Commercial |
$4,210.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,427.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,916.87
|
| Rate for Payer: Healthscope Commercial |
$4,406.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,161.68
|
| Rate for Payer: PHP Commercial |
$4,161.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,182.46
|
| Rate for Payer: Priority Health SBD |
$3,084.54
|
|
|
HC INTERMEDIATE NURSERY CARE
|
Facility
|
IP
|
$2,965.64
|
|
| Hospital Charge Code |
17100001
|
|
Hospital Revenue Code
|
171
|
| Min. Negotiated Rate |
$1,868.35 |
| Max. Negotiated Rate |
$2,669.08 |
| Rate for Payer: Aetna Commercial |
$2,520.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,927.67
|
| Rate for Payer: Cash Price |
$2,372.51
|
| Rate for Payer: Cofinity Commercial |
$2,075.95
|
| Rate for Payer: Cofinity Commercial |
$2,550.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,075.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,372.51
|
| Rate for Payer: Healthscope Commercial |
$2,669.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,520.79
|
| Rate for Payer: PHP Commercial |
$2,520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,927.67
|
| Rate for Payer: Priority Health SBD |
$1,868.35
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
OP
|
$536.85
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$204.35 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$456.32
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$256.81
|
| Rate for Payer: BCN Commercial |
$256.81
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cofinity Commercial |
$461.69
|
| Rate for Payer: Cofinity Commercial |
$375.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$375.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$483.16
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.32
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$456.32
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$338.22
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.35
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
IP
|
$536.85
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$338.22 |
| Max. Negotiated Rate |
$483.16 |
| Rate for Payer: Aetna Commercial |
$456.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.95
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cofinity Commercial |
$375.80
|
| Rate for Payer: Cofinity Commercial |
$461.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$375.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.48
|
| Rate for Payer: Healthscope Commercial |
$483.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.32
|
| Rate for Payer: PHP Commercial |
$456.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.95
|
| Rate for Payer: Priority Health SBD |
$338.22
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
OP
|
$1,888.39
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$755.36 |
| Max. Negotiated Rate |
$1,699.55 |
| Rate for Payer: Aetna Commercial |
$1,605.13
|
| Rate for Payer: Aetna Medicare |
$944.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,227.45
|
| Rate for Payer: BCBS Complete |
$755.36
|
| Rate for Payer: Cash Price |
$1,510.71
|
| Rate for Payer: Cofinity Commercial |
$1,321.87
|
| Rate for Payer: Cofinity Commercial |
$1,624.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,321.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.71
|
| Rate for Payer: Healthscope Commercial |
$1,699.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.13
|
| Rate for Payer: PHP Commercial |
$1,605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.45
|
| Rate for Payer: Priority Health SBD |
$1,189.69
|
| Rate for Payer: UHC Core |
$1,397.41
|
| Rate for Payer: UHC Exchange |
$1,397.41
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
IP
|
$1,888.39
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,189.69 |
| Max. Negotiated Rate |
$1,699.55 |
| Rate for Payer: Aetna Commercial |
$1,605.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,227.45
|
| Rate for Payer: Cash Price |
$1,510.71
|
| Rate for Payer: Cofinity Commercial |
$1,321.87
|
| Rate for Payer: Cofinity Commercial |
$1,624.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,321.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.71
|
| Rate for Payer: Healthscope Commercial |
$1,699.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.13
|
| Rate for Payer: PHP Commercial |
$1,605.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.45
|
| Rate for Payer: Priority Health SBD |
$1,189.69
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.74 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$240.15
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$177.40
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.74
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.40 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.03
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health SBD |
$177.40
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.14 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$321.80
|
| Rate for Payer: BCN Commercial |
$321.80
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Cofinity Commercial |
$216.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$278.78
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$195.14
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.85
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.14 |
| Max. Negotiated Rate |
$278.78 |
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.34
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$216.82
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$278.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health SBD |
$195.14
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
OP
|
$498.64
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.82 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$322.02
|
| Rate for Payer: BCN Commercial |
$322.02
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Commercial |
$349.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$314.14
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.09
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
IP
|
$498.64
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.14 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.12
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$349.05
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health SBD |
$314.14
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.40 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.03
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health SBD |
$177.40
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.73 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$141.73
|
| Rate for Payer: BCN Commercial |
$141.73
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Cofinity Commercial |
$197.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$177.40
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.09
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.14 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$255.93
|
| Rate for Payer: BCN Commercial |
$255.93
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Cofinity Commercial |
$216.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$278.78
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$195.14
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.40
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.14 |
| Max. Negotiated Rate |
$278.78 |
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.34
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$216.82
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$278.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health SBD |
$195.14
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
OP
|
$899.53
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.14 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$764.60
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$120.14
|
| Rate for Payer: BCN Commercial |
$120.14
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cofinity Commercial |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$629.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$629.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$809.58
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.60
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$764.60
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$566.70
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.25
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
IP
|
$899.53
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$566.70 |
| Max. Negotiated Rate |
$809.58 |
| Rate for Payer: Aetna Commercial |
$764.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.69
|
| Rate for Payer: Cash Price |
$719.62
|
| Rate for Payer: Cofinity Commercial |
$629.67
|
| Rate for Payer: Cofinity Commercial |
$773.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$629.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.62
|
| Rate for Payer: Healthscope Commercial |
$809.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.60
|
| Rate for Payer: PHP Commercial |
$764.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.69
|
| Rate for Payer: Priority Health SBD |
$566.70
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$2,205.80
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$274.38 |
| Max. Negotiated Rate |
$11,989.00 |
| Rate for Payer: Aetna Commercial |
$1,874.93
|
| Rate for Payer: Aetna Medicare |
$1,102.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.77
|
| Rate for Payer: BCBS Complete |
$882.32
|
| Rate for Payer: BCBS Trust/PPO |
$548.19
|
| Rate for Payer: BCN Commercial |
$548.19
|
| Rate for Payer: Cash Price |
$1,764.64
|
| Rate for Payer: Cash Price |
$1,764.64
|
| Rate for Payer: Cash Price |
$1,764.64
|
| Rate for Payer: Cofinity Commercial |
$1,544.06
|
| Rate for Payer: Cofinity Commercial |
$1,896.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,544.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.64
|
| Rate for Payer: Healthscope Commercial |
$1,985.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.93
|
| Rate for Payer: PHP Commercial |
$1,874.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.77
|
| Rate for Payer: Priority Health SBD |
$1,389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.38
|
| Rate for Payer: UHC Core |
$11,194.00
|
| Rate for Payer: UHC Exchange |
$11,989.00
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$2,205.80
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,389.65 |
| Max. Negotiated Rate |
$1,985.22 |
| Rate for Payer: Aetna Commercial |
$1,874.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.77
|
| Rate for Payer: Cash Price |
$1,764.64
|
| Rate for Payer: Cofinity Commercial |
$1,544.06
|
| Rate for Payer: Cofinity Commercial |
$1,896.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,544.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.64
|
| Rate for Payer: Healthscope Commercial |
$1,985.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.93
|
| Rate for Payer: PHP Commercial |
$1,874.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.77
|
| Rate for Payer: Priority Health SBD |
$1,389.65
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
OP
|
$1,340.24
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35.86 |
| Max. Negotiated Rate |
$11,989.00 |
| Rate for Payer: Aetna Commercial |
$1,139.20
|
| Rate for Payer: Aetna Medicare |
$670.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.16
|
| Rate for Payer: BCBS Complete |
$536.10
|
| Rate for Payer: BCBS Trust/PPO |
$71.06
|
| Rate for Payer: BCN Commercial |
$71.06
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cofinity Commercial |
$1,152.61
|
| Rate for Payer: Cofinity Commercial |
$938.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$938.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.19
|
| Rate for Payer: Healthscope Commercial |
$1,206.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.20
|
| Rate for Payer: PHP Commercial |
$1,139.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.16
|
| Rate for Payer: Priority Health SBD |
$844.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.86
|
| Rate for Payer: UHC Core |
$11,194.00
|
| Rate for Payer: UHC Exchange |
$11,989.00
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,340.24
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$844.35 |
| Max. Negotiated Rate |
$1,206.22 |
| Rate for Payer: Aetna Commercial |
$1,139.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.16
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cofinity Commercial |
$1,152.61
|
| Rate for Payer: Cofinity Commercial |
$938.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$938.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.19
|
| Rate for Payer: Healthscope Commercial |
$1,206.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.20
|
| Rate for Payer: PHP Commercial |
$1,139.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.16
|
| Rate for Payer: Priority Health SBD |
$844.35
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,073.12
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$676.07 |
| Max. Negotiated Rate |
$965.81 |
| Rate for Payer: Aetna Commercial |
$912.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.53
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cofinity Commercial |
$751.18
|
| Rate for Payer: Cofinity Commercial |
$922.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$751.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.50
|
| Rate for Payer: Healthscope Commercial |
$965.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.15
|
| Rate for Payer: PHP Commercial |
$912.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.53
|
| Rate for Payer: Priority Health SBD |
$676.07
|
|
