|
HC MYCOBACTERIUM TUBERCULOSIS, RIFAMPIN RESISTANCE, AMP PROBE
|
Facility
|
IP
|
$117.50
|
|
|
Service Code
|
CPT 87564
|
| Hospital Charge Code |
30600345
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.03 |
| Max. Negotiated Rate |
$105.75 |
| Rate for Payer: Aetna Commercial |
$99.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.38
|
| Rate for Payer: Cash Price |
$94.00
|
| Rate for Payer: Cofinity Commercial |
$101.05
|
| Rate for Payer: Cofinity Commercial |
$82.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.00
|
| Rate for Payer: Healthscope Commercial |
$105.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.88
|
| Rate for Payer: PHP Commercial |
$99.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.38
|
| Rate for Payer: Priority Health SBD |
$74.03
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: BCBS Complete |
$10.16
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$9.67
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: Meridian Medicaid |
$10.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.05
|
| Rate for Payer: UHCCP Medicaid |
$10.16
|
| Rate for Payer: VA VA |
$18.05
|
|
|
HC MYCOPHENOLIC ACID
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.32 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$37.27 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$15.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.45
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$15.29
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health SBD |
$13.77
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
OP
|
$21.66
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$37.27 |
| Rate for Payer: Aetna Commercial |
$18.41
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Commercial |
$15.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$19.49
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.41
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$18.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.08
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$13.65
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.45
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
IP
|
$21.66
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$19.49 |
| Rate for Payer: Aetna Commercial |
$18.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.08
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Cofinity Commercial |
$15.16
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.33
|
| Rate for Payer: Healthscope Commercial |
$19.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.41
|
| Rate for Payer: PHP Commercial |
$18.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.08
|
| Rate for Payer: Priority Health SBD |
$13.65
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
OP
|
$109.75
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna Medicare |
$16.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.24
|
| Rate for Payer: BCBS Complete |
$8.66
|
| Rate for Payer: BCBS MAPPO |
$15.39
|
| Rate for Payer: BCN Medicare Advantage |
$15.39
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.39
|
| Rate for Payer: Cofinity Commercial |
$76.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Mclaren Medicare |
$15.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.16
|
| Rate for Payer: Meridian Medicaid |
$8.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: PACE Medicare |
$14.62
|
| Rate for Payer: PACE SWMI |
$15.39
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health Medicare |
$15.39
|
| Rate for Payer: Priority Health SBD |
$69.14
|
| Rate for Payer: Railroad Medicare Medicare |
$15.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.39
|
| Rate for Payer: UHC Medicare Advantage |
$15.39
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$15.39
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
IP
|
$109.75
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$69.14 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.34
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$76.83
|
| Rate for Payer: Cofinity Commercial |
$94.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health SBD |
$69.14
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$91.93
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$91.93 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health SBD |
$91.93
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$91.93
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$91.93 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health SBD |
$91.93
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$91.93
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$91.93 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health SBD |
$91.93
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$37.27 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Commercial |
$15.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.45
|
| Rate for Payer: VA VA |
$13.24
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$15.29
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health SBD |
$13.77
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$220.32
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$198.29 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$189.48
|
| Rate for Payer: Cofinity Commercial |
$154.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$198.29
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.27
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$187.27
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.21
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$138.80
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$19.76
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$220.32
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$138.80 |
| Max. Negotiated Rate |
$198.29 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.21
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$154.22
|
| Rate for Payer: Cofinity Commercial |
$189.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.26
|
| Rate for Payer: Healthscope Commercial |
$198.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.27
|
| Rate for Payer: PHP Commercial |
$187.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.21
|
| Rate for Payer: Priority Health SBD |
$138.80
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$645.05
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$94.01 |
| Max. Negotiated Rate |
$580.54 |
| Rate for Payer: Aetna Commercial |
$548.29
|
| Rate for Payer: Aetna Medicare |
$182.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: BCBS Complete |
$98.72
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$554.74
|
| Rate for Payer: Cofinity Commercial |
$451.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$451.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$580.54
|
| Rate for Payer: Mclaren Medicaid |
$94.01
|
| Rate for Payer: Mclaren Medicare |
$175.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: Meridian Medicaid |
$98.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.29
|
| Rate for Payer: PACE Medicare |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$548.29
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.28
|
| Rate for Payer: Priority Health Medicare |
$175.40
|
| Rate for Payer: Priority Health SBD |
$406.38
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$493.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.40
|
| Rate for Payer: UHC Medicare Advantage |
$175.40
|
| Rate for Payer: UHCCP Medicaid |
$98.75
|
| Rate for Payer: VA VA |
$175.40
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$645.05
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$406.38 |
| Max. Negotiated Rate |
$580.54 |
| Rate for Payer: Aetna Commercial |
$548.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.28
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$451.54
|
| Rate for Payer: Cofinity Commercial |
$554.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$451.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.04
|
| Rate for Payer: Healthscope Commercial |
$580.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.29
|
| Rate for Payer: PHP Commercial |
$548.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.28
|
| Rate for Payer: Priority Health SBD |
$406.38
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$78.66
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$12.06
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.66 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.15
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$87.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health SBD |
$78.66
|
|
