|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
OP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$238.31 |
| Max. Negotiated Rate |
$536.20 |
| Rate for Payer: Aetna Commercial |
$506.41
|
| Rate for Payer: Aetna Medicare |
$297.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.26
|
| Rate for Payer: BCBS Complete |
$238.31
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$417.05
|
| Rate for Payer: Cofinity Commercial |
$512.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$536.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: PHP Commercial |
$506.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: Priority Health SBD |
$375.34
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
IP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$375.34 |
| Max. Negotiated Rate |
$536.20 |
| Rate for Payer: Aetna Commercial |
$506.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.26
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$417.05
|
| Rate for Payer: Cofinity Commercial |
$512.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$536.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: PHP Commercial |
$506.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: Priority Health SBD |
$375.34
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$102.38 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.46
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$36.37
|
| Rate for Payer: BCN Medicare Advantage |
$36.37
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$36.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.19
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PACE Medicare |
$34.55
|
| Rate for Payer: PACE SWMI |
$36.37
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$36.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health Medicare |
$36.37
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$36.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.37
|
| Rate for Payer: UHC Medicare Advantage |
$36.37
|
| Rate for Payer: UHCCP Medicaid |
$20.48
|
| Rate for Payer: VA VA |
$36.37
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.47 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
IP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$218.48 |
| Max. Negotiated Rate |
$312.12 |
| Rate for Payer: Aetna Commercial |
$294.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.42
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$242.76
|
| Rate for Payer: Cofinity Commercial |
$298.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Healthscope Commercial |
$312.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: PHP Commercial |
$294.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: Priority Health SBD |
$218.48
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
OP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$353.78 |
| Rate for Payer: Aetna Commercial |
$294.78
|
| Rate for Payer: Aetna Medicare |
$130.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.10
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$125.68
|
| Rate for Payer: BCN Medicare Advantage |
$125.68
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$298.25
|
| Rate for Payer: Cofinity Commercial |
$242.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$312.12
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$125.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.96
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: PACE Medicare |
$119.40
|
| Rate for Payer: PACE SWMI |
$125.68
|
| Rate for Payer: PHP Commercial |
$294.78
|
| Rate for Payer: PHP Medicare Advantage |
$125.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: Priority Health Medicare |
$125.68
|
| Rate for Payer: Priority Health SBD |
$218.48
|
| Rate for Payer: Railroad Medicare Medicare |
$125.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.68
|
| Rate for Payer: UHC Medicare Advantage |
$125.68
|
| Rate for Payer: UHCCP Medicaid |
$70.76
|
| Rate for Payer: VA VA |
$125.68
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
OP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$97.54
|
| Rate for Payer: Aetna Medicare |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.46
|
| Rate for Payer: BCBS Complete |
$20.47
|
| Rate for Payer: BCBS MAPPO |
$36.37
|
| Rate for Payer: BCN Medicare Advantage |
$36.37
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$80.33
|
| Rate for Payer: Cofinity Commercial |
$98.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.37
|
| Rate for Payer: Healthscope Commercial |
$103.28
|
| Rate for Payer: Mclaren Medicaid |
$19.49
|
| Rate for Payer: Mclaren Medicare |
$36.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.19
|
| Rate for Payer: Meridian Medicaid |
$20.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$34.55
|
| Rate for Payer: PACE SWMI |
$36.37
|
| Rate for Payer: PHP Commercial |
$97.54
|
| Rate for Payer: PHP Medicare Advantage |
$36.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health Medicare |
$36.37
|
| Rate for Payer: Priority Health SBD |
$72.29
|
| Rate for Payer: Railroad Medicare Medicare |
$36.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.38
|
| Rate for Payer: UHC Core |
$84.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.37
|
| Rate for Payer: UHC Exchange |
$84.92
|
| Rate for Payer: UHC Medicare Advantage |
$36.37
|
| Rate for Payer: UHCCP Medicaid |
$20.48
|
| Rate for Payer: VA VA |
$36.37
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
IP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$72.29 |
| Max. Negotiated Rate |
$103.28 |
| Rate for Payer: Aetna Commercial |
$97.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.59
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$80.33
|
| Rate for Payer: Cofinity Commercial |
$98.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Healthscope Commercial |
$103.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: PHP Commercial |
$97.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health SBD |
$72.29
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$230.67 |
| Max. Negotiated Rate |
$329.53 |
| Rate for Payer: Aetna Commercial |
$311.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.99
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$256.30
|
| Rate for Payer: Cofinity Commercial |
$314.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Healthscope Commercial |
$329.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: PHP Commercial |
$311.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health SBD |
$230.67
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$67.36 |
| Max. Negotiated Rate |
$353.78 |
| Rate for Payer: Aetna Commercial |
$311.22
|
| Rate for Payer: Aetna Medicare |
$130.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.10
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$125.68
|
| Rate for Payer: BCN Medicare Advantage |
$125.68
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$256.30
|
| Rate for Payer: Cofinity Commercial |
$314.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$329.53
|
| Rate for Payer: Mclaren Medicaid |
$67.36
|
| Rate for Payer: Mclaren Medicare |
$125.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.96
|
| Rate for Payer: Meridian Medicaid |
$70.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$119.40
|
| Rate for Payer: PACE SWMI |
$125.68
|
| Rate for Payer: PHP Commercial |
$311.22
|
| Rate for Payer: PHP Medicare Advantage |
$125.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health Medicare |
$125.68
|
| Rate for Payer: Priority Health SBD |
$230.67
|
| Rate for Payer: Railroad Medicare Medicare |
$125.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.78
|
| Rate for Payer: UHC Core |
$270.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.68
|
| Rate for Payer: UHC Exchange |
$270.94
|
| Rate for Payer: UHC Medicare Advantage |
$125.68
|
| Rate for Payer: UHCCP Medicaid |
$70.76
|
| Rate for Payer: VA VA |
$125.68
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.96 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna Medicare |
$331.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.57
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$463.69
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$463.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health SBD |
$417.32
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$417.32 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$463.69
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$463.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health SBD |
$417.32
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,373.76 |
| Max. Negotiated Rate |
$1,962.51 |
| Rate for Payer: Aetna Commercial |
$1,853.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.37
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$1,526.40
|
| Rate for Payer: Cofinity Commercial |
$1,875.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,526.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Healthscope Commercial |
$1,962.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: PHP Commercial |
$1,853.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health SBD |
$1,373.76
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna Commercial |
$1,853.48
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$1,875.29
|
| Rate for Payer: Cofinity Commercial |
$1,526.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,526.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,962.51
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,853.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,373.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$852.97
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.60 |
| Max. Negotiated Rate |
$1,095.50 |
| Rate for Payer: Aetna Commercial |
$291.83
|
| Rate for Payer: Aetna Medicare |
$404.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$240.33
|
| Rate for Payer: Cofinity Commercial |
$295.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$291.83
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health SBD |
$216.30
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$219.11
|
| Rate for Payer: VA VA |
$389.18
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.30 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$291.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.16
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$240.33
|
| Rate for Payer: Cofinity Commercial |
$295.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: PHP Commercial |
$291.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health SBD |
$216.30
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.60 |
| Max. Negotiated Rate |
$1,095.50 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$404.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health SBD |
$706.86
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$219.11
|
| Rate for Payer: VA VA |
$389.18
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$706.86 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health SBD |
$706.86
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$224.91 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.05
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$249.90
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$249.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health SBD |
$224.91
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Commercial |
$249.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$249.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$224.91
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$70.77
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,349.51 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,203.05 |
| Max. Negotiated Rate |
$4,575.79 |
| Rate for Payer: Aetna Commercial |
$4,321.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,304.74
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$3,558.95
|
| Rate for Payer: Cofinity Commercial |
$4,372.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,558.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Healthscope Commercial |
$4,575.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: PHP Commercial |
$4,321.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health SBD |
$3,203.05
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,433.59 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$4,321.58
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,304.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$4,372.42
|
| Rate for Payer: Cofinity Commercial |
$3,558.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,558.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$4,575.79
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$4,321.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$3,203.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,902.45 |
| Max. Negotiated Rate |
$9,991.04 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: Aetna Medicare |
$3,691.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,990.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,436.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,436.68
|
| Rate for Payer: BCBS Complete |
$1,997.57
|
| Rate for Payer: BCBS MAPPO |
$3,549.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,549.34
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Cofinity Commercial |
$2,143.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,143.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,549.34
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Mclaren Medicaid |
$1,902.45
|
| Rate for Payer: Mclaren Medicare |
$3,549.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,726.81
|
| Rate for Payer: Meridian Medicaid |
$1,997.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,081.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: PACE Medicare |
$3,371.87
|
| Rate for Payer: PACE SWMI |
$3,549.34
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: PHP Medicare Advantage |
$3,549.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,902.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health Medicare |
$3,549.34
|
| Rate for Payer: Priority Health SBD |
$1,929.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3,549.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,991.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,549.34
|
| Rate for Payer: UHC Medicare Advantage |
$3,549.34
|
| Rate for Payer: UHCCP Medicaid |
$1,998.28
|
| Rate for Payer: VA VA |
$3,549.34
|
|
