|
HC SILVER HAWK CATHETER
|
Facility
|
OP
|
$8,746.56
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,498.62 |
| Max. Negotiated Rate |
$7,871.90 |
| Rate for Payer: Aetna Commercial |
$7,434.58
|
| Rate for Payer: Aetna Medicare |
$4,373.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,685.26
|
| Rate for Payer: BCBS Complete |
$3,498.62
|
| Rate for Payer: Cash Price |
$6,997.25
|
| Rate for Payer: Cofinity Commercial |
$6,122.59
|
| Rate for Payer: Cofinity Commercial |
$7,522.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,122.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,997.25
|
| Rate for Payer: Healthscope Commercial |
$7,871.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,434.58
|
| Rate for Payer: PHP Commercial |
$7,434.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,685.26
|
| Rate for Payer: Priority Health SBD |
$5,510.33
|
|
|
HC SILVER ROPE
|
Facility
|
OP
|
$54.58
|
|
| Hospital Charge Code |
27000147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna Medicare |
$27.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
|
|
HC SILVER ROPE
|
Facility
|
IP
|
$54.58
|
|
| Hospital Charge Code |
27000147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.39 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.48
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health SBD |
$34.39
|
|
|
HC SIMIAN B AB
|
Facility
|
IP
|
$91.09
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$57.39 |
| Max. Negotiated Rate |
$81.98 |
| Rate for Payer: Aetna Commercial |
$77.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.21
|
| Rate for Payer: Cash Price |
$72.87
|
| Rate for Payer: Cofinity Commercial |
$63.76
|
| Rate for Payer: Cofinity Commercial |
$78.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.87
|
| Rate for Payer: Healthscope Commercial |
$81.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.43
|
| Rate for Payer: PHP Commercial |
$77.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.21
|
| Rate for Payer: Priority Health SBD |
$57.39
|
|
|
HC SIMIAN B AB
|
Facility
|
OP
|
$91.09
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$81.98 |
| Rate for Payer: Aetna Commercial |
$77.43
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$72.87
|
| Rate for Payer: Cash Price |
$72.87
|
| Rate for Payer: Cofinity Commercial |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$63.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$81.98
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$7.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.43
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$77.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.21
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health SBD |
$57.39
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.88
|
| Rate for Payer: UHC Medicare Advantage |
$12.88
|
| Rate for Payer: UHCCP Medicaid |
$7.25
|
| Rate for Payer: VA VA |
$12.88
|
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
IP
|
$361.15
|
|
|
Service Code
|
CPT 51725
|
| Hospital Charge Code |
76100189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.52 |
| Max. Negotiated Rate |
$325.04 |
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.75
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$252.81
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health SBD |
$227.52
|
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
OP
|
$361.15
|
|
|
Service Code
|
CPT 51725
|
| Hospital Charge Code |
76100189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Cofinity Commercial |
$252.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$227.52
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$133.54
|
| Rate for Payer: VA VA |
$237.20
|
|
|
HC SIMPLE REPAIR FACE EARS EYELIDS NOSE LIP OR MUC MEMB 2.6 CM-5.0 CM
|
Facility
|
OP
|
$562.00
|
|
|
Service Code
|
CPT 12013
|
| Hospital Charge Code |
76100434
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$477.70
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$483.32
|
| Rate for Payer: Cofinity Commercial |
$393.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$505.80
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.70
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$477.70
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.30
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$354.06
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SIMPLE REPAIR FACE EARS EYELIDS NOSE LIP OR MUC MEMB 2.6 CM-5.0 CM
|
Facility
|
IP
|
$562.00
|
|
|
Service Code
|
CPT 12013
|
| Hospital Charge Code |
76100434
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$354.06 |
| Max. Negotiated Rate |
$505.80 |
| Rate for Payer: Aetna Commercial |
$477.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.30
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$393.40
|
| Rate for Payer: Cofinity Commercial |
$483.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$393.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.60
|
| Rate for Payer: Healthscope Commercial |
$505.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.70
|
| Rate for Payer: PHP Commercial |
$477.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.30
|
| Rate for Payer: Priority Health SBD |
$354.06
|
|
|
HC SIMPLE REPAIR FACE EARS EYELIDS NOSE LIP OR MUC MEMB 5.1CM-7.5 CM
|
Facility
|
IP
|
$638.00
|
|
|
Service Code
|
CPT 12014
|
| Hospital Charge Code |
76100433
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$401.94 |
| Max. Negotiated Rate |
$574.20 |
| Rate for Payer: Aetna Commercial |
$542.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.70
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cofinity Commercial |
$446.60
|
| Rate for Payer: Cofinity Commercial |
$548.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$446.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.40
|
| Rate for Payer: Healthscope Commercial |
$574.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.30
|
| Rate for Payer: PHP Commercial |
$542.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.70
|
| Rate for Payer: Priority Health SBD |
$401.94
|
|
|
HC SIMPLE REPAIR FACE EARS EYELIDS NOSE LIP OR MUC MEMB 5.1CM-7.5 CM
|
Facility
|
OP
|
$638.00
|
|
|
Service Code
|
CPT 12014
|
| Hospital Charge Code |
76100433
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$574.20 |
| Rate for Payer: Aetna Commercial |
$542.30
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cofinity Commercial |
$548.68
|
| Rate for Payer: Cofinity Commercial |
$446.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$446.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$574.20
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.30
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$542.30
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.70
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$401.94
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SIMPLE REP WD FACE,EAR,EYELID,NOSE,LIP,MUC MEMB 2.5CM OR LESS
|
Facility
|
IP
|
$272.69
|
|
|
Service Code
|
CPT 12011
|
| Hospital Charge Code |
76100274
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.79 |
| Max. Negotiated Rate |
$245.42 |
| Rate for Payer: Aetna Commercial |
$231.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.25
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cofinity Commercial |
$190.88
|
| Rate for Payer: Cofinity Commercial |
$234.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.15
|
| Rate for Payer: Healthscope Commercial |
$245.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.79
|
| Rate for Payer: PHP Commercial |
$231.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.25
|
| Rate for Payer: Priority Health SBD |
$171.79
|
|
|
HC SIMPLE REP WD FACE,EAR,EYELID,NOSE,LIP,MUC MEMB 2.5CM OR LESS
|
Facility
|
OP
|
$272.69
|
|
|
Service Code
|
CPT 12011
|
| Hospital Charge Code |
76100274
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$231.79
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cofinity Commercial |
$234.51
|
| Rate for Payer: Cofinity Commercial |
$190.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$245.42
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.79
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$231.79
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.25
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$171.79
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SIMPLE REP WD SCALP,NECK,AXILLAE,GENITALIA,TRUNK, EXTREMS 2.6 TO 7.5 CM
|
Facility
|
OP
|
$147.11
|
|
|
Service Code
|
CPT 12002
|
| Hospital Charge Code |
76100114
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.68 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$125.04
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cofinity Commercial |
$126.51
|
| Rate for Payer: Cofinity Commercial |
$102.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$132.40
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.04
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$125.04
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.62
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$92.68
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SIMPLE REP WD SCALP,NECK,AXILLAE,GENITALIA,TRUNK, EXTREMS 2.6 TO 7.5 CM
|
Facility
|
IP
|
$147.11
|
|
|
Service Code
|
CPT 12002
|
| Hospital Charge Code |
76100114
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.68 |
| Max. Negotiated Rate |
$132.40 |
| Rate for Payer: Aetna Commercial |
$125.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.62
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cofinity Commercial |
$102.98
|
| Rate for Payer: Cofinity Commercial |
$126.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.69
|
| Rate for Payer: Healthscope Commercial |
$132.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.04
|
| Rate for Payer: PHP Commercial |
$125.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.62
|
| Rate for Payer: Priority Health SBD |
$92.68
|
|
|
HC SIMPLE REP WD SCALPNECKAXILLAEGENITALIIATRUNK EXTREMS 7.6 TO 12.5 CM
|
Facility
|
IP
|
$556.48
|
|
|
Service Code
|
CPT 12004
|
| Hospital Charge Code |
76100437
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.58 |
| Max. Negotiated Rate |
$500.83 |
| Rate for Payer: Aetna Commercial |
$473.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.71
|
| Rate for Payer: Cash Price |
$445.18
|
| Rate for Payer: Cofinity Commercial |
$389.54
|
| Rate for Payer: Cofinity Commercial |
$478.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$389.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.18
|
| Rate for Payer: Healthscope Commercial |
$500.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.01
|
| Rate for Payer: PHP Commercial |
$473.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.71
|
| Rate for Payer: Priority Health SBD |
$350.58
|
|
|
HC SIMPLE REP WD SCALPNECKAXILLAEGENITALIIATRUNK EXTREMS 7.6 TO 12.5 CM
|
Facility
|
OP
|
$556.48
|
|
|
Service Code
|
CPT 12004
|
| Hospital Charge Code |
76100437
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna Commercial |
$473.01
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$445.18
|
| Rate for Payer: Cash Price |
$445.18
|
| Rate for Payer: Cofinity Commercial |
$478.57
|
| Rate for Payer: Cofinity Commercial |
$389.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$389.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$500.83
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.01
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$473.01
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.71
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$350.58
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$109.10
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC SIMULATION - 3D
|
Facility
|
OP
|
$5,248.82
|
|
|
Service Code
|
CPT 77295
|
| Hospital Charge Code |
33300004
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$715.26 |
| Max. Negotiated Rate |
$4,723.94 |
| Rate for Payer: Aetna Commercial |
$4,461.50
|
| Rate for Payer: Aetna Medicare |
$1,387.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,411.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,668.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,668.05
|
| Rate for Payer: BCBS Complete |
$751.02
|
| Rate for Payer: BCBS MAPPO |
$1,334.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,334.44
|
| Rate for Payer: Cash Price |
$4,199.06
|
| Rate for Payer: Cash Price |
$4,199.06
|
| Rate for Payer: Cofinity Commercial |
$4,513.99
|
| Rate for Payer: Cofinity Commercial |
$3,674.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,674.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,199.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,334.44
|
| Rate for Payer: Healthscope Commercial |
$4,723.94
|
| Rate for Payer: Mclaren Medicaid |
$715.26
|
| Rate for Payer: Mclaren Medicare |
$1,334.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,401.16
|
| Rate for Payer: Meridian Medicaid |
$751.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,534.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,461.50
|
| Rate for Payer: PACE Medicare |
$1,267.72
|
| Rate for Payer: PACE SWMI |
$1,334.44
|
| Rate for Payer: PHP Commercial |
$4,461.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,334.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,411.73
|
| Rate for Payer: Priority Health Medicare |
$1,334.44
|
| Rate for Payer: Priority Health SBD |
$3,306.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,334.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,756.32
|
| Rate for Payer: UHC Core |
$3,884.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,334.44
|
| Rate for Payer: UHC Exchange |
$3,884.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,334.44
|
| Rate for Payer: UHCCP Medicaid |
$751.29
|
| Rate for Payer: VA VA |
$1,334.44
|
|
|
HC SIMULATION - 3D
|
Facility
|
IP
|
$5,248.82
|
|
|
Service Code
|
CPT 77295
|
| Hospital Charge Code |
33300004
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,306.76 |
| Max. Negotiated Rate |
$4,723.94 |
| Rate for Payer: Aetna Commercial |
$4,461.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,411.73
|
| Rate for Payer: Cash Price |
$4,199.06
|
| Rate for Payer: Cofinity Commercial |
$3,674.17
|
| Rate for Payer: Cofinity Commercial |
$4,513.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,674.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,199.06
|
| Rate for Payer: Healthscope Commercial |
$4,723.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,461.50
|
| Rate for Payer: PHP Commercial |
$4,461.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,411.73
|
| Rate for Payer: Priority Health SBD |
$3,306.76
|
|
|
HC SIMULATION - C
|
Facility
|
OP
|
$1,707.30
|
|
|
Service Code
|
CPT 77290
|
| Hospital Charge Code |
33300003
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,536.57 |
| Rate for Payer: Aetna Commercial |
$1,451.20
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,109.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$1,365.84
|
| Rate for Payer: Cash Price |
$1,365.84
|
| Rate for Payer: Cofinity Commercial |
$1,468.28
|
| Rate for Payer: Cofinity Commercial |
$1,195.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,195.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,365.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$1,536.57
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,451.20
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$1,451.20
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,109.74
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$1,075.60
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$1,263.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$1,263.40
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$201.00
|
| Rate for Payer: VA VA |
$357.02
|
|
|
HC SIMULATION - C
|
Facility
|
IP
|
$1,707.30
|
|
|
Service Code
|
CPT 77290
|
| Hospital Charge Code |
33300003
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,075.60 |
| Max. Negotiated Rate |
$1,536.57 |
| Rate for Payer: Aetna Commercial |
$1,451.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,109.74
|
| Rate for Payer: Cash Price |
$1,365.84
|
| Rate for Payer: Cofinity Commercial |
$1,195.11
|
| Rate for Payer: Cofinity Commercial |
$1,468.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,195.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,365.84
|
| Rate for Payer: Healthscope Commercial |
$1,536.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,451.20
|
| Rate for Payer: PHP Commercial |
$1,451.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,109.74
|
| Rate for Payer: Priority Health SBD |
$1,075.60
|
|
|
HC SIMULATION - I
|
Facility
|
OP
|
$1,193.40
|
|
|
Service Code
|
CPT 77285
|
| Hospital Charge Code |
33300060
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$191.36 |
| Max. Negotiated Rate |
$1,074.06 |
| Rate for Payer: Aetna Commercial |
$1,014.39
|
| Rate for Payer: Aetna Medicare |
$371.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.27
|
| Rate for Payer: BCBS Complete |
$200.93
|
| Rate for Payer: BCBS MAPPO |
$357.02
|
| Rate for Payer: BCN Medicare Advantage |
$357.02
|
| Rate for Payer: Cash Price |
$954.72
|
| Rate for Payer: Cash Price |
$954.72
|
| Rate for Payer: Cofinity Commercial |
$1,026.32
|
| Rate for Payer: Cofinity Commercial |
$835.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$835.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.02
|
| Rate for Payer: Healthscope Commercial |
$1,074.06
|
| Rate for Payer: Mclaren Medicaid |
$191.36
|
| Rate for Payer: Mclaren Medicare |
$357.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.87
|
| Rate for Payer: Meridian Medicaid |
$200.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.39
|
| Rate for Payer: PACE Medicare |
$339.17
|
| Rate for Payer: PACE SWMI |
$357.02
|
| Rate for Payer: PHP Commercial |
$1,014.39
|
| Rate for Payer: PHP Medicare Advantage |
$357.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.71
|
| Rate for Payer: Priority Health Medicare |
$357.02
|
| Rate for Payer: Priority Health SBD |
$751.84
|
| Rate for Payer: Railroad Medicare Medicare |
$357.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.98
|
| Rate for Payer: UHC Core |
$883.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.02
|
| Rate for Payer: UHC Exchange |
$883.12
|
| Rate for Payer: UHC Medicare Advantage |
$357.02
|
| Rate for Payer: UHCCP Medicaid |
$201.00
|
| Rate for Payer: VA VA |
$357.02
|
|
|
HC SIMULATION - I
|
Facility
|
IP
|
$1,193.40
|
|
|
Service Code
|
CPT 77285
|
| Hospital Charge Code |
33300060
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$751.84 |
| Max. Negotiated Rate |
$1,074.06 |
| Rate for Payer: Aetna Commercial |
$1,014.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.71
|
| Rate for Payer: Cash Price |
$954.72
|
| Rate for Payer: Cofinity Commercial |
$1,026.32
|
| Rate for Payer: Cofinity Commercial |
$835.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$835.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.72
|
| Rate for Payer: Healthscope Commercial |
$1,074.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.39
|
| Rate for Payer: PHP Commercial |
$1,014.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.71
|
| Rate for Payer: Priority Health SBD |
$751.84
|
|
|
HC SIMULATION - S
|
Facility
|
OP
|
$728.28
|
|
|
Service Code
|
CPT 77280
|
| Hospital Charge Code |
33300002
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$69.41 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna Medicare |
$134.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.86
|
| Rate for Payer: BCBS Complete |
$72.88
|
| Rate for Payer: BCBS MAPPO |
$129.49
|
| Rate for Payer: BCN Medicare Advantage |
$129.49
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$509.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.49
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Mclaren Medicaid |
$69.41
|
| Rate for Payer: Mclaren Medicare |
$129.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.96
|
| Rate for Payer: Meridian Medicaid |
$72.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: PACE Medicare |
$123.02
|
| Rate for Payer: PACE SWMI |
$129.49
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: PHP Medicare Advantage |
$129.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.38
|
| Rate for Payer: Priority Health Medicare |
$129.49
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: Railroad Medicare Medicare |
$129.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.50
|
| Rate for Payer: UHC Core |
$538.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.49
|
| Rate for Payer: UHC Exchange |
$538.93
|
| Rate for Payer: UHC Medicare Advantage |
$129.49
|
| Rate for Payer: UHCCP Medicaid |
$72.90
|
| Rate for Payer: VA VA |
$129.49
|
|
|
HC SIMULATION - S
|
Facility
|
IP
|
$728.28
|
|
|
Service Code
|
CPT 77280
|
| Hospital Charge Code |
33300002
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$458.82 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$509.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.38
|
| Rate for Payer: Priority Health SBD |
$458.82
|
|
