|
HC SOMATOMEDIN
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$59.84 |
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.57
|
| Rate for Payer: BCBS Complete |
$11.97
|
| Rate for Payer: BCBS MAPPO |
$21.26
|
| Rate for Payer: BCN Medicare Advantage |
$21.26
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.26
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Mclaren Medicaid |
$11.40
|
| Rate for Payer: Mclaren Medicare |
$21.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.32
|
| Rate for Payer: Meridian Medicaid |
$11.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: PACE Medicare |
$20.20
|
| Rate for Payer: PACE SWMI |
$21.26
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$21.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health Medicare |
$21.26
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: Railroad Medicare Medicare |
$21.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.26
|
| Rate for Payer: UHC Medicare Advantage |
$21.26
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: VA VA |
$21.26
|
|
|
HC SOMATOMEDIN
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.74 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health SBD |
$34.74
|
|
|
HC SOYBEAN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC SOYBEAN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
IP
|
$6,048.60
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,810.62 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,931.59
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$4,234.02
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,234.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.59
|
| Rate for Payer: Priority Health SBD |
$3,810.62
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
OP
|
$6,048.60
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,419.44 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna Medicare |
$3,024.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,931.59
|
| Rate for Payer: BCBS Complete |
$2,419.44
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$4,234.02
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,234.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.59
|
| Rate for Payer: Priority Health SBD |
$3,810.62
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,425.17 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$2,694.64
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,694.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Cofinity Commercial |
$2,694.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,694.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,588.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Cofinity Commercial |
$2,787.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,787.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,508.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,508.70 |
| Max. Negotiated Rate |
$3,583.86 |
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,588.35
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$2,787.45
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,787.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health SBD |
$2,508.70
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,057.66 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,122.98
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,286.29
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,286.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health SBD |
$2,057.66
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,122.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Cofinity Commercial |
$2,286.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,286.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,057.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$2,416.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$2,416.94
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,728.24
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$69.41 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna Medicare |
$134.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.09
|
| 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 |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Cofinity Commercial |
$107.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.49
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| 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 |
$130.88
|
| Rate for Payer: PACE Medicare |
$123.02
|
| Rate for Payer: PACE SWMI |
$129.49
|
| Rate for Payer: PHP Commercial |
$130.88
|
| 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 |
$100.09
|
| Rate for Payer: Priority Health Medicare |
$129.49
|
| Rate for Payer: Priority Health SBD |
$97.01
|
| Rate for Payer: Railroad Medicare Medicare |
$129.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.50
|
| Rate for Payer: UHC Core |
$113.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.49
|
| Rate for Payer: UHC Exchange |
$113.95
|
| Rate for Payer: UHC Medicare Advantage |
$129.49
|
| Rate for Payer: UHCCP Medicaid |
$72.90
|
| Rate for Payer: VA VA |
$129.49
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$97.01 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.09
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$107.79
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health SBD |
$97.01
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$157.88
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$142.10
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$29.34
|
| Rate for Payer: VA VA |
$52.11
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$142.10 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.61
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$157.88
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$157.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health SBD |
$142.10
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$186.45
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.46 |
| Max. Negotiated Rate |
$167.81 |
| Rate for Payer: Aetna Commercial |
$158.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.19
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cofinity Commercial |
$130.51
|
| Rate for Payer: Cofinity Commercial |
$160.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$130.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.16
|
| Rate for Payer: Healthscope Commercial |
$167.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.48
|
| Rate for Payer: PHP Commercial |
$158.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.19
|
| Rate for Payer: Priority Health SBD |
$117.46
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$186.45
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna Commercial |
$158.48
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.19
|
| 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 |
$149.16
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cofinity Commercial |
$160.35
|
| Rate for Payer: Cofinity Commercial |
$130.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$130.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$167.81
|
| 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 |
$158.48
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$158.48
|
| 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 |
$121.19
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$117.46
|
| 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 SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.34
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.77 |
| Max. Negotiated Rate |
$11.11 |
| Rate for Payer: Aetna Commercial |
$10.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.02
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cofinity Commercial |
$10.61
|
| Rate for Payer: Cofinity Commercial |
$8.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.49
|
| Rate for Payer: PHP Commercial |
$10.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.02
|
| Rate for Payer: Priority Health SBD |
$7.77
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.34
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.76 |
| Max. Negotiated Rate |
$11.11 |
| Rate for Payer: Aetna Commercial |
$10.49
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: BCBS Complete |
$1.85
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cofinity Commercial |
$8.64
|
| Rate for Payer: Cofinity Commercial |
$10.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Healthscope Commercial |
$11.11
|
| Rate for Payer: Mclaren Medicaid |
$1.76
|
| Rate for Payer: Mclaren Medicare |
$3.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.44
|
| Rate for Payer: Meridian Medicaid |
$1.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.49
|
| Rate for Payer: PACE Medicare |
$3.12
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$10.49
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.02
|
| Rate for Payer: Priority Health Medicare |
$3.28
|
| Rate for Payer: Priority Health SBD |
$7.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: UHCCP Medicaid |
$1.85
|
| Rate for Payer: VA VA |
$3.28
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health SBD |
$27.76
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare |
$6.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$30.84
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health SBD |
$27.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.68
|
| Rate for Payer: UHCCP Medicaid |
$3.76
|
| Rate for Payer: VA VA |
$6.68
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$556.61
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$69.41 |
| Max. Negotiated Rate |
$500.95 |
| Rate for Payer: Aetna Commercial |
$473.12
|
| Rate for Payer: Aetna Medicare |
$134.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.80
|
| 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 |
$445.29
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cofinity Commercial |
$478.68
|
| Rate for Payer: Cofinity Commercial |
$389.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$389.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.49
|
| Rate for Payer: Healthscope Commercial |
$500.95
|
| 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 |
$473.12
|
| Rate for Payer: PACE Medicare |
$123.02
|
| Rate for Payer: PACE SWMI |
$129.49
|
| Rate for Payer: PHP Commercial |
$473.12
|
| 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 |
$361.80
|
| Rate for Payer: Priority Health Medicare |
$129.49
|
| Rate for Payer: Priority Health SBD |
$350.66
|
| Rate for Payer: Railroad Medicare Medicare |
$129.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.50
|
| Rate for Payer: UHC Core |
$411.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.49
|
| Rate for Payer: UHC Exchange |
$411.89
|
| Rate for Payer: UHC Medicare Advantage |
$129.49
|
| Rate for Payer: UHCCP Medicaid |
$72.90
|
| Rate for Payer: VA VA |
$129.49
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
IP
|
$556.61
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$350.66 |
| Max. Negotiated Rate |
$500.95 |
| Rate for Payer: Aetna Commercial |
$473.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.80
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cofinity Commercial |
$389.63
|
| Rate for Payer: Cofinity Commercial |
$478.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$389.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.29
|
| Rate for Payer: Healthscope Commercial |
$500.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.12
|
| Rate for Payer: PHP Commercial |
$473.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.80
|
| Rate for Payer: Priority Health SBD |
$350.66
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
IP
|
$493.59
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$310.96 |
| Max. Negotiated Rate |
$444.23 |
| Rate for Payer: Aetna Commercial |
$419.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.83
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cofinity Commercial |
$345.51
|
| Rate for Payer: Cofinity Commercial |
$424.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.87
|
| Rate for Payer: Healthscope Commercial |
$444.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.55
|
| Rate for Payer: PHP Commercial |
$419.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.83
|
| Rate for Payer: Priority Health SBD |
$310.96
|
|
