|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$557.54 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.24
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Advantage |
$619.49
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: Priority Health SBD |
$557.54
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$432.30
|
| Rate for Payer: BCN Commercial |
$432.30
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Advantage |
$619.49
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$557.54
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.24
|
| Rate for Payer: UHC Core |
$461.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$347.80
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$557.54 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.24
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Advantage |
$619.49
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: Priority Health SBD |
$557.54
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$432.30
|
| Rate for Payer: BCN Commercial |
$432.30
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Advantage |
$619.49
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$557.54
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.24
|
| Rate for Payer: UHC Core |
$461.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$347.80
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
OP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$948.29 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: Aetna Medicare |
$1,206.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.42
|
| Rate for Payer: BCBS Complete |
$965.18
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Advantage |
$1,689.07
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,930.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.72
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: Priority Health SBD |
$1,520.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,568.42
|
| Rate for Payer: UHC Core |
$1,257.15
|
| Rate for Payer: UHC Exchange |
$948.29
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
IP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,520.16 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.42
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Advantage |
$1,689.07
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.72
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: Priority Health SBD |
$1,520.16
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
OP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,158.74 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: Aetna Medicare |
$1,474.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,916.50
|
| Rate for Payer: BCBS Complete |
$1,179.38
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Advantage |
$2,063.92
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,358.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,211.34
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: Priority Health SBD |
$1,857.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,916.50
|
| Rate for Payer: UHC Core |
$1,536.15
|
| Rate for Payer: UHC Exchange |
$1,158.74
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
IP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,857.53 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,916.50
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Advantage |
$2,063.92
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,211.34
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: Priority Health SBD |
$1,857.53
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$416.23
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$262.22 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.55
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Advantage |
$291.36
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: Priority Health SBD |
$262.22
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$416.23
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$166.49 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: Aetna Medicare |
$208.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.55
|
| Rate for Payer: BCBS Complete |
$166.49
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Advantage |
$291.36
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: Priority Health SBD |
$262.22
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$30.66
|
| Rate for Payer: BCN Commercial |
$30.66
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UHCCP Medicaid |
$144.00
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,994.30
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,666.41 |
| Max. Negotiated Rate |
$8,094.87 |
| Rate for Payer: Aetna Commercial |
$7,645.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,846.30
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cofinity Advantage |
$6,296.01
|
| Rate for Payer: Cofinity Commercial |
$7,735.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,195.44
|
| Rate for Payer: Healthscope Commercial |
$8,094.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,645.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,745.73
|
| Rate for Payer: PHP Commercial |
$7,645.15
|
| Rate for Payer: Priority Health SBD |
$5,666.41
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,994.30
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$168.84 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$7,645.15
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,846.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$168.84
|
| Rate for Payer: BCN Commercial |
$168.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cofinity Advantage |
$6,296.01
|
| Rate for Payer: Cofinity Commercial |
$7,735.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,195.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$8,094.87
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,645.15
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,745.73
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$7,645.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$5,666.41
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,846.30
|
| Rate for Payer: UHC Core |
$4,686.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$3,534.76
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$5,118.57
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,224.70 |
| Max. Negotiated Rate |
$4,606.71 |
| Rate for Payer: Aetna Commercial |
$4,350.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,327.07
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cofinity Advantage |
$3,583.00
|
| Rate for Payer: Cofinity Commercial |
$4,401.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,094.86
|
| Rate for Payer: Healthscope Commercial |
$4,606.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,350.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,838.93
|
| Rate for Payer: PHP Commercial |
$4,350.78
|
| Rate for Payer: Priority Health SBD |
$3,224.70
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$5,118.57
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$165.82 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$4,350.78
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,327.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$165.82
|
| Rate for Payer: BCN Commercial |
$165.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cofinity Advantage |
$3,583.00
|
| Rate for Payer: Cofinity Commercial |
$4,401.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,094.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,606.71
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,350.78
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,838.93
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,350.78
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$3,224.70
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,327.07
|
| Rate for Payer: UHC Core |
$2,666.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$2,011.60
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,491.21
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$236.98 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$2,117.53
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,619.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$236.98
|
| Rate for Payer: BCN Commercial |
$236.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cofinity Advantage |
$1,743.85
|
| Rate for Payer: Cofinity Commercial |
$2,142.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,242.09
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.53
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.41
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,117.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,569.46
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,619.29
|
| Rate for Payer: UHC Core |
$1,297.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$979.05
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,491.21
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,569.46 |
| Max. Negotiated Rate |
$2,242.09 |
| Rate for Payer: Aetna Commercial |
$2,117.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,619.29
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cofinity Advantage |
$1,743.85
|
| Rate for Payer: Cofinity Commercial |
$2,142.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.97
|
| Rate for Payer: Healthscope Commercial |
$2,242.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.41
|
| Rate for Payer: PHP Commercial |
$2,117.53
|
| Rate for Payer: Priority Health SBD |
$1,569.46
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,832.02
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,154.17 |
| Max. Negotiated Rate |
$1,648.82 |
| Rate for Payer: Aetna Commercial |
$1,557.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,190.81
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cofinity Advantage |
$1,282.41
|
| Rate for Payer: Cofinity Commercial |
$1,575.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.62
|
| Rate for Payer: Healthscope Commercial |
$1,648.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,557.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.02
|
| Rate for Payer: PHP Commercial |
$1,557.22
|
| Rate for Payer: Priority Health SBD |
$1,154.17
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,832.02
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,648.82 |
| Rate for Payer: Aetna Commercial |
$1,557.22
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,190.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$676.58
|
| Rate for Payer: BCN Commercial |
$676.58
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cofinity Advantage |
$1,282.41
|
| Rate for Payer: Cofinity Commercial |
$1,575.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,648.82
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,557.22
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.02
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,557.22
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,154.17
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.81
|
| Rate for Payer: UHC Core |
$954.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$719.98
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,737.42
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,984.57 |
| Max. Negotiated Rate |
$4,263.68 |
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,079.32
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Advantage |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: Priority Health SBD |
$2,984.57
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,737.42
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,460.54 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,079.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.54
|
| Rate for Payer: BCN Commercial |
$1,460.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Advantage |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Mclaren Medicaid |
$1,645.43
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,984.57
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$905.22 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.96
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Advantage |
$1,005.80
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: Priority Health SBD |
$905.22
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$676.58
|
| Rate for Payer: BCN Commercial |
$676.58
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Advantage |
$1,005.80
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$905.22
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$933.96
|
| Rate for Payer: UHC Core |
$748.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$564.69
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$676.58
|
| Rate for Payer: BCN Commercial |
$676.58
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Advantage |
$1,005.80
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Mclaren Medicaid |
$124.34
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$905.22
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$933.96
|
| Rate for Payer: UHC Core |
$748.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$564.69
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: VA VA |
$237.74
|
|
