|
HC XR ELBOW 2 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
32000071
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.65 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$249.78 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
|
|
HC XR ELBOW BIL 3 VW
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000074
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$55.27
|
| Rate for Payer: BCN Commercial |
$55.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.71
|
| Rate for Payer: UHC Core |
$206.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$155.82
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ELBOW MIN 3 VW
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$55.27
|
| Rate for Payer: BCN Commercial |
$55.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR ELBOW MIN 3 VW
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
32000073
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.65 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
OP
|
$566.77
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.45 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: Aetna Medicare |
$283.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.40
|
| Rate for Payer: BCBS Complete |
$226.71
|
| Rate for Payer: BCBS Trust/PPO |
$179.45
|
| Rate for Payer: BCN Commercial |
$179.45
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Advantage |
$396.74
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$453.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: Priority Health SBD |
$357.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.40
|
| Rate for Payer: UHC Core |
$295.29
|
| Rate for Payer: UHC Exchange |
$222.74
|
|
|
HC XR ENDO RETROGRADE CHOLANGIOGR
|
Facility
|
IP
|
$566.77
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
32000154
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$357.07 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.40
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Advantage |
$396.74
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: Priority Health SBD |
$357.07
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
IP
|
$268.31
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.04 |
| Max. Negotiated Rate |
$241.48 |
| Rate for Payer: Aetna Commercial |
$228.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.40
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cofinity Advantage |
$187.82
|
| Rate for Payer: Cofinity Commercial |
$230.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.65
|
| Rate for Payer: Healthscope Commercial |
$241.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.23
|
| Rate for Payer: PHP Commercial |
$228.06
|
| Rate for Payer: Priority Health SBD |
$169.04
|
|
|
HC XR ESOPHAGEAL DILATION
|
Facility
|
OP
|
$268.31
|
|
|
Service Code
|
CPT 74360
|
| Hospital Charge Code |
32000297
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$105.45 |
| Max. Negotiated Rate |
$275.61 |
| Rate for Payer: Aetna Commercial |
$228.06
|
| Rate for Payer: Aetna Medicare |
$134.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.40
|
| Rate for Payer: BCBS Complete |
$107.32
|
| Rate for Payer: BCBS Trust/PPO |
$275.61
|
| Rate for Payer: BCN Commercial |
$275.61
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cofinity Advantage |
$187.82
|
| Rate for Payer: Cofinity Commercial |
$230.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.65
|
| Rate for Payer: Healthscope Commercial |
$241.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.23
|
| Rate for Payer: PHP Commercial |
$228.06
|
| Rate for Payer: Priority Health SBD |
$169.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.40
|
| Rate for Payer: UHC Core |
$139.79
|
| Rate for Payer: UHC Exchange |
$105.45
|
|
|
HC XR ESOPHAGUS
|
Facility
|
OP
|
$655.74
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$153.70
|
| Rate for Payer: BCN Commercial |
$153.70
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Advantage |
$459.02
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$413.12
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.23
|
| Rate for Payer: UHC Core |
$341.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$257.71
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR ESOPHAGUS
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 74220
|
| Hospital Charge Code |
32000136
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$413.12 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.23
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Advantage |
$459.02
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: Priority Health SBD |
$413.12
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
OP
|
$500.82
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$196.82 |
| Max. Negotiated Rate |
$450.74 |
| Rate for Payer: Aetna Commercial |
$425.70
|
| Rate for Payer: Aetna Medicare |
$250.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.53
|
| Rate for Payer: BCBS Complete |
$200.33
|
| Rate for Payer: BCBS Trust/PPO |
$216.54
|
| Rate for Payer: BCN Commercial |
$216.54
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cofinity Advantage |
$350.57
|
| Rate for Payer: Cofinity Commercial |
$430.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.66
|
| Rate for Payer: Healthscope Commercial |
$450.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.62
|
| Rate for Payer: PHP Commercial |
$425.70
|
| Rate for Payer: Priority Health SBD |
$315.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.53
|
| Rate for Payer: UHC Core |
$260.93
|
| Rate for Payer: UHC Exchange |
$196.82
|
|
|
HC XR ESOPHAGUS FB
|
Facility
|
IP
|
$500.82
|
|
|
Service Code
|
HCPCS 74235
|
| Hospital Charge Code |
32000296
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$315.52 |
| Max. Negotiated Rate |
$450.74 |
| Rate for Payer: Aetna Commercial |
$425.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.53
|
| Rate for Payer: Cash Price |
$400.66
|
| Rate for Payer: Cofinity Advantage |
$350.57
|
| Rate for Payer: Cofinity Commercial |
$430.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.66
|
| Rate for Payer: Healthscope Commercial |
$450.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.62
|
| Rate for Payer: PHP Commercial |
$425.70
|
| Rate for Payer: Priority Health SBD |
$315.52
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$413.12 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.23
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Advantage |
$459.02
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: Priority Health SBD |
$413.12
|
|
|
HC XR ESOPHAGUS HIGH DENSITY
|
Facility
|
OP
|
$655.74
|
|
|
Service Code
|
CPT 74221
|
| Hospital Charge Code |
32000330
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$170.36
|
| Rate for Payer: BCN Commercial |
$170.36
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Advantage |
$459.02
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Mclaren Medicaid |
$91.40
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$413.12
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.23
|
| Rate for Payer: UHC Core |
$341.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$257.71
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: VA VA |
$174.77
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
IP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$295.39 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.77
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Advantage |
$328.21
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: Priority Health SBD |
$295.39
|
|
|
HC XR EYE FOREIGN BODY PRE MRI
|
Facility
|
OP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$55.27
|
| Rate for Payer: BCN Commercial |
$55.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Advantage |
$328.21
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$295.39
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.77
|
| Rate for Payer: UHC Core |
$244.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$184.27
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
IP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$295.39 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.77
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Advantage |
$328.21
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: Priority Health SBD |
$295.39
|
|
|
HC XR EYE FOR FOREIGN BODY
|
Facility
|
OP
|
$468.87
|
|
|
Service Code
|
CPT 70030
|
| Hospital Charge Code |
32000004
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$421.98 |
| Rate for Payer: Aetna Commercial |
$398.54
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$55.27
|
| Rate for Payer: BCN Commercial |
$55.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cash Price |
$375.10
|
| Rate for Payer: Cofinity Advantage |
$328.21
|
| Rate for Payer: Cofinity Commercial |
$403.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$421.98
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.54
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.65
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$398.54
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$295.39
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.77
|
| Rate for Payer: UHC Core |
$244.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$184.27
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
OP
|
$353.86
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna Commercial |
$300.78
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.01
|
| 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 |
$77.99
|
| Rate for Payer: BCN Commercial |
$77.99
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$283.09
|
| Rate for Payer: Cash Price |
$283.09
|
| Rate for Payer: Cofinity Advantage |
$247.70
|
| Rate for Payer: Cofinity Commercial |
$304.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$318.47
|
| 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 |
$300.78
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.39
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$300.78
|
| 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 |
$222.93
|
| 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) |
$230.01
|
| Rate for Payer: UHC Core |
$184.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$139.07
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$104.17
|
|
|
HC XR FACIAL BONES MIN 3 VW
|
Facility
|
IP
|
$353.86
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
32000010
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$222.93 |
| Max. Negotiated Rate |
$318.47 |
| Rate for Payer: Aetna Commercial |
$300.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.01
|
| Rate for Payer: Cash Price |
$283.09
|
| Rate for Payer: Cofinity Advantage |
$247.70
|
| Rate for Payer: Cofinity Commercial |
$304.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.09
|
| Rate for Payer: Healthscope Commercial |
$318.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.39
|
| Rate for Payer: PHP Commercial |
$300.78
|
| Rate for Payer: Priority Health SBD |
$222.93
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$49.22
|
| Rate for Payer: BCN Commercial |
$49.22
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.69
|
| Rate for Payer: UHC Core |
$132.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$100.18
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
|
HC XR FEMUR 1 VIEW BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000341
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.59 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health SBD |
$160.59
|
|
|
HC XR FEMUR 2 VIEWS BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.59 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health SBD |
$160.59
|
|
|
HC XR FEMUR 2 VIEWS BILATERAL
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000336
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$61.33
|
| Rate for Payer: BCN Commercial |
$61.33
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$45.35
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.69
|
| Rate for Payer: UHC Core |
$132.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$100.18
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: VA VA |
$86.71
|
|
