|
INFECTIONS OF UPPER RESPIRATORY TRACT
|
Facility
|
IP
|
$4,910.31
|
|
|
Service Code
|
APR-DRG 1133
|
| Min. Negotiated Rate |
$4,676.49 |
| Max. Negotiated Rate |
$4,910.31 |
| Rate for Payer: BCBS Complete |
$4,910.31
|
| Rate for Payer: Mclaren Medicaid |
$4,676.49
|
| Rate for Payer: Meridian Medicaid |
$4,910.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,676.49
|
| Rate for Payer: UHC Medicaid |
$4,676.49
|
| Rate for Payer: UHCCP Medicaid |
$4,676.49
|
|
|
INFECTIONS OF UPPER RESPIRATORY TRACT
|
Facility
|
IP
|
$8,977.88
|
|
|
Service Code
|
APR-DRG 1134
|
| Min. Negotiated Rate |
$8,550.36 |
| Max. Negotiated Rate |
$8,977.88 |
| Rate for Payer: BCBS Complete |
$8,977.88
|
| Rate for Payer: Mclaren Medicaid |
$8,550.36
|
| Rate for Payer: Meridian Medicaid |
$8,977.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,550.36
|
| Rate for Payer: UHC Medicaid |
$8,550.36
|
| Rate for Payer: UHCCP Medicaid |
$8,550.36
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$21,345.68
|
|
|
Service Code
|
APR-DRG 7104
|
| Min. Negotiated Rate |
$20,329.22 |
| Max. Negotiated Rate |
$21,345.68 |
| Rate for Payer: BCBS Complete |
$21,345.68
|
| Rate for Payer: Mclaren Medicaid |
$20,329.22
|
| Rate for Payer: Meridian Medicaid |
$21,345.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,329.22
|
| Rate for Payer: UHC Medicaid |
$20,329.22
|
| Rate for Payer: UHCCP Medicaid |
$20,329.22
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$8,675.18
|
|
|
Service Code
|
APR-DRG 7102
|
| Min. Negotiated Rate |
$8,262.07 |
| Max. Negotiated Rate |
$8,675.18 |
| Rate for Payer: BCBS Complete |
$8,675.18
|
| Rate for Payer: Mclaren Medicaid |
$8,262.07
|
| Rate for Payer: Meridian Medicaid |
$8,675.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,262.07
|
| Rate for Payer: UHC Medicaid |
$8,262.07
|
| Rate for Payer: UHCCP Medicaid |
$8,262.07
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$8,097.86
|
|
|
Service Code
|
APR-DRG 7101
|
| Min. Negotiated Rate |
$7,712.25 |
| Max. Negotiated Rate |
$8,097.86 |
| Rate for Payer: BCBS Complete |
$8,097.86
|
| Rate for Payer: Mclaren Medicaid |
$7,712.25
|
| Rate for Payer: Meridian Medicaid |
$8,097.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,712.25
|
| Rate for Payer: UHC Medicaid |
$7,712.25
|
| Rate for Payer: UHCCP Medicaid |
$7,712.25
|
|
|
INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE
|
Facility
|
IP
|
$14,341.67
|
|
|
Service Code
|
APR-DRG 7103
|
| Min. Negotiated Rate |
$13,658.74 |
| Max. Negotiated Rate |
$14,341.67 |
| Rate for Payer: BCBS Complete |
$14,341.67
|
| Rate for Payer: Mclaren Medicaid |
$13,658.74
|
| Rate for Payer: Meridian Medicaid |
$14,341.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,658.74
|
| Rate for Payer: UHC Medicaid |
$13,658.74
|
| Rate for Payer: UHCCP Medicaid |
$13,658.74
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$32,569.03
|
|
|
Service Code
|
MSDRG 854
|
| Min. Negotiated Rate |
$15,219.72 |
| Max. Negotiated Rate |
$32,569.03 |
| Rate for Payer: Aetna Medicare |
$16,661.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,025.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,025.95
|
| Rate for Payer: BCBS MAPPO |
$16,020.76
|
| Rate for Payer: BCBS Trust/PPO |
$25,830.73
|
| Rate for Payer: BCN Commercial |
$25,830.73
|
| Rate for Payer: BCN Medicare Advantage |
$16,020.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,020.76
|
| Rate for Payer: Mclaren Medicare |
$16,020.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,821.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,423.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,622.84
|
| Rate for Payer: Nomi Health Commercial |
$25,775.49
|
| Rate for Payer: PACE Medicare |
$15,219.72
|
| Rate for Payer: PACE SWMI |
$16,020.76
|
| Rate for Payer: PHP Medicare Advantage |
$16,020.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$32,213.65
|
| Rate for Payer: Priority Health Medicare |
$16,020.76
|
| Rate for Payer: Priority Health Tiered Network |
$25,770.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16,020.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32,569.03
|
| Rate for Payer: UHC Core |
$27,248.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,020.76
|
| Rate for Payer: UHC Exchange |
$22,252.84
|
| Rate for Payer: VA VA |
$16,020.76
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$80,499.18
|
|
|
Service Code
|
MSDRG 853
|
| Min. Negotiated Rate |
$36,808.35 |
| Max. Negotiated Rate |
$80,499.18 |
| Rate for Payer: Aetna Medicare |
$40,295.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48,432.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48,432.04
|
| Rate for Payer: BCBS MAPPO |
$38,745.63
|
| Rate for Payer: BCBS Trust/PPO |
$75,312.90
|
| Rate for Payer: BCN Commercial |
$75,312.90
|
| Rate for Payer: BCN Medicare Advantage |
$38,745.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38,745.63
|
| Rate for Payer: Mclaren Medicare |
$38,745.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40,682.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,557.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$42,620.19
|
| Rate for Payer: Nomi Health Commercial |
$63,707.94
|
| Rate for Payer: PACE Medicare |
$36,808.35
|
| Rate for Payer: PACE SWMI |
$38,745.63
|
| Rate for Payer: PHP Medicare Advantage |
$38,745.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$79,620.80
|
| Rate for Payer: Priority Health Medicare |
$38,745.63
|
| Rate for Payer: Priority Health Tiered Network |
$63,696.63
|
| Rate for Payer: Railroad Medicare Medicare |
$38,745.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80,499.18
|
| Rate for Payer: UHC Core |
$67,347.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38,745.63
|
| Rate for Payer: UHC Exchange |
$55,001.19
|
| Rate for Payer: VA VA |
$38,745.63
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$24,404.36
|
|
|
Service Code
|
MSDRG 855
|
| Min. Negotiated Rate |
$11,542.22 |
| Max. Negotiated Rate |
$24,404.36 |
| Rate for Payer: Aetna Medicare |
$12,635.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,187.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,187.14
|
| Rate for Payer: BCBS MAPPO |
$12,149.71
|
| Rate for Payer: BCBS Trust/PPO |
$20,460.93
|
| Rate for Payer: BCN Commercial |
$20,460.93
|
| Rate for Payer: BCN Medicare Advantage |
$12,149.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,149.71
|
| Rate for Payer: Mclaren Medicare |
$12,149.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,757.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,972.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,364.68
|
| Rate for Payer: Nomi Health Commercial |
$19,313.88
|
| Rate for Payer: PACE Medicare |
$11,542.22
|
| Rate for Payer: PACE SWMI |
$12,149.71
|
| Rate for Payer: PHP Medicare Advantage |
$12,149.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,138.07
|
| Rate for Payer: Priority Health Medicare |
$12,149.71
|
| Rate for Payer: Priority Health Tiered Network |
$19,310.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12,149.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,404.36
|
| Rate for Payer: UHC Core |
$20,417.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,149.71
|
| Rate for Payer: UHC Exchange |
$16,674.32
|
| Rate for Payer: VA VA |
$12,149.71
|
|
|
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$24,171.27
|
|
|
Service Code
|
MSDRG 727
|
| Min. Negotiated Rate |
$11,437.22 |
| Max. Negotiated Rate |
$24,171.27 |
| Rate for Payer: Aetna Medicare |
$12,520.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,048.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,048.98
|
| Rate for Payer: BCBS MAPPO |
$12,039.18
|
| Rate for Payer: BCBS Trust/PPO |
$23,148.17
|
| Rate for Payer: BCN Commercial |
$23,148.17
|
| Rate for Payer: BCN Medicare Advantage |
$12,039.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,039.18
|
| Rate for Payer: Mclaren Medicare |
$12,039.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,641.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,845.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,243.10
|
| Rate for Payer: Nomi Health Commercial |
$19,129.41
|
| Rate for Payer: PACE Medicare |
$11,437.22
|
| Rate for Payer: PACE SWMI |
$12,039.18
|
| Rate for Payer: PHP Medicare Advantage |
$12,039.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,907.52
|
| Rate for Payer: Priority Health Medicare |
$12,039.18
|
| Rate for Payer: Priority Health Tiered Network |
$19,126.01
|
| Rate for Payer: Railroad Medicare Medicare |
$12,039.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,171.27
|
| Rate for Payer: UHC Core |
$20,222.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,039.18
|
| Rate for Payer: UHC Exchange |
$16,515.06
|
| Rate for Payer: VA VA |
$12,039.18
|
|
|
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$13,222.56
|
|
|
Service Code
|
MSDRG 728
|
| Min. Negotiated Rate |
$6,505.74 |
| Max. Negotiated Rate |
$13,222.56 |
| Rate for Payer: Aetna Medicare |
$7,122.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,560.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,560.19
|
| Rate for Payer: BCBS MAPPO |
$6,848.15
|
| Rate for Payer: BCBS Trust/PPO |
$10,086.51
|
| Rate for Payer: BCN Commercial |
$10,086.51
|
| Rate for Payer: BCN Medicare Advantage |
$6,848.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,848.15
|
| Rate for Payer: Mclaren Medicare |
$6,848.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,190.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,875.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,532.97
|
| Rate for Payer: Nomi Health Commercial |
$10,464.48
|
| Rate for Payer: PACE Medicare |
$6,505.74
|
| Rate for Payer: PACE SWMI |
$6,848.15
|
| Rate for Payer: PHP Medicare Advantage |
$6,848.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13,078.28
|
| Rate for Payer: Priority Health Medicare |
$6,848.15
|
| Rate for Payer: Priority Health Tiered Network |
$10,462.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6,848.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,222.56
|
| Rate for Payer: UHC Core |
$11,062.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,848.15
|
| Rate for Payer: UHC Exchange |
$9,034.33
|
| Rate for Payer: VA VA |
$6,848.15
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$10,881.23
|
|
|
Service Code
|
APR-DRG 2454
|
| Min. Negotiated Rate |
$10,363.08 |
| Max. Negotiated Rate |
$10,881.23 |
| Rate for Payer: BCBS Complete |
$10,881.23
|
| Rate for Payer: Mclaren Medicaid |
$10,363.08
|
| Rate for Payer: Meridian Medicaid |
$10,881.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,363.08
|
| Rate for Payer: UHC Medicaid |
$10,363.08
|
| Rate for Payer: UHCCP Medicaid |
$10,363.08
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$7,654.13
|
|
|
Service Code
|
APR-DRG 2453
|
| Min. Negotiated Rate |
$7,289.65 |
| Max. Negotiated Rate |
$7,654.13 |
| Rate for Payer: BCBS Complete |
$7,654.13
|
| Rate for Payer: Mclaren Medicaid |
$7,289.65
|
| Rate for Payer: Meridian Medicaid |
$7,654.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,289.65
|
| Rate for Payer: UHC Medicaid |
$7,289.65
|
| Rate for Payer: UHCCP Medicaid |
$7,289.65
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$3,479.36
|
|
|
Service Code
|
APR-DRG 2451
|
| Min. Negotiated Rate |
$3,313.67 |
| Max. Negotiated Rate |
$3,479.36 |
| Rate for Payer: BCBS Complete |
$3,479.36
|
| Rate for Payer: Mclaren Medicaid |
$3,313.67
|
| Rate for Payer: Meridian Medicaid |
$3,479.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,313.67
|
| Rate for Payer: UHC Medicaid |
$3,313.67
|
| Rate for Payer: UHCCP Medicaid |
$3,313.67
|
|
|
INFLAMMATORY BOWEL DISEASE
|
Facility
|
IP
|
$4,932.10
|
|
|
Service Code
|
APR-DRG 2452
|
| Min. Negotiated Rate |
$4,697.24 |
| Max. Negotiated Rate |
$4,932.10 |
| Rate for Payer: BCBS Complete |
$4,932.10
|
| Rate for Payer: Mclaren Medicaid |
$4,697.24
|
| Rate for Payer: Meridian Medicaid |
$4,932.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,697.24
|
| Rate for Payer: UHC Medicaid |
$4,697.24
|
| Rate for Payer: UHCCP Medicaid |
$4,697.24
|
|
|
INFLAMMATORY BOWEL DISEASE WITH CC
|
Facility
|
IP
|
$18,230.15
|
|
|
Service Code
|
MSDRG 386
|
| Min. Negotiated Rate |
$7,717.87 |
| Max. Negotiated Rate |
$18,230.15 |
| Rate for Payer: Aetna Medicare |
$8,449.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,155.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,155.09
|
| Rate for Payer: BCBS MAPPO |
$8,124.07
|
| Rate for Payer: BCBS Trust/PPO |
$18,230.15
|
| Rate for Payer: BCN Commercial |
$18,230.15
|
| Rate for Payer: BCN Medicare Advantage |
$8,124.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,124.07
|
| Rate for Payer: Mclaren Medicare |
$8,124.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,530.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,342.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,936.48
|
| Rate for Payer: Nomi Health Commercial |
$12,594.27
|
| Rate for Payer: PACE Medicare |
$7,717.87
|
| Rate for Payer: PACE SWMI |
$8,124.07
|
| Rate for Payer: PHP Medicare Advantage |
$8,124.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15,740.05
|
| Rate for Payer: Priority Health Medicare |
$8,124.07
|
| Rate for Payer: Priority Health Tiered Network |
$12,592.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8,124.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,913.69
|
| Rate for Payer: UHC Core |
$13,313.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,124.07
|
| Rate for Payer: UHC Exchange |
$10,873.05
|
| Rate for Payer: VA VA |
$8,124.07
|
|
|
INFLAMMATORY BOWEL DISEASE WITH MCC
|
Facility
|
IP
|
$25,791.49
|
|
|
Service Code
|
MSDRG 385
|
| Min. Negotiated Rate |
$12,167.01 |
| Max. Negotiated Rate |
$25,791.49 |
| Rate for Payer: Aetna Medicare |
$13,319.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,009.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,009.23
|
| Rate for Payer: BCBS MAPPO |
$12,807.38
|
| Rate for Payer: BCBS Trust/PPO |
$24,470.72
|
| Rate for Payer: BCN Commercial |
$24,470.72
|
| Rate for Payer: BCN Medicare Advantage |
$12,807.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,807.38
|
| Rate for Payer: Mclaren Medicare |
$12,807.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,447.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,728.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,088.12
|
| Rate for Payer: Nomi Health Commercial |
$20,411.67
|
| Rate for Payer: PACE Medicare |
$12,167.01
|
| Rate for Payer: PACE SWMI |
$12,807.38
|
| Rate for Payer: PHP Medicare Advantage |
$12,807.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,510.06
|
| Rate for Payer: Priority Health Medicare |
$12,807.38
|
| Rate for Payer: Priority Health Tiered Network |
$20,408.05
|
| Rate for Payer: Railroad Medicare Medicare |
$12,807.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,791.49
|
| Rate for Payer: UHC Core |
$21,577.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,807.38
|
| Rate for Payer: UHC Exchange |
$17,622.08
|
| Rate for Payer: VA VA |
$12,807.38
|
|
|
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$12,469.44
|
|
|
Service Code
|
MSDRG 387
|
| Min. Negotiated Rate |
$5,552.03 |
| Max. Negotiated Rate |
$12,469.44 |
| Rate for Payer: Aetna Medicare |
$6,078.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,305.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,305.30
|
| Rate for Payer: BCBS MAPPO |
$5,844.24
|
| Rate for Payer: BCBS Trust/PPO |
$12,469.44
|
| Rate for Payer: BCN Commercial |
$12,469.44
|
| Rate for Payer: BCN Medicare Advantage |
$5,844.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,844.24
|
| Rate for Payer: Mclaren Medicare |
$5,844.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,136.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,720.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,428.66
|
| Rate for Payer: Nomi Health Commercial |
$8,788.77
|
| Rate for Payer: PACE Medicare |
$5,552.03
|
| Rate for Payer: PACE SWMI |
$5,844.24
|
| Rate for Payer: PHP Medicare Advantage |
$5,844.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,984.01
|
| Rate for Payer: Priority Health Medicare |
$5,844.24
|
| Rate for Payer: Priority Health Tiered Network |
$8,787.21
|
| Rate for Payer: Railroad Medicare Medicare |
$5,844.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,105.19
|
| Rate for Payer: UHC Core |
$9,290.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,844.24
|
| Rate for Payer: UHC Exchange |
$7,587.64
|
| Rate for Payer: VA VA |
$5,844.24
|
|
|
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3,641.80
|
|
|
Service Code
|
HCPCS J1745
|
| Hospital Charge Code |
23796
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$3,277.62 |
| Rate for Payer: Aetna Commercial |
$3,095.53
|
| Rate for Payer: Aetna Commercial |
$1,259.06
|
| Rate for Payer: Aetna Medicare |
$32.28
|
| Rate for Payer: Aetna Medicare |
$32.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.80
|
| Rate for Payer: BCBS Complete |
$17.05
|
| Rate for Payer: BCBS Complete |
$17.05
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCBS Trust/PPO |
$81.33
|
| Rate for Payer: BCBS Trust/PPO |
$81.33
|
| Rate for Payer: BCN Commercial |
$81.33
|
| Rate for Payer: BCN Commercial |
$81.33
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: Cash Price |
$1,185.00
|
| Rate for Payer: Cash Price |
$1,185.00
|
| Rate for Payer: Cash Price |
$2,913.44
|
| Rate for Payer: Cash Price |
$2,913.44
|
| Rate for Payer: Cofinity Advantage |
$2,549.26
|
| Rate for Payer: Cofinity Advantage |
$1,036.88
|
| Rate for Payer: Cofinity Commercial |
$3,131.95
|
| Rate for Payer: Cofinity Commercial |
$1,273.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$1,333.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.62
|
| Rate for Payer: Mclaren Medicaid |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$16.23
|
| Rate for Payer: Mclaren Medicare |
$31.04
|
| Rate for Payer: Mclaren Medicare |
$31.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.59
|
| Rate for Payer: Meridian Medicaid |
$32.59
|
| Rate for Payer: Meridian Medicaid |
$32.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.53
|
| Rate for Payer: Nomi Health Commercial |
$93.12
|
| Rate for Payer: Nomi Health Commercial |
$93.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.94
|
| Rate for Payer: PACE Medicare |
$29.49
|
| Rate for Payer: PACE Medicare |
$29.49
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PHP Commercial |
$1,259.06
|
| Rate for Payer: PHP Commercial |
$3,095.53
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.06
|
| Rate for Payer: Priority Health Medicare |
$31.04
|
| Rate for Payer: Priority Health Medicare |
$31.04
|
| Rate for Payer: Priority Health SBD |
$2,294.33
|
| Rate for Payer: Priority Health SBD |
$933.19
|
| Rate for Payer: Priority Health Tiered Network |
$78.45
|
| Rate for Payer: Priority Health Tiered Network |
$78.45
|
| Rate for Payer: Railroad Medicare Medicare |
$31.04
|
| Rate for Payer: Railroad Medicare Medicare |
$31.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.49
|
| Rate for Payer: UHC Core |
$53.49
|
| Rate for Payer: UHC Core |
$53.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.04
|
| Rate for Payer: UHC Exchange |
$53.49
|
| Rate for Payer: UHC Exchange |
$53.49
|
| Rate for Payer: UHC Medicaid |
$16.23
|
| Rate for Payer: UHC Medicaid |
$16.23
|
| Rate for Payer: UHCCP Medicaid |
$16.23
|
| Rate for Payer: UHCCP Medicaid |
$16.23
|
| Rate for Payer: VA VA |
$31.04
|
| Rate for Payer: VA VA |
$31.04
|
|
|
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3,641.80
|
|
|
Service Code
|
HCPCS J1745
|
| Hospital Charge Code |
23796
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,294.33 |
| Max. Negotiated Rate |
$3,277.62 |
| Rate for Payer: Aetna Commercial |
$3,095.53
|
| Rate for Payer: Aetna Commercial |
$1,259.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.81
|
| Rate for Payer: Cash Price |
$1,185.00
|
| Rate for Payer: Cash Price |
$2,913.44
|
| Rate for Payer: Cofinity Advantage |
$2,549.26
|
| Rate for Payer: Cofinity Advantage |
$1,036.88
|
| Rate for Payer: Cofinity Commercial |
$1,273.88
|
| Rate for Payer: Cofinity Commercial |
$3,131.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.00
|
| Rate for Payer: Healthscope Commercial |
$3,277.62
|
| Rate for Payer: Healthscope Commercial |
$1,333.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.35
|
| Rate for Payer: PHP Commercial |
$1,259.06
|
| Rate for Payer: PHP Commercial |
$3,095.53
|
| Rate for Payer: Priority Health SBD |
$2,294.33
|
| Rate for Payer: Priority Health SBD |
$933.19
|
|
|
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,253.12
|
|
|
Service Code
|
HCPCS Q5104
|
| Hospital Charge Code |
184064
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.02 |
| Max. Negotiated Rate |
$1,127.81 |
| Rate for Payer: Aetna Commercial |
$1,065.15
|
| Rate for Payer: Aetna Commercial |
$1,259.72
|
| Rate for Payer: Aetna Medicare |
$27.87
|
| Rate for Payer: Aetna Medicare |
$27.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.50
|
| Rate for Payer: BCBS Complete |
$14.72
|
| Rate for Payer: BCBS Complete |
$14.72
|
| Rate for Payer: BCBS MAPPO |
$26.80
|
| Rate for Payer: BCBS MAPPO |
$26.80
|
| Rate for Payer: BCBS Trust/PPO |
$67.30
|
| Rate for Payer: BCBS Trust/PPO |
$67.30
|
| Rate for Payer: BCN Commercial |
$67.30
|
| Rate for Payer: BCN Commercial |
$67.30
|
| Rate for Payer: BCN Medicare Advantage |
$26.80
|
| Rate for Payer: BCN Medicare Advantage |
$26.80
|
| Rate for Payer: Cash Price |
$1,002.50
|
| Rate for Payer: Cash Price |
$1,185.62
|
| Rate for Payer: Cash Price |
$1,185.62
|
| Rate for Payer: Cash Price |
$1,002.50
|
| Rate for Payer: Cofinity Advantage |
$1,037.41
|
| Rate for Payer: Cofinity Advantage |
$877.18
|
| Rate for Payer: Cofinity Commercial |
$1,274.54
|
| Rate for Payer: Cofinity Commercial |
$1,077.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$1,127.81
|
| Rate for Payer: Healthscope Commercial |
$1,333.82
|
| Rate for Payer: Mclaren Medicaid |
$14.02
|
| Rate for Payer: Mclaren Medicaid |
$14.02
|
| Rate for Payer: Mclaren Medicare |
$26.80
|
| Rate for Payer: Mclaren Medicare |
$26.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.14
|
| Rate for Payer: Meridian Medicaid |
$28.14
|
| Rate for Payer: Meridian Medicaid |
$28.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.72
|
| Rate for Payer: Nomi Health Commercial |
$80.40
|
| Rate for Payer: Nomi Health Commercial |
$80.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$939.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.52
|
| Rate for Payer: PACE Medicare |
$25.46
|
| Rate for Payer: PACE Medicare |
$25.46
|
| Rate for Payer: PACE SWMI |
$26.80
|
| Rate for Payer: PACE SWMI |
$26.80
|
| Rate for Payer: PHP Commercial |
$1,259.72
|
| Rate for Payer: PHP Commercial |
$1,065.15
|
| Rate for Payer: PHP Medicare Advantage |
$26.80
|
| Rate for Payer: PHP Medicare Advantage |
$26.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.14
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health SBD |
$933.67
|
| Rate for Payer: Priority Health SBD |
$789.47
|
| Rate for Payer: Priority Health Tiered Network |
$68.11
|
| Rate for Payer: Priority Health Tiered Network |
$68.11
|
| Rate for Payer: Railroad Medicare Medicare |
$26.80
|
| Rate for Payer: Railroad Medicare Medicare |
$26.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.79
|
| Rate for Payer: UHC Core |
$45.79
|
| Rate for Payer: UHC Core |
$45.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.80
|
| Rate for Payer: UHC Exchange |
$45.79
|
| Rate for Payer: UHC Exchange |
$45.79
|
| Rate for Payer: UHC Medicaid |
$14.02
|
| Rate for Payer: UHC Medicaid |
$14.02
|
| Rate for Payer: UHCCP Medicaid |
$14.02
|
| Rate for Payer: UHCCP Medicaid |
$14.02
|
| Rate for Payer: VA VA |
$26.80
|
| Rate for Payer: VA VA |
$26.80
|
|
|
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,253.12
|
|
|
Service Code
|
HCPCS Q5104
|
| Hospital Charge Code |
184064
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$789.47 |
| Max. Negotiated Rate |
$1,127.81 |
| Rate for Payer: Aetna Commercial |
$1,065.15
|
| Rate for Payer: Aetna Commercial |
$1,259.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.31
|
| Rate for Payer: Cash Price |
$1,002.50
|
| Rate for Payer: Cash Price |
$1,185.62
|
| Rate for Payer: Cofinity Advantage |
$877.18
|
| Rate for Payer: Cofinity Advantage |
$1,037.41
|
| Rate for Payer: Cofinity Commercial |
$1,077.68
|
| Rate for Payer: Cofinity Commercial |
$1,274.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.50
|
| Rate for Payer: Healthscope Commercial |
$1,333.82
|
| Rate for Payer: Healthscope Commercial |
$1,127.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$939.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.52
|
| Rate for Payer: PHP Commercial |
$1,065.15
|
| Rate for Payer: PHP Commercial |
$1,259.72
|
| Rate for Payer: Priority Health SBD |
$789.47
|
| Rate for Payer: Priority Health SBD |
$933.67
|
|
|
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,818.98
|
|
|
Service Code
|
HCPCS Q5103
|
| Hospital Charge Code |
181037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.62 |
| Max. Negotiated Rate |
$1,637.08 |
| Rate for Payer: Aetna Commercial |
$1,546.13
|
| Rate for Payer: Aetna Medicare |
$27.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.55
|
| Rate for Payer: BCBS Complete |
$14.30
|
| Rate for Payer: BCBS MAPPO |
$26.04
|
| Rate for Payer: BCBS Trust/PPO |
$111.13
|
| Rate for Payer: BCN Commercial |
$111.13
|
| Rate for Payer: BCN Medicare Advantage |
$26.04
|
| Rate for Payer: Cash Price |
$1,455.18
|
| Rate for Payer: Cash Price |
$1,455.18
|
| Rate for Payer: Cofinity Advantage |
$1,273.29
|
| Rate for Payer: Cofinity Commercial |
$1,564.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.04
|
| Rate for Payer: Healthscope Commercial |
$1,637.08
|
| Rate for Payer: Mclaren Medicaid |
$13.62
|
| Rate for Payer: Mclaren Medicare |
$26.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.34
|
| Rate for Payer: Meridian Medicaid |
$27.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,546.13
|
| Rate for Payer: Nomi Health Commercial |
$78.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,364.23
|
| Rate for Payer: PACE Medicare |
$24.74
|
| Rate for Payer: PACE SWMI |
$26.04
|
| Rate for Payer: PHP Commercial |
$1,546.13
|
| Rate for Payer: PHP Medicare Advantage |
$26.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63.06
|
| Rate for Payer: Priority Health Medicare |
$26.04
|
| Rate for Payer: Priority Health SBD |
$1,145.96
|
| Rate for Payer: Priority Health Tiered Network |
$50.45
|
| Rate for Payer: Railroad Medicare Medicare |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.96
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.04
|
| Rate for Payer: UHC Exchange |
$39.96
|
| Rate for Payer: UHC Medicaid |
$13.62
|
| Rate for Payer: UHCCP Medicaid |
$13.62
|
| Rate for Payer: VA VA |
$26.04
|
|
|
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,818.98
|
|
|
Service Code
|
HCPCS Q5103
|
| Hospital Charge Code |
181037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,145.96 |
| Max. Negotiated Rate |
$1,637.08 |
| Rate for Payer: Aetna Commercial |
$1,546.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.34
|
| Rate for Payer: Cash Price |
$1,455.18
|
| Rate for Payer: Cofinity Advantage |
$1,273.29
|
| Rate for Payer: Cofinity Commercial |
$1,564.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.18
|
| Rate for Payer: Healthscope Commercial |
$1,637.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,546.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,364.23
|
| Rate for Payer: PHP Commercial |
$1,546.13
|
| Rate for Payer: Priority Health SBD |
$1,145.96
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC
|
Facility
|
IP
|
$27,869.56
|
|
|
Service Code
|
MSDRG 351
|
| Min. Negotiated Rate |
$11,742.64 |
| Max. Negotiated Rate |
$27,869.56 |
| Rate for Payer: Aetna Medicare |
$12,855.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,450.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,450.84
|
| Rate for Payer: BCBS MAPPO |
$12,360.67
|
| Rate for Payer: BCBS Trust/PPO |
$27,869.56
|
| Rate for Payer: BCN Commercial |
$27,869.56
|
| Rate for Payer: BCN Medicare Advantage |
$12,360.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,360.67
|
| Rate for Payer: Mclaren Medicare |
$12,360.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,978.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,214.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,596.74
|
| Rate for Payer: Nomi Health Commercial |
$19,666.05
|
| Rate for Payer: PACE Medicare |
$11,742.64
|
| Rate for Payer: PACE SWMI |
$12,360.67
|
| Rate for Payer: PHP Medicare Advantage |
$12,360.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24,578.20
|
| Rate for Payer: Priority Health Medicare |
$12,360.67
|
| Rate for Payer: Priority Health Tiered Network |
$19,662.56
|
| Rate for Payer: Railroad Medicare Medicare |
$12,360.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,849.35
|
| Rate for Payer: UHC Core |
$20,789.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,360.67
|
| Rate for Payer: UHC Exchange |
$16,978.36
|
| Rate for Payer: VA VA |
$12,360.67
|
|
