|
OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 27829
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,218.76
|
| Rate for Payer: BCN Commercial |
$4,218.76
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILON OR TIBIAL PLAFOND), WITH INTERNAL FIXATION, WHEN PERFORMED; OF BOTH TIBIA AND FIBULA
|
Facility
|
OP
|
$41,369.85
|
|
|
Service Code
|
CPT 27828
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,543.65 |
| Max. Negotiated Rate |
$41,369.85 |
| Rate for Payer: Aetna Medicare |
$13,304.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,990.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,990.64
|
| Rate for Payer: BCBS Complete |
$7,025.65
|
| Rate for Payer: BCBS MAPPO |
$12,792.51
|
| Rate for Payer: BCBS Trust/PPO |
$6,543.65
|
| Rate for Payer: BCN Commercial |
$6,543.65
|
| Rate for Payer: BCN Medicare Advantage |
$12,792.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,792.51
|
| Rate for Payer: Mclaren Medicaid |
$6,690.48
|
| Rate for Payer: Mclaren Medicare |
$12,792.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,432.14
|
| Rate for Payer: Meridian Medicaid |
$13,432.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,711.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,071.76
|
| Rate for Payer: Nomi Health Commercial |
$38,377.53
|
| Rate for Payer: PACE Medicare |
$12,152.88
|
| Rate for Payer: PACE SWMI |
$12,792.51
|
| Rate for Payer: PHP Medicare Advantage |
$12,792.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,690.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41,369.85
|
| Rate for Payer: Priority Health Medicare |
$12,792.51
|
| Rate for Payer: Priority Health Tiered Network |
$33,095.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12,792.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,792.51
|
| Rate for Payer: UHC Medicaid |
$6,690.48
|
| Rate for Payer: UHCCP Medicaid |
$6,690.48
|
| Rate for Payer: VA VA |
$12,792.51
|
|
|
OPEN TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 23630
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,947.07
|
| Rate for Payer: BCN Commercial |
$3,947.07
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED; WITHOUT INTERCONDYLAR EXTENSION
|
Facility
|
OP
|
$41,369.85
|
|
|
Service Code
|
CPT 24545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,690.48 |
| Max. Negotiated Rate |
$41,369.85 |
| Rate for Payer: Aetna Medicare |
$13,304.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,990.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,990.64
|
| Rate for Payer: BCBS Complete |
$7,025.65
|
| Rate for Payer: BCBS MAPPO |
$12,792.51
|
| Rate for Payer: BCBS Trust/PPO |
$7,999.88
|
| Rate for Payer: BCN Commercial |
$7,999.88
|
| Rate for Payer: BCN Medicare Advantage |
$12,792.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,792.51
|
| Rate for Payer: Mclaren Medicaid |
$6,690.48
|
| Rate for Payer: Mclaren Medicare |
$12,792.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,432.14
|
| Rate for Payer: Meridian Medicaid |
$13,432.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,711.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,071.76
|
| Rate for Payer: Nomi Health Commercial |
$38,377.53
|
| Rate for Payer: PACE Medicare |
$12,152.88
|
| Rate for Payer: PACE SWMI |
$12,792.51
|
| Rate for Payer: PHP Medicare Advantage |
$12,792.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,690.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41,369.85
|
| Rate for Payer: Priority Health Medicare |
$12,792.51
|
| Rate for Payer: Priority Health Tiered Network |
$33,095.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12,792.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,792.51
|
| Rate for Payer: UHC Medicaid |
$6,690.48
|
| Rate for Payer: UHCCP Medicaid |
$6,690.48
|
| Rate for Payer: VA VA |
$12,792.51
|
|
|
OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 27766
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,254.63
|
| Rate for Payer: BCN Commercial |
$4,254.63
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 27524
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,769.86
|
| Rate for Payer: BCN Commercial |
$4,769.86
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, INCLUDES REPAIR OF TUBEROSITY(S), WHEN PERFORMED;
|
Facility
|
OP
|
$41,369.85
|
|
|
Service Code
|
CPT 23615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,558.85 |
| Max. Negotiated Rate |
$41,369.85 |
| Rate for Payer: Aetna Medicare |
$13,304.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,990.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,990.64
|
| Rate for Payer: BCBS Complete |
$7,025.65
|
| Rate for Payer: BCBS MAPPO |
$12,792.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,558.85
|
| Rate for Payer: BCN Commercial |
$5,558.85
|
| Rate for Payer: BCN Medicare Advantage |
$12,792.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,792.51
|
| Rate for Payer: Mclaren Medicaid |
$6,690.48
|
| Rate for Payer: Mclaren Medicare |
$12,792.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,432.14
|
| Rate for Payer: Meridian Medicaid |
$13,432.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,711.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,071.76
|
| Rate for Payer: Nomi Health Commercial |
$38,377.53
|
| Rate for Payer: PACE Medicare |
$12,152.88
|
| Rate for Payer: PACE SWMI |
$12,792.51
|
| Rate for Payer: PHP Medicare Advantage |
$12,792.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,690.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41,369.85
|
| Rate for Payer: Priority Health Medicare |
$12,792.51
|
| Rate for Payer: Priority Health Tiered Network |
$33,095.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12,792.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,792.51
|
| Rate for Payer: UHC Medicaid |
$6,690.48
|
| Rate for Payer: UHCCP Medicaid |
$6,690.48
|
| Rate for Payer: VA VA |
$12,792.51
|
|
|
OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, INCLUDES REPAIR OF TUBEROSITY(S), WHEN PERFORMED; WITH PROXIMAL HUMERAL PROSTHETIC REPLACEMENT
|
Facility
|
OP
|
$56,498.90
|
|
|
Service Code
|
CPT 23616
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,137.21 |
| Max. Negotiated Rate |
$56,498.90 |
| Rate for Payer: Aetna Medicare |
$18,169.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,838.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,838.46
|
| Rate for Payer: BCBS Complete |
$9,594.95
|
| Rate for Payer: BCBS MAPPO |
$17,470.77
|
| Rate for Payer: BCBS Trust/PPO |
$12,996.42
|
| Rate for Payer: BCN Commercial |
$12,996.42
|
| Rate for Payer: BCN Medicare Advantage |
$17,470.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,470.77
|
| Rate for Payer: Mclaren Medicaid |
$9,137.21
|
| Rate for Payer: Mclaren Medicare |
$17,470.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,344.31
|
| Rate for Payer: Meridian Medicaid |
$18,344.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,091.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,217.85
|
| Rate for Payer: Nomi Health Commercial |
$52,412.31
|
| Rate for Payer: PACE Medicare |
$16,597.23
|
| Rate for Payer: PACE SWMI |
$17,470.77
|
| Rate for Payer: PHP Medicare Advantage |
$17,470.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,137.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56,498.90
|
| Rate for Payer: Priority Health Medicare |
$17,470.77
|
| Rate for Payer: Priority Health Tiered Network |
$45,199.12
|
| Rate for Payer: Railroad Medicare Medicare |
$17,470.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17,470.77
|
| Rate for Payer: UHC Medicaid |
$9,137.21
|
| Rate for Payer: UHCCP Medicaid |
$9,137.21
|
| Rate for Payer: VA VA |
$17,470.77
|
|
|
OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 27535
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$6,266.51
|
| Rate for Payer: BCN Commercial |
$6,266.51
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE
|
Facility
|
OP
|
$41,369.85
|
|
|
Service Code
|
CPT 27758
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,368.73 |
| Max. Negotiated Rate |
$41,369.85 |
| Rate for Payer: Aetna Medicare |
$13,304.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,990.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,990.64
|
| Rate for Payer: BCBS Complete |
$7,025.65
|
| Rate for Payer: BCBS MAPPO |
$12,792.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,368.73
|
| Rate for Payer: BCN Commercial |
$3,368.73
|
| Rate for Payer: BCN Medicare Advantage |
$12,792.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,792.51
|
| Rate for Payer: Mclaren Medicaid |
$6,690.48
|
| Rate for Payer: Mclaren Medicare |
$12,792.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,432.14
|
| Rate for Payer: Meridian Medicaid |
$13,432.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,711.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,071.76
|
| Rate for Payer: Nomi Health Commercial |
$38,377.53
|
| Rate for Payer: PACE Medicare |
$12,152.88
|
| Rate for Payer: PACE SWMI |
$12,792.51
|
| Rate for Payer: PHP Medicare Advantage |
$12,792.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,690.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41,369.85
|
| Rate for Payer: Priority Health Medicare |
$12,792.51
|
| Rate for Payer: Priority Health Tiered Network |
$33,095.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12,792.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,792.51
|
| Rate for Payer: UHC Medicaid |
$6,690.48
|
| Rate for Payer: UHCCP Medicaid |
$6,690.48
|
| Rate for Payer: VA VA |
$12,792.51
|
|
|
OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITHOUT FIXATION OF POSTERIOR LIP
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 27822
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,639.74
|
| Rate for Payer: BCN Commercial |
$4,639.74
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]), INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 24685
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,821.45
|
| Rate for Payer: BCN Commercial |
$4,821.45
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$3,781.35
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPIOID ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$2,065.03
|
|
|
Service Code
|
APR-DRG 7731
|
| Min. Negotiated Rate |
$1,966.69 |
| Max. Negotiated Rate |
$2,065.03 |
| Rate for Payer: BCBS Complete |
$2,065.03
|
| Rate for Payer: Mclaren Medicaid |
$1,966.69
|
| Rate for Payer: Meridian Medicaid |
$2,065.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,966.69
|
| Rate for Payer: UHC Medicaid |
$1,966.69
|
| Rate for Payer: UHCCP Medicaid |
$1,966.69
|
|
|
OPIOID ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$3,646.19
|
|
|
Service Code
|
APR-DRG 7732
|
| Min. Negotiated Rate |
$3,472.56 |
| Max. Negotiated Rate |
$3,646.19 |
| Rate for Payer: BCBS Complete |
$3,646.19
|
| Rate for Payer: Mclaren Medicaid |
$3,472.56
|
| Rate for Payer: Meridian Medicaid |
$3,646.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,472.56
|
| Rate for Payer: UHC Medicaid |
$3,472.56
|
| Rate for Payer: UHCCP Medicaid |
$3,472.56
|
|
|
OPIOID ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$13,518.99
|
|
|
Service Code
|
APR-DRG 7734
|
| Min. Negotiated Rate |
$12,875.23 |
| Max. Negotiated Rate |
$13,518.99 |
| Rate for Payer: BCBS Complete |
$13,518.99
|
| Rate for Payer: Mclaren Medicaid |
$12,875.23
|
| Rate for Payer: Meridian Medicaid |
$13,518.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,875.23
|
| Rate for Payer: UHC Medicaid |
$12,875.23
|
| Rate for Payer: UHCCP Medicaid |
$12,875.23
|
|
|
OPIOID ABUSE AND DEPENDENCE
|
Facility
|
IP
|
$4,573.79
|
|
|
Service Code
|
APR-DRG 7733
|
| Min. Negotiated Rate |
$4,355.99 |
| Max. Negotiated Rate |
$4,573.79 |
| Rate for Payer: BCBS Complete |
$4,573.79
|
| Rate for Payer: Mclaren Medicaid |
$4,355.99
|
| Rate for Payer: Meridian Medicaid |
$4,573.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,355.99
|
| Rate for Payer: UHC Medicaid |
$4,355.99
|
| Rate for Payer: UHCCP Medicaid |
$4,355.99
|
|
|
ORBITAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$42,637.67
|
|
|
Service Code
|
MSDRG 113
|
| Min. Negotiated Rate |
$17,811.39 |
| Max. Negotiated Rate |
$42,637.67 |
| Rate for Payer: Aetna Medicare |
$19,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,436.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,436.04
|
| Rate for Payer: BCBS MAPPO |
$18,748.83
|
| Rate for Payer: BCBS Trust/PPO |
$42,637.67
|
| Rate for Payer: BCN Commercial |
$42,637.67
|
| Rate for Payer: BCN Medicare Advantage |
$18,748.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,748.83
|
| Rate for Payer: Mclaren Medicare |
$18,748.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,686.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,561.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,623.71
|
| Rate for Payer: Nomi Health Commercial |
$30,329.19
|
| Rate for Payer: PACE Medicare |
$17,811.39
|
| Rate for Payer: PACE SWMI |
$18,748.83
|
| Rate for Payer: PHP Medicare Advantage |
$18,748.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,904.76
|
| Rate for Payer: Priority Health Medicare |
$18,748.83
|
| Rate for Payer: Priority Health Tiered Network |
$30,323.81
|
| Rate for Payer: Railroad Medicare Medicare |
$18,748.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,322.93
|
| Rate for Payer: UHC Core |
$32,061.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,748.83
|
| Rate for Payer: UHC Exchange |
$26,184.20
|
| Rate for Payer: VA VA |
$18,748.83
|
|
|
ORBITAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,162.16
|
|
|
Service Code
|
MSDRG 114
|
| Min. Negotiated Rate |
$10,483.53 |
| Max. Negotiated Rate |
$28,162.16 |
| Rate for Payer: Aetna Medicare |
$11,476.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,794.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,794.12
|
| Rate for Payer: BCBS MAPPO |
$11,035.30
|
| Rate for Payer: BCBS Trust/PPO |
$28,162.16
|
| Rate for Payer: BCN Commercial |
$28,162.16
|
| Rate for Payer: BCN Medicare Advantage |
$11,035.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,035.30
|
| Rate for Payer: Mclaren Medicare |
$11,035.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,587.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,690.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,138.83
|
| Rate for Payer: Nomi Health Commercial |
$17,453.70
|
| Rate for Payer: PACE Medicare |
$10,483.53
|
| Rate for Payer: PACE SWMI |
$11,035.30
|
| Rate for Payer: PHP Medicare Advantage |
$11,035.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,813.26
|
| Rate for Payer: Priority Health Medicare |
$11,035.30
|
| Rate for Payer: Priority Health Tiered Network |
$17,450.60
|
| Rate for Payer: Railroad Medicare Medicare |
$11,035.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,053.90
|
| Rate for Payer: UHC Core |
$18,450.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,035.30
|
| Rate for Payer: UHC Exchange |
$15,068.36
|
| Rate for Payer: VA VA |
$11,035.30
|
|
|
ORBIT AND EYE PROCEDURES
|
Facility
|
IP
|
$9,340.20
|
|
|
Service Code
|
APR-DRG 0732
|
| Min. Negotiated Rate |
$8,895.43 |
| Max. Negotiated Rate |
$9,340.20 |
| Rate for Payer: BCBS Complete |
$9,340.20
|
| Rate for Payer: Mclaren Medicaid |
$8,895.43
|
| Rate for Payer: Meridian Medicaid |
$9,340.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,895.43
|
| Rate for Payer: UHC Medicaid |
$8,895.43
|
| Rate for Payer: UHCCP Medicaid |
$8,895.43
|
|
|
ORBIT AND EYE PROCEDURES
|
Facility
|
IP
|
$7,556.67
|
|
|
Service Code
|
APR-DRG 0731
|
| Min. Negotiated Rate |
$7,196.83 |
| Max. Negotiated Rate |
$7,556.67 |
| Rate for Payer: BCBS Complete |
$7,556.67
|
| Rate for Payer: Mclaren Medicaid |
$7,196.83
|
| Rate for Payer: Meridian Medicaid |
$7,556.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,196.83
|
| Rate for Payer: UHC Medicaid |
$7,196.83
|
| Rate for Payer: UHCCP Medicaid |
$7,196.83
|
|
|
ORBIT AND EYE PROCEDURES
|
Facility
|
IP
|
$22,484.83
|
|
|
Service Code
|
APR-DRG 0734
|
| Min. Negotiated Rate |
$21,414.12 |
| Max. Negotiated Rate |
$22,484.83 |
| Rate for Payer: BCBS Complete |
$22,484.83
|
| Rate for Payer: Mclaren Medicaid |
$21,414.12
|
| Rate for Payer: Meridian Medicaid |
$22,484.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,414.12
|
| Rate for Payer: UHC Medicaid |
$21,414.12
|
| Rate for Payer: UHCCP Medicaid |
$21,414.12
|
|
|
ORBIT AND EYE PROCEDURES
|
Facility
|
IP
|
$12,696.88
|
|
|
Service Code
|
APR-DRG 0733
|
| Min. Negotiated Rate |
$12,092.26 |
| Max. Negotiated Rate |
$12,696.88 |
| Rate for Payer: BCBS Complete |
$12,696.88
|
| Rate for Payer: Mclaren Medicaid |
$12,092.26
|
| Rate for Payer: Meridian Medicaid |
$12,696.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,092.26
|
| Rate for Payer: UHC Medicaid |
$12,092.26
|
| Rate for Payer: UHCCP Medicaid |
$12,092.26
|
|
|
ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH
|
Facility
|
OP
|
$11,537.07
|
|
|
Service Code
|
CPT 54530
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,934.03
|
| Rate for Payer: BCN Commercial |
$2,934.03
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
ORCHIOPEXY, INGUINAL OR SCROTAL APPROACH
|
Facility
|
OP
|
$11,537.07
|
|
|
Service Code
|
CPT 54640
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,720.31
|
| Rate for Payer: BCN Commercial |
$2,720.31
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY
|
Facility
|
IP
|
$26,225.07
|
|
|
Service Code
|
MSDRG 884
|
| Min. Negotiated Rate |
$1,069.00 |
| Max. Negotiated Rate |
$26,225.07 |
| Rate for Payer: Aetna Medicare |
$13,533.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,266.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,266.19
|
| Rate for Payer: BCBS MAPPO |
$13,012.95
|
| Rate for Payer: BCBS Trust/PPO |
$20,018.52
|
| Rate for Payer: BCN Commercial |
$20,018.52
|
| Rate for Payer: BCN Medicare Advantage |
$13,012.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,012.95
|
| Rate for Payer: Mclaren Medicare |
$13,012.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,663.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,964.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,314.25
|
| Rate for Payer: Nomi Health Commercial |
$1,069.00
|
| Rate for Payer: PACE Medicare |
$12,362.30
|
| Rate for Payer: PACE SWMI |
$13,012.95
|
| Rate for Payer: PHP Medicare Advantage |
$13,012.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,938.91
|
| Rate for Payer: Priority Health Medicare |
$13,012.95
|
| Rate for Payer: Priority Health Tiered Network |
$20,751.13
|
| Rate for Payer: Railroad Medicare Medicare |
$13,012.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,225.07
|
| Rate for Payer: UHC Core |
$21,940.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13,012.95
|
| Rate for Payer: UHC Exchange |
$17,918.32
|
| Rate for Payer: VA VA |
$13,012.95
|
|
