|
PR BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 15823
|
| Min. Negotiated Rate |
$46.61 |
| Max. Negotiated Rate |
$95,191.00 |
| Rate for Payer: Aetna Commercial |
$683.83
|
| Rate for Payer: Aetna Medicare |
$530.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.86
|
| Rate for Payer: BCBS Complete |
$368.57
|
| Rate for Payer: BCBS MAPPO |
$510.32
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$510.32
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$734.86
|
| Rate for Payer: Cofinity Commercial |
$683.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.32
|
| Rate for Payer: Healthscope Commercial |
$944.09
|
| Rate for Payer: Healthscope Commercial |
$816.51
|
| Rate for Payer: Mclaren Medicaid |
$351.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.84
|
| Rate for Payer: Meridian Medicaid |
$368.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,191.00
|
| Rate for Payer: Nomi Health Commercial |
$612.38
|
| Rate for Payer: PACE SWMI |
$510.32
|
| Rate for Payer: PHP Medicare Advantage |
$510.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$745.91
|
| Rate for Payer: Priority Health Medicare |
$510.32
|
| Rate for Payer: Priority Health Narrow Network |
$745.91
|
| Rate for Payer: Priority Health SBD |
$745.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$707.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.32
|
| Rate for Payer: UHC Exchange |
$707.75
|
| Rate for Payer: UHC Medicare Advantage |
$510.32
|
| Rate for Payer: UHCCP Medicaid |
$351.02
|
|
|
PR BLEPHAROTOMY DRAINAGE ABSCESS EYELID
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 67700
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$19,931.00 |
| Rate for Payer: Aetna Commercial |
$144.57
|
| Rate for Payer: Aetna Medicare |
$112.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.36
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$107.89
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: BCN Commercial |
$416.84
|
| Rate for Payer: BCN Medicare Advantage |
$107.89
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$155.36
|
| Rate for Payer: Cofinity Commercial |
$144.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.89
|
| Rate for Payer: Healthscope Commercial |
$199.60
|
| Rate for Payer: Healthscope Commercial |
$172.62
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.28
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,931.00
|
| Rate for Payer: Nomi Health Commercial |
$129.47
|
| Rate for Payer: PACE SWMI |
$107.89
|
| Rate for Payer: PHP Medicare Advantage |
$107.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.97
|
| Rate for Payer: Priority Health Medicare |
$107.89
|
| Rate for Payer: Priority Health Narrow Network |
$202.97
|
| Rate for Payer: Priority Health SBD |
$202.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.89
|
| Rate for Payer: UHC Exchange |
$356.95
|
| Rate for Payer: UHC Medicare Advantage |
$107.89
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR BLUE TIDAL
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 00072
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR BONE GRAFT ANY DONOR AREA MAJOR/LARGE
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 20902
|
| Min. Negotiated Rate |
$175.30 |
| Max. Negotiated Rate |
$48,888.00 |
| Rate for Payer: Aetna Commercial |
$351.95
|
| Rate for Payer: Aetna Medicare |
$273.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.22
|
| Rate for Payer: BCBS Complete |
$184.06
|
| Rate for Payer: BCBS MAPPO |
$262.65
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$400.72
|
| Rate for Payer: BCN Medicare Advantage |
$262.65
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$378.22
|
| Rate for Payer: Cofinity Commercial |
$351.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.65
|
| Rate for Payer: Healthscope Commercial |
$485.90
|
| Rate for Payer: Healthscope Commercial |
$420.24
|
| Rate for Payer: Mclaren Medicaid |
$175.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.78
|
| Rate for Payer: Meridian Medicaid |
$184.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,888.00
|
| Rate for Payer: Nomi Health Commercial |
$315.18
|
| Rate for Payer: PACE SWMI |
$262.65
|
| Rate for Payer: PHP Medicare Advantage |
$262.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.28
|
| Rate for Payer: Priority Health Medicare |
$262.65
|
| Rate for Payer: Priority Health Narrow Network |
$418.28
|
| Rate for Payer: Priority Health SBD |
$418.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.65
|
| Rate for Payer: UHC Exchange |
$693.84
|
| Rate for Payer: UHC Medicare Advantage |
$262.65
|
| Rate for Payer: UHCCP Medicaid |
$175.30
|
|
|
PR BONE GRAFT ANY DONOR AREA MINOR/SMALL
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 20900
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$32,148.00 |
| Rate for Payer: Aetna Commercial |
$231.27
|
| Rate for Payer: Aetna Medicare |
$179.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.53
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$172.59
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$574.19
|
| Rate for Payer: BCN Medicare Advantage |
$172.59
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cofinity Commercial |
$248.53
|
| Rate for Payer: Cofinity Commercial |
$231.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.59
|
| Rate for Payer: Healthscope Commercial |
$319.29
|
| Rate for Payer: Healthscope Commercial |
$276.14
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.22
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,148.00
|
| Rate for Payer: Nomi Health Commercial |
$207.11
|
| Rate for Payer: PACE SWMI |
$172.59
|
| Rate for Payer: PHP Medicare Advantage |
$172.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.28
|
| Rate for Payer: Priority Health Medicare |
$172.59
|
| Rate for Payer: Priority Health Narrow Network |
$274.28
|
| Rate for Payer: Priority Health SBD |
$274.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$546.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.59
|
| Rate for Payer: UHC Exchange |
$546.57
|
| Rate for Payer: UHC Medicare Advantage |
$172.59
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR
|
Professional
|
Both
|
$4,588.00
|
|
|
Service Code
|
HCPCS 20962
|
| Min. Negotiated Rate |
$1,721.25 |
| Max. Negotiated Rate |
$471,172.00 |
| Rate for Payer: Aetna Commercial |
$3,433.25
|
| Rate for Payer: Aetna Medicare |
$2,664.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,433.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,689.47
|
| Rate for Payer: BCBS Complete |
$1,807.31
|
| Rate for Payer: BCBS MAPPO |
$2,562.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,247.68
|
| Rate for Payer: BCN Commercial |
$3,886.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,562.13
|
| Rate for Payer: Cash Price |
$3,670.40
|
| Rate for Payer: Cash Price |
$3,670.40
|
| Rate for Payer: Cofinity Commercial |
$3,689.47
|
| Rate for Payer: Cofinity Commercial |
$3,433.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,562.13
|
| Rate for Payer: Healthscope Commercial |
$4,739.94
|
| Rate for Payer: Healthscope Commercial |
$4,099.41
|
| Rate for Payer: Mclaren Medicaid |
$1,721.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,690.24
|
| Rate for Payer: Meridian Medicaid |
$1,807.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471,172.00
|
| Rate for Payer: Nomi Health Commercial |
$3,074.56
|
| Rate for Payer: PACE SWMI |
$2,562.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,562.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,721.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,982.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,077.50
|
| Rate for Payer: Priority Health Medicare |
$2,562.13
|
| Rate for Payer: Priority Health Narrow Network |
$4,077.50
|
| Rate for Payer: Priority Health SBD |
$4,077.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,390.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,562.13
|
| Rate for Payer: UHC Exchange |
$3,390.31
|
| Rate for Payer: UHC Medicare Advantage |
$2,562.13
|
| Rate for Payer: UHCCP Medicaid |
$1,721.25
|
|
|
PR BOTOX UNIT
|
Professional
|
Both
|
$13.00
|
|
|
Service Code
|
HCPCS 00084
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
|
|
PR BRACHIOPLASTY
|
Professional
|
Both
|
$4,590.00
|
|
|
Service Code
|
HCPCS 00537
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,836.00 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Medicare |
$2,295.00
|
| Rate for Payer: BCBS Complete |
$1,836.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,000.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
|
|
PR BREAST AUGMENTATION WITH IMPLANT
|
Professional
|
Both
|
$2,040.00
|
|
|
Service Code
|
HCPCS 19325
|
| Min. Negotiated Rate |
$399.38 |
| Max. Negotiated Rate |
$108,365.00 |
| Rate for Payer: Aetna Commercial |
$788.74
|
| Rate for Payer: Aetna Medicare |
$612.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$788.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$847.60
|
| Rate for Payer: BCBS Complete |
$419.35
|
| Rate for Payer: BCBS MAPPO |
$588.61
|
| Rate for Payer: BCBS Trust/PPO |
$630.49
|
| Rate for Payer: BCN Commercial |
$901.13
|
| Rate for Payer: BCN Medicare Advantage |
$588.61
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Cofinity Commercial |
$847.60
|
| Rate for Payer: Cofinity Commercial |
$788.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.61
|
| Rate for Payer: Healthscope Commercial |
$941.78
|
| Rate for Payer: Healthscope Commercial |
$1,088.93
|
| Rate for Payer: Mclaren Medicaid |
$399.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.04
|
| Rate for Payer: Meridian Medicaid |
$419.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,365.00
|
| Rate for Payer: Nomi Health Commercial |
$706.33
|
| Rate for Payer: PACE SWMI |
$588.61
|
| Rate for Payer: PHP Medicare Advantage |
$588.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$838.02
|
| Rate for Payer: Priority Health Medicare |
$588.61
|
| Rate for Payer: Priority Health Narrow Network |
$838.02
|
| Rate for Payer: Priority Health SBD |
$838.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.61
|
| Rate for Payer: UHC Exchange |
$728.69
|
| Rate for Payer: UHC Medicare Advantage |
$588.61
|
| Rate for Payer: UHCCP Medicaid |
$399.38
|
|
|
PR BREAST AUGMENT W MASTOPEXY-GEL 2.5
|
Professional
|
Both
|
$6,671.00
|
|
|
Service Code
|
HCPCS 00258
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,668.40 |
| Max. Negotiated Rate |
$4,336.15 |
| Rate for Payer: Aetna Medicare |
$3,335.50
|
| Rate for Payer: BCBS Complete |
$2,668.40
|
| Rate for Payer: Cash Price |
$5,336.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,336.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,336.15
|
|
|
PR BREAST AUGMENT W MASTOPEXY-GEL 3.5
|
Professional
|
Both
|
$7,589.00
|
|
|
Service Code
|
HCPCS 00260
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$3,035.60 |
| Max. Negotiated Rate |
$4,932.85 |
| Rate for Payer: Aetna Medicare |
$3,794.50
|
| Rate for Payer: BCBS Complete |
$3,035.60
|
| Rate for Payer: Cash Price |
$6,071.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,932.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,932.85
|
|
|
PR BREAST AUGMENT W MASTOPEXY-SALINE 2.5
|
Professional
|
Both
|
$5,610.00
|
|
|
Service Code
|
HCPCS 00257
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,244.00 |
| Max. Negotiated Rate |
$3,646.50 |
| Rate for Payer: Aetna Medicare |
$2,805.00
|
| Rate for Payer: BCBS Complete |
$2,244.00
|
| Rate for Payer: Cash Price |
$4,488.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,646.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,646.50
|
|
|
PR BREAST AUGMENT W MASTOPEXY-SALINE 3.5
|
Professional
|
Both
|
$6,528.00
|
|
|
Service Code
|
HCPCS 00259
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,611.20 |
| Max. Negotiated Rate |
$4,243.20 |
| Rate for Payer: Aetna Medicare |
$3,264.00
|
| Rate for Payer: BCBS Complete |
$2,611.20
|
| Rate for Payer: Cash Price |
$5,222.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,243.20
|
|
|
PR BREAST IMPLANT WARRANTY
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 00523
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
|
|
PR BREAST RECONSTRUCTION 1PEDICLED TRAM FLAP ANAST
|
Professional
|
Both
|
$4,809.00
|
|
|
Service Code
|
HCPCS 19368
|
| Min. Negotiated Rate |
$1,327.27 |
| Max. Negotiated Rate |
$384,291.00 |
| Rate for Payer: Aetna Commercial |
$2,781.24
|
| Rate for Payer: Aetna Medicare |
$2,158.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,781.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,988.79
|
| Rate for Payer: BCBS Complete |
$1,461.33
|
| Rate for Payer: BCBS MAPPO |
$2,075.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,327.27
|
| Rate for Payer: BCN Commercial |
$3,163.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,075.55
|
| Rate for Payer: Cash Price |
$3,847.20
|
| Rate for Payer: Cash Price |
$3,847.20
|
| Rate for Payer: Cofinity Commercial |
$2,988.79
|
| Rate for Payer: Cofinity Commercial |
$2,781.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,075.55
|
| Rate for Payer: Healthscope Commercial |
$3,839.77
|
| Rate for Payer: Healthscope Commercial |
$3,320.88
|
| Rate for Payer: Mclaren Medicaid |
$1,391.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,179.33
|
| Rate for Payer: Meridian Medicaid |
$1,461.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384,291.00
|
| Rate for Payer: Nomi Health Commercial |
$2,490.66
|
| Rate for Payer: PACE SWMI |
$2,075.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,075.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,391.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,125.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,926.28
|
| Rate for Payer: Priority Health Medicare |
$2,075.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,926.28
|
| Rate for Payer: Priority Health SBD |
$2,926.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,667.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,075.55
|
| Rate for Payer: UHC Exchange |
$2,667.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,075.55
|
| Rate for Payer: UHCCP Medicaid |
$1,391.74
|
|
|
PR BREAST RECONSTRUCTION BIPEDICLED TRAM FLAP
|
Professional
|
Both
|
$4,213.00
|
|
|
Service Code
|
HCPCS 19369
|
| Min. Negotiated Rate |
$199.98 |
| Max. Negotiated Rate |
$356,972.00 |
| Rate for Payer: Aetna Commercial |
$2,583.48
|
| Rate for Payer: Aetna Medicare |
$2,005.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,583.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,776.28
|
| Rate for Payer: BCBS Complete |
$1,358.01
|
| Rate for Payer: BCBS MAPPO |
$1,927.97
|
| Rate for Payer: BCBS Trust/PPO |
$199.98
|
| Rate for Payer: BCN Commercial |
$2,939.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,927.97
|
| Rate for Payer: Cash Price |
$3,370.40
|
| Rate for Payer: Cash Price |
$3,370.40
|
| Rate for Payer: Cofinity Commercial |
$2,776.28
|
| Rate for Payer: Cofinity Commercial |
$2,583.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,927.97
|
| Rate for Payer: Healthscope Commercial |
$3,566.74
|
| Rate for Payer: Healthscope Commercial |
$3,084.75
|
| Rate for Payer: Mclaren Medicaid |
$1,293.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,024.37
|
| Rate for Payer: Meridian Medicaid |
$1,358.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356,972.00
|
| Rate for Payer: Nomi Health Commercial |
$2,313.56
|
| Rate for Payer: PACE SWMI |
$1,927.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,927.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,293.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,738.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,719.49
|
| Rate for Payer: Priority Health Medicare |
$1,927.97
|
| Rate for Payer: Priority Health Narrow Network |
$2,719.49
|
| Rate for Payer: Priority Health SBD |
$2,719.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,550.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,927.97
|
| Rate for Payer: UHC Exchange |
$2,550.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,927.97
|
| Rate for Payer: UHCCP Medicaid |
$1,293.34
|
|
|
PR BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP
|
Professional
|
Both
|
$3,032.00
|
|
|
Service Code
|
HCPCS 19367
|
| Min. Negotiated Rate |
$1,139.12 |
| Max. Negotiated Rate |
$313,133.00 |
| Rate for Payer: Aetna Commercial |
$2,270.88
|
| Rate for Payer: Aetna Medicare |
$1,762.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,270.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,440.35
|
| Rate for Payer: BCBS Complete |
$1,196.08
|
| Rate for Payer: BCBS MAPPO |
$1,694.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,327.27
|
| Rate for Payer: BCN Commercial |
$2,583.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,694.69
|
| Rate for Payer: Cash Price |
$2,425.60
|
| Rate for Payer: Cash Price |
$2,425.60
|
| Rate for Payer: Cofinity Commercial |
$2,440.35
|
| Rate for Payer: Cofinity Commercial |
$2,270.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,694.69
|
| Rate for Payer: Healthscope Commercial |
$3,135.18
|
| Rate for Payer: Healthscope Commercial |
$2,711.50
|
| Rate for Payer: Mclaren Medicaid |
$1,139.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,779.42
|
| Rate for Payer: Meridian Medicaid |
$1,196.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313,133.00
|
| Rate for Payer: Nomi Health Commercial |
$2,033.63
|
| Rate for Payer: PACE SWMI |
$1,694.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,694.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,139.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,970.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,392.58
|
| Rate for Payer: Priority Health Medicare |
$1,694.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,392.58
|
| Rate for Payer: Priority Health SBD |
$2,392.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,304.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,694.69
|
| Rate for Payer: UHC Exchange |
$2,304.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,694.69
|
| Rate for Payer: UHCCP Medicaid |
$1,139.12
|
|
|
PR BREAST RECONSTRUCTION W/LATISSIMUS DORSI FLAP
|
Professional
|
Both
|
$2,920.00
|
|
|
Service Code
|
HCPCS 19361
|
| Min. Negotiated Rate |
$312.59 |
| Max. Negotiated Rate |
$275,573.00 |
| Rate for Payer: Aetna Commercial |
$1,999.74
|
| Rate for Payer: Aetna Medicare |
$1,552.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,999.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,148.97
|
| Rate for Payer: BCBS Complete |
$1,053.61
|
| Rate for Payer: BCBS MAPPO |
$1,492.34
|
| Rate for Payer: BCBS Trust/PPO |
$312.59
|
| Rate for Payer: BCN Commercial |
$2,274.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,492.34
|
| Rate for Payer: Cash Price |
$2,336.00
|
| Rate for Payer: Cash Price |
$2,336.00
|
| Rate for Payer: Cofinity Commercial |
$2,148.97
|
| Rate for Payer: Cofinity Commercial |
$1,999.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,492.34
|
| Rate for Payer: Healthscope Commercial |
$2,760.83
|
| Rate for Payer: Healthscope Commercial |
$2,387.74
|
| Rate for Payer: Mclaren Medicaid |
$1,003.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,566.96
|
| Rate for Payer: Meridian Medicaid |
$1,053.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275,573.00
|
| Rate for Payer: Nomi Health Commercial |
$1,790.81
|
| Rate for Payer: PACE SWMI |
$1,492.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,492.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,003.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,898.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,107.68
|
| Rate for Payer: Priority Health Medicare |
$1,492.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,107.68
|
| Rate for Payer: Priority Health SBD |
$2,107.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,535.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,492.34
|
| Rate for Payer: UHC Exchange |
$1,535.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,492.34
|
| Rate for Payer: UHCCP Medicaid |
$1,003.44
|
|
|
PR BREAST RECONSTRUC W OTHR TECHNIQ
|
Professional
|
Both
|
$2,903.00
|
|
|
Service Code
|
HCPCS 19366
|
| Min. Negotiated Rate |
$1,161.20 |
| Max. Negotiated Rate |
$1,886.95 |
| Rate for Payer: Aetna Medicare |
$1,451.50
|
| Rate for Payer: BCBS Complete |
$1,161.20
|
| Rate for Payer: Cash Price |
$2,322.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,886.95
|
|
|
PR BREAST REDUCTION
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19318
|
| Hospital Charge Code |
19318
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$193,369.00 |
| Rate for Payer: Aetna Commercial |
$1,404.78
|
| Rate for Payer: Aetna Medicare |
$1,090.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.61
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS MAPPO |
$1,048.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,597.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.34
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,509.61
|
| Rate for Payer: Cofinity Commercial |
$1,404.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.34
|
| Rate for Payer: Healthscope Commercial |
$1,939.43
|
| Rate for Payer: Healthscope Commercial |
$1,677.34
|
| Rate for Payer: Mclaren Medicaid |
$706.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.76
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193,369.00
|
| Rate for Payer: Nomi Health Commercial |
$1,258.01
|
| Rate for Payer: PACE SWMI |
$1,048.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,482.33
|
| Rate for Payer: Priority Health Medicare |
$1,048.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,482.33
|
| Rate for Payer: Priority Health SBD |
$1,482.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,491.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.34
|
| Rate for Payer: UHC Exchange |
$1,491.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.34
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
|
|
PR BREAST REDUCTION
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19318
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$193,369.00 |
| Rate for Payer: Aetna Commercial |
$1,404.78
|
| Rate for Payer: Aetna Medicare |
$1,090.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.61
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS MAPPO |
$1,048.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,597.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.34
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,509.61
|
| Rate for Payer: Cofinity Commercial |
$1,404.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.34
|
| Rate for Payer: Healthscope Commercial |
$1,939.43
|
| Rate for Payer: Healthscope Commercial |
$1,677.34
|
| Rate for Payer: Mclaren Medicaid |
$706.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.76
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193,369.00
|
| Rate for Payer: Nomi Health Commercial |
$1,258.01
|
| Rate for Payer: PACE SWMI |
$1,048.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,482.33
|
| Rate for Payer: Priority Health Medicare |
$1,048.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,482.33
|
| Rate for Payer: Priority Health SBD |
$1,482.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,491.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.34
|
| Rate for Payer: UHC Exchange |
$1,491.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.34
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
|
|
PR BREAST REDUCTION
|
Facility
|
OP
|
$1,938.00
|
|
|
Service Code
|
CPT 19318
|
| Hospital Charge Code |
19318
|
| Min. Negotiated Rate |
$1,156.95 |
| Max. Negotiated Rate |
$20,082.39 |
| Rate for Payer: Aetna Commercial |
$1,647.30
|
| Rate for Payer: Aetna Medicare |
$6,645.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,987.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,987.00
|
| Rate for Payer: BCBS Complete |
$3,596.07
|
| Rate for Payer: BCBS MAPPO |
$6,389.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,912.43
|
| Rate for Payer: BCN Commercial |
$3,912.43
|
| Rate for Payer: BCN Medicare Advantage |
$6,389.60
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,666.68
|
| Rate for Payer: Cofinity Commercial |
$1,356.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,356.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,389.60
|
| Rate for Payer: Healthscope Commercial |
$1,744.20
|
| Rate for Payer: Mclaren Medicaid |
$3,424.83
|
| Rate for Payer: Mclaren Medicare |
$6,389.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,709.08
|
| Rate for Payer: Meridian Medicaid |
$3,596.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,348.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.30
|
| Rate for Payer: Nomi Health Commercial |
$13,418.16
|
| Rate for Payer: PACE Medicare |
$6,070.12
|
| Rate for Payer: PACE SWMI |
$6,389.60
|
| Rate for Payer: PHP Commercial |
$1,647.30
|
| Rate for Payer: PHP Medicare Advantage |
$6,389.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,424.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,082.39
|
| Rate for Payer: Priority Health Medicare |
$6,389.60
|
| Rate for Payer: Priority Health Narrow Network |
$16,065.91
|
| Rate for Payer: Priority Health SBD |
$1,220.94
|
| Rate for Payer: Railroad Medicare Medicare |
$6,389.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,156.95
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,389.60
|
| Rate for Payer: UHC Medicare Advantage |
$6,389.60
|
| Rate for Payer: UHCCP Medicaid |
$3,597.34
|
| Rate for Payer: VA VA |
$6,389.60
|
|
|
PR BREAST REDUCTION
|
Facility
|
IP
|
$1,938.00
|
|
|
Service Code
|
CPT 19318
|
| Hospital Charge Code |
19318
|
| Min. Negotiated Rate |
$1,220.94 |
| Max. Negotiated Rate |
$1,744.20 |
| Rate for Payer: Aetna Commercial |
$1,647.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.70
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,356.60
|
| Rate for Payer: Cofinity Commercial |
$1,666.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,356.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.40
|
| Rate for Payer: Healthscope Commercial |
$1,744.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.30
|
| Rate for Payer: PHP Commercial |
$1,647.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health SBD |
$1,220.94
|
|
|
PR BREATH HYDROGEN/METHANE TEST
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 91065
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$11,777.00 |
| Rate for Payer: Aetna Commercial |
$78.39
|
| Rate for Payer: Aetna Medicare |
$60.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.24
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$58.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.85
|
| Rate for Payer: BCN Commercial |
$123.15
|
| Rate for Payer: BCN Medicare Advantage |
$58.50
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$78.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.50
|
| Rate for Payer: Healthscope Commercial |
$93.60
|
| Rate for Payer: Healthscope Commercial |
$108.22
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.42
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,777.00
|
| Rate for Payer: Nomi Health Commercial |
$70.20
|
| Rate for Payer: PACE SWMI |
$58.50
|
| Rate for Payer: PHP Medicare Advantage |
$58.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.42
|
| Rate for Payer: Priority Health Medicare |
$58.50
|
| Rate for Payer: Priority Health Narrow Network |
$100.42
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.50
|
| Rate for Payer: UHC Exchange |
$160.10
|
| Rate for Payer: UHC Medicare Advantage |
$58.50
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
|
|
PR BREATHING RESPONSE TO HYPOXIA
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 94450
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$11,559.00 |
| Rate for Payer: Aetna Commercial |
$105.85
|
| Rate for Payer: Aetna Medicare |
$82.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.75
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$78.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$78.99
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$113.75
|
| Rate for Payer: Cofinity Commercial |
$105.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.99
|
| Rate for Payer: Healthscope Commercial |
$146.13
|
| Rate for Payer: Healthscope Commercial |
$126.38
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.94
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,559.00
|
| Rate for Payer: Nomi Health Commercial |
$94.79
|
| Rate for Payer: PACE SWMI |
$78.99
|
| Rate for Payer: PHP Medicare Advantage |
$78.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.11
|
| Rate for Payer: Priority Health Medicare |
$78.99
|
| Rate for Payer: Priority Health Narrow Network |
$108.11
|
| Rate for Payer: Priority Health SBD |
$25.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.99
|
| Rate for Payer: UHC Exchange |
$45.30
|
| Rate for Payer: UHC Medicare Advantage |
$78.99
|
| Rate for Payer: UHCCP Medicaid |
$12.57
|
|
