|
PR EMERGENCY DEPARTMENT VISIT HIGH MDM
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 99285
|
| Min. Negotiated Rate |
$109.27 |
| Max. Negotiated Rate |
$317.33 |
| Rate for Payer: Aetna Commercial |
$229.85
|
| Rate for Payer: Aetna Medicare |
$178.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.00
|
| Rate for Payer: BCBS Complete |
$114.73
|
| Rate for Payer: BCBS MAPPO |
$171.53
|
| Rate for Payer: BCN Commercial |
$259.95
|
| Rate for Payer: BCN Medicare Advantage |
$171.53
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cofinity Commercial |
$247.00
|
| Rate for Payer: Cofinity Commercial |
$229.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.53
|
| Rate for Payer: Healthscope Commercial |
$317.33
|
| Rate for Payer: Healthscope Commercial |
$274.45
|
| Rate for Payer: Mclaren Medicaid |
$109.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.11
|
| Rate for Payer: Meridian Medicaid |
$114.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.88
|
| Rate for Payer: Nomi Health Commercial |
$205.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.50
|
| Rate for Payer: PACE SWMI |
$171.53
|
| Rate for Payer: PHP Medicare Advantage |
$171.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$299.15
|
| Rate for Payer: Priority Health Medicare |
$171.53
|
| Rate for Payer: Priority Health SBD |
$299.15
|
| Rate for Payer: Priority Health Tiered Network |
$299.15
|
| Rate for Payer: Railroad Medicare Medicare |
$171.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.51
|
| Rate for Payer: UHC Core |
$248.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.53
|
| Rate for Payer: UHC Exchange |
$248.51
|
| Rate for Payer: UHC Medicaid |
$109.27
|
| Rate for Payer: UHCCP Medicaid |
$109.27
|
|
|
PR EMERGENCY DEPARTMENT VISIT LOW MDM
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 99283
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: Aetna Commercial |
$93.16
|
| Rate for Payer: Aetna Medicare |
$72.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.16
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$69.52
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: BCN Medicare Advantage |
$69.52
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$93.16
|
| Rate for Payer: Cofinity Commercial |
$100.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.52
|
| Rate for Payer: Healthscope Commercial |
$128.61
|
| Rate for Payer: Healthscope Commercial |
$111.23
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.00
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.39
|
| Rate for Payer: Nomi Health Commercial |
$83.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: PACE SWMI |
$69.52
|
| Rate for Payer: PHP Medicare Advantage |
$69.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114.00
|
| Rate for Payer: Priority Health Medicare |
$69.52
|
| Rate for Payer: Priority Health SBD |
$114.00
|
| Rate for Payer: Priority Health Tiered Network |
$114.00
|
| Rate for Payer: Railroad Medicare Medicare |
$69.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.02
|
| Rate for Payer: UHC Core |
$93.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.52
|
| Rate for Payer: UHC Exchange |
$93.02
|
| Rate for Payer: UHC Medicaid |
$44.30
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 99281
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$14.75
|
| Rate for Payer: Aetna Medicare |
$11.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.85
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$11.01
|
| Rate for Payer: BCN Commercial |
$16.93
|
| Rate for Payer: BCN Medicare Advantage |
$11.01
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.01
|
| Rate for Payer: Healthscope Commercial |
$20.37
|
| Rate for Payer: Healthscope Commercial |
$17.62
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.56
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$13.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: PACE SWMI |
$11.01
|
| Rate for Payer: PHP Medicare Advantage |
$11.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36.89
|
| Rate for Payer: Priority Health Medicare |
$11.01
|
| Rate for Payer: Priority Health SBD |
$36.89
|
| Rate for Payer: Priority Health Tiered Network |
$36.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.32
|
| Rate for Payer: UHC Core |
$32.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.01
|
| Rate for Payer: UHC Exchange |
$32.32
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
|
|
PR EMERGENCY DEPARTMENT VISIT MODERATE MDM
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 99284
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$219.11 |
| Rate for Payer: Aetna Commercial |
$158.71
|
| Rate for Payer: Aetna Medicare |
$123.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.55
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$118.44
|
| Rate for Payer: BCN Commercial |
$179.28
|
| Rate for Payer: BCN Medicare Advantage |
$118.44
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$170.55
|
| Rate for Payer: Cofinity Commercial |
$158.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.44
|
| Rate for Payer: Healthscope Commercial |
$219.11
|
| Rate for Payer: Healthscope Commercial |
$189.50
|
| Rate for Payer: Mclaren Medicaid |
$75.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.36
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.44
|
| Rate for Payer: Nomi Health Commercial |
$142.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$118.44
|
| Rate for Payer: PHP Medicare Advantage |
$118.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.10
|
| Rate for Payer: Priority Health Medicare |
$118.44
|
| Rate for Payer: Priority Health SBD |
$203.10
|
| Rate for Payer: Priority Health Tiered Network |
$203.10
|
| Rate for Payer: Railroad Medicare Medicare |
$118.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.98
|
| Rate for Payer: UHC Core |
$170.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.44
|
| Rate for Payer: UHC Exchange |
$170.98
|
| Rate for Payer: UHC Medicaid |
$75.40
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
|
|
PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 99282
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Aetna Commercial |
$54.14
|
| Rate for Payer: Aetna Medicare |
$42.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.18
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$40.40
|
| Rate for Payer: BCN Commercial |
$62.25
|
| Rate for Payer: BCN Medicare Advantage |
$40.40
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$58.18
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.40
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Healthscope Commercial |
$64.64
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.42
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.46
|
| Rate for Payer: Nomi Health Commercial |
$48.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.50
|
| Rate for Payer: PACE SWMI |
$40.40
|
| Rate for Payer: PHP Medicare Advantage |
$40.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.81
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health SBD |
$71.81
|
| Rate for Payer: Priority Health Tiered Network |
$71.81
|
| Rate for Payer: Railroad Medicare Medicare |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.11
|
| Rate for Payer: UHC Core |
$62.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.40
|
| Rate for Payer: UHC Exchange |
$62.11
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 51784
|
| Min. Negotiated Rate |
$63.38 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: UHC Core |
$114.81
|
| Rate for Payer: Aetna Commercial |
$84.93
|
| Rate for Payer: Aetna Medicare |
$65.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.27
|
| Rate for Payer: BCBS MAPPO |
$63.38
|
| Rate for Payer: BCN Commercial |
$95.61
|
| Rate for Payer: BCN Medicare Advantage |
$63.38
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$91.27
|
| Rate for Payer: Cofinity Commercial |
$84.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.38
|
| Rate for Payer: Healthscope Commercial |
$117.25
|
| Rate for Payer: Healthscope Commercial |
$101.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.01
|
| Rate for Payer: Nomi Health Commercial |
$76.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.75
|
| Rate for Payer: PACE SWMI |
$63.38
|
| Rate for Payer: PHP Medicare Advantage |
$63.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$104.16
|
| Rate for Payer: Priority Health Medicare |
$63.38
|
| Rate for Payer: Priority Health SBD |
$104.16
|
| Rate for Payer: Priority Health Tiered Network |
$104.16
|
| Rate for Payer: Railroad Medicare Medicare |
$63.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.38
|
| Rate for Payer: UHC Exchange |
$114.81
|
|
|
PRENATAL VITS-FERROUS FUMARATE-IRON-FOLIC ACID 800 MCG TABLET WRAPPER
|
Facility
|
OP
|
$3.76
|
|
|
Service Code
|
NDC 77333071525
|
| Hospital Charge Code |
300610
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna Commercial |
$3.20
|
| Rate for Payer: Aetna Medicare |
$1.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.44
|
| Rate for Payer: BCBS Complete |
$1.50
|
| Rate for Payer: Cash Price |
$3.01
|
| Rate for Payer: Cofinity Advantage |
$2.63
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.01
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.82
|
| Rate for Payer: PHP Commercial |
$3.20
|
| Rate for Payer: Priority Health SBD |
$2.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.44
|
| Rate for Payer: UHC Core |
$1.96
|
| Rate for Payer: UHC Exchange |
$1.48
|
|
|
PRENATAL VITS-FERROUS FUMARATE-IRON-FOLIC ACID 800 MCG TABLET WRAPPER
|
Facility
|
IP
|
$251.45
|
|
|
Service Code
|
NDC 39328010610
|
| Hospital Charge Code |
300610
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$158.41 |
| Max. Negotiated Rate |
$226.31 |
| Rate for Payer: Aetna Commercial |
$213.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.44
|
| Rate for Payer: Cash Price |
$201.16
|
| Rate for Payer: Cofinity Advantage |
$176.01
|
| Rate for Payer: Cofinity Commercial |
$216.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.16
|
| Rate for Payer: Healthscope Commercial |
$226.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.59
|
| Rate for Payer: PHP Commercial |
$213.73
|
| Rate for Payer: Priority Health SBD |
$158.41
|
|
|
PRENATAL VITS-FERROUS FUMARATE-IRON-FOLIC ACID 800 MCG TABLET WRAPPER
|
Facility
|
IP
|
$376.00
|
|
|
Service Code
|
NDC 77333071510
|
| Hospital Charge Code |
300610
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$236.88 |
| Max. Negotiated Rate |
$338.40 |
| Rate for Payer: Aetna Commercial |
$319.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.40
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Advantage |
$263.20
|
| Rate for Payer: Cofinity Commercial |
$323.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.80
|
| Rate for Payer: Healthscope Commercial |
$338.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: PHP Commercial |
$319.60
|
| Rate for Payer: Priority Health SBD |
$236.88
|
|
|
PRENATAL VITS-FERROUS FUMARATE-IRON-FOLIC ACID 800 MCG TABLET WRAPPER
|
Facility
|
OP
|
$251.45
|
|
|
Service Code
|
NDC 39328010610
|
| Hospital Charge Code |
300610
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.82 |
| Max. Negotiated Rate |
$226.31 |
| Rate for Payer: Aetna Commercial |
$213.73
|
| Rate for Payer: Aetna Medicare |
$125.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.44
|
| Rate for Payer: BCBS Complete |
$100.58
|
| Rate for Payer: Cash Price |
$201.16
|
| Rate for Payer: Cofinity Advantage |
$176.01
|
| Rate for Payer: Cofinity Commercial |
$216.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.16
|
| Rate for Payer: Healthscope Commercial |
$226.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.59
|
| Rate for Payer: PHP Commercial |
$213.73
|
| Rate for Payer: Priority Health SBD |
$158.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.44
|
| Rate for Payer: UHC Core |
$131.01
|
| Rate for Payer: UHC Exchange |
$98.82
|
|
|
PRENATAL VITS-FERROUS FUMARATE-IRON-FOLIC ACID 800 MCG TABLET WRAPPER
|
Facility
|
IP
|
$3.76
|
|
|
Service Code
|
NDC 77333071525
|
| Hospital Charge Code |
300610
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna Commercial |
$3.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.44
|
| Rate for Payer: Cash Price |
$3.01
|
| Rate for Payer: Cofinity Advantage |
$2.63
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.01
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.82
|
| Rate for Payer: PHP Commercial |
$3.20
|
| Rate for Payer: Priority Health SBD |
$2.37
|
|
|
PRENATAL VITS-FERROUS FUMARATE-IRON-FOLIC ACID 800 MCG TABLET WRAPPER
|
Facility
|
OP
|
$376.00
|
|
|
Service Code
|
NDC 77333071510
|
| Hospital Charge Code |
300610
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$147.77 |
| Max. Negotiated Rate |
$338.40 |
| Rate for Payer: Aetna Commercial |
$319.60
|
| Rate for Payer: Aetna Medicare |
$188.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.40
|
| Rate for Payer: BCBS Complete |
$150.40
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Advantage |
$263.20
|
| Rate for Payer: Cofinity Commercial |
$323.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.80
|
| Rate for Payer: Healthscope Commercial |
$338.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.00
|
| Rate for Payer: PHP Commercial |
$319.60
|
| Rate for Payer: Priority Health SBD |
$236.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.40
|
| Rate for Payer: UHC Core |
$195.90
|
| Rate for Payer: UHC Exchange |
$147.77
|
|
|
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET
|
Facility
|
OP
|
$179.78
|
|
|
Service Code
|
NDC 07610010418
|
| Hospital Charge Code |
177116
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.65 |
| Max. Negotiated Rate |
$161.80 |
| Rate for Payer: Aetna Commercial |
$152.81
|
| Rate for Payer: Aetna Medicare |
$89.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.86
|
| Rate for Payer: BCBS Complete |
$71.91
|
| Rate for Payer: Cash Price |
$143.82
|
| Rate for Payer: Cofinity Advantage |
$125.85
|
| Rate for Payer: Cofinity Commercial |
$154.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.82
|
| Rate for Payer: Healthscope Commercial |
$161.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.84
|
| Rate for Payer: PHP Commercial |
$152.81
|
| Rate for Payer: Priority Health SBD |
$113.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.86
|
| Rate for Payer: UHC Core |
$93.67
|
| Rate for Payer: UHC Exchange |
$70.65
|
|
|
PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET
|
Facility
|
IP
|
$179.78
|
|
|
Service Code
|
NDC 07610010418
|
| Hospital Charge Code |
177116
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$113.26 |
| Max. Negotiated Rate |
$161.80 |
| Rate for Payer: Aetna Commercial |
$152.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.86
|
| Rate for Payer: Cash Price |
$143.82
|
| Rate for Payer: Cofinity Advantage |
$125.85
|
| Rate for Payer: Cofinity Commercial |
$154.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.82
|
| Rate for Payer: Healthscope Commercial |
$161.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.84
|
| Rate for Payer: PHP Commercial |
$152.81
|
| Rate for Payer: Priority Health SBD |
$113.26
|
|
|
PR ENDOBRONCHIAL U/S ADD-ON
|
Professional
|
Both
|
$478.00
|
|
|
Service Code
|
HCPCS 31620
|
| Min. Negotiated Rate |
$191.20 |
| Max. Negotiated Rate |
$358.50 |
| Rate for Payer: Aetna Medicare |
$239.00
|
| Rate for Payer: BCBS Complete |
$191.20
|
| Rate for Payer: Cash Price |
$382.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.50
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
OP
|
$321.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna Commercial |
$272.85
|
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$580.01
|
| Rate for Payer: BCCCP Commercial |
$145.60
|
| Rate for Payer: BCN Commercial |
$580.01
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Advantage |
$224.70
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$288.90
|
| Rate for Payer: Mclaren Medicaid |
$479.98
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.85
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$272.85
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health SBD |
$202.23
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: VA VA |
$917.74
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 57505
|
| Hospital Charge Code |
57505
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$99.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.89
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$95.76
|
| Rate for Payer: BCN Commercial |
$129.59
|
| Rate for Payer: BCN Medicare Advantage |
$95.76
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$137.89
|
| Rate for Payer: Cofinity Commercial |
$128.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$177.16
|
| Rate for Payer: Healthscope Commercial |
$153.22
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.55
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.20
|
| Rate for Payer: Nomi Health Commercial |
$114.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE SWMI |
$95.76
|
| Rate for Payer: PHP Medicare Advantage |
$95.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.43
|
| Rate for Payer: Priority Health Medicare |
$95.76
|
| Rate for Payer: Priority Health SBD |
$166.43
|
| Rate for Payer: Priority Health Tiered Network |
$166.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.93
|
| Rate for Payer: UHC Core |
$173.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.76
|
| Rate for Payer: UHC Exchange |
$173.93
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
57505
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$202.23 |
| Max. Negotiated Rate |
$288.90 |
| Rate for Payer: Aetna Commercial |
$272.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.65
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Advantage |
$224.70
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.80
|
| Rate for Payer: Healthscope Commercial |
$288.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PHP Commercial |
$272.85
|
| Rate for Payer: Priority Health SBD |
$202.23
|
|
|
PR ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 57505
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$99.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.89
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$95.76
|
| Rate for Payer: BCN Commercial |
$129.59
|
| Rate for Payer: BCN Medicare Advantage |
$95.76
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$137.89
|
| Rate for Payer: Cofinity Commercial |
$128.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$177.16
|
| Rate for Payer: Healthscope Commercial |
$153.22
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.55
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.20
|
| Rate for Payer: Nomi Health Commercial |
$114.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.75
|
| Rate for Payer: PACE SWMI |
$95.76
|
| Rate for Payer: PHP Medicare Advantage |
$95.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.43
|
| Rate for Payer: Priority Health Medicare |
$95.76
|
| Rate for Payer: Priority Health SBD |
$166.43
|
| Rate for Payer: Priority Health Tiered Network |
$166.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.93
|
| Rate for Payer: UHC Core |
$173.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.76
|
| Rate for Payer: UHC Exchange |
$173.93
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR END OF LIFE COUNSELING
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS S0257
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$47.64 |
| Rate for Payer: Aetna Commercial |
$3.85
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.85
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCN Commercial |
$29.04
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.64
|
| Rate for Payer: Priority Health SBD |
$47.64
|
| Rate for Payer: Priority Health Tiered Network |
$47.64
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 92979
|
| Min. Negotiated Rate |
$110.06 |
| Max. Negotiated Rate |
$284.12 |
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.41
|
| Rate for Payer: BCN Commercial |
$110.06
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$227.18
|
| Rate for Payer: Priority Health SBD |
$227.18
|
| Rate for Payer: Priority Health Tiered Network |
$227.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.12
|
| Rate for Payer: UHC Core |
$284.12
|
| Rate for Payer: UHC Exchange |
$284.12
|
|
|
PR ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 92978
|
| Min. Negotiated Rate |
$137.95 |
| Max. Negotiated Rate |
$463.55 |
| Rate for Payer: Aetna Commercial |
$348.91
|
| Rate for Payer: Aetna Medicare |
$258.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.91
|
| Rate for Payer: BCN Commercial |
$137.95
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$374.38
|
| Rate for Payer: Priority Health SBD |
$374.38
|
| Rate for Payer: Priority Health Tiered Network |
$374.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.55
|
| Rate for Payer: UHC Core |
$463.55
|
| Rate for Payer: UHC Exchange |
$463.55
|
|
|
PR ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
|
Professional
|
Both
|
$2,104.00
|
|
|
Service Code
|
HCPCS 58353
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$1,578.00 |
| Rate for Payer: Aetna Commercial |
$268.83
|
| Rate for Payer: Aetna Medicare |
$208.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.89
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$200.62
|
| Rate for Payer: BCN Commercial |
$346.10
|
| Rate for Payer: BCN Medicare Advantage |
$200.62
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cash Price |
$1,683.20
|
| Rate for Payer: Cofinity Commercial |
$288.89
|
| Rate for Payer: Cofinity Commercial |
$268.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.62
|
| Rate for Payer: Healthscope Commercial |
$371.15
|
| Rate for Payer: Healthscope Commercial |
$320.99
|
| Rate for Payer: Mclaren Medicaid |
$129.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.65
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.24
|
| Rate for Payer: Nomi Health Commercial |
$240.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,578.00
|
| Rate for Payer: PACE SWMI |
$200.62
|
| Rate for Payer: PHP Medicare Advantage |
$200.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$350.52
|
| Rate for Payer: Priority Health Medicare |
$200.62
|
| Rate for Payer: Priority Health SBD |
$350.52
|
| Rate for Payer: Priority Health Tiered Network |
$350.52
|
| Rate for Payer: Railroad Medicare Medicare |
$200.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.94
|
| Rate for Payer: UHC Core |
$397.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.62
|
| Rate for Payer: UHC Exchange |
$397.94
|
| Rate for Payer: UHC Medicaid |
$129.93
|
| Rate for Payer: UHCCP Medicaid |
$129.93
|
|
|
PR ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 58110
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$47.58
|
| Rate for Payer: Aetna Medicare |
$36.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.13
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$35.51
|
| Rate for Payer: BCN Commercial |
$60.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.51
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$51.13
|
| Rate for Payer: Cofinity Commercial |
$47.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.51
|
| Rate for Payer: Healthscope Commercial |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$56.82
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.29
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.51
|
| Rate for Payer: Nomi Health Commercial |
$42.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$35.51
|
| Rate for Payer: PHP Medicare Advantage |
$35.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.03
|
| Rate for Payer: Priority Health Medicare |
$35.51
|
| Rate for Payer: Priority Health SBD |
$61.03
|
| Rate for Payer: Priority Health Tiered Network |
$61.03
|
| Rate for Payer: Railroad Medicare Medicare |
$35.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.11
|
| Rate for Payer: UHC Core |
$73.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.51
|
| Rate for Payer: UHC Exchange |
$73.11
|
| Rate for Payer: UHC Medicaid |
$22.58
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 58100
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$74.05
|
| Rate for Payer: Aetna Medicare |
$57.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.57
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$55.26
|
| Rate for Payer: BCN Commercial |
$74.22
|
| Rate for Payer: BCN Medicare Advantage |
$55.26
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$79.57
|
| Rate for Payer: Cofinity Commercial |
$74.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.26
|
| Rate for Payer: Healthscope Commercial |
$88.42
|
| Rate for Payer: Healthscope Commercial |
$102.23
|
| Rate for Payer: Mclaren Medicaid |
$35.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.02
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.95
|
| Rate for Payer: Nomi Health Commercial |
$66.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.75
|
| Rate for Payer: PACE SWMI |
$55.26
|
| Rate for Payer: PHP Medicare Advantage |
$55.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.31
|
| Rate for Payer: Priority Health Medicare |
$55.26
|
| Rate for Payer: Priority Health SBD |
$95.31
|
| Rate for Payer: Priority Health Tiered Network |
$95.31
|
| Rate for Payer: Railroad Medicare Medicare |
$55.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.34
|
| Rate for Payer: UHC Core |
$114.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.26
|
| Rate for Payer: UHC Exchange |
$114.34
|
| Rate for Payer: UHC Medicaid |
$35.15
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
|
