|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 43247
|
| Min. Negotiated Rate |
$166.46 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Aetna Commercial |
$223.06
|
| Rate for Payer: Aetna Medicare |
$173.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.06
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS MAPPO |
$166.46
|
| Rate for Payer: BCN Medicare Advantage |
$166.46
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Cofinity Commercial |
$223.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$307.95
|
| Rate for Payer: Healthscope Commercial |
$266.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.90
|
| Rate for Payer: Nomi Health Commercial |
$199.75
|
| Rate for Payer: PACE SWMI |
$166.46
|
| Rate for Payer: PHP Medicare Advantage |
$166.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health Medicare |
$166.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.46
|
| Rate for Payer: UHC Medicare Advantage |
$166.46
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43250
|
| Hospital Charge Code |
43250
|
| Min. Negotiated Rate |
$161.39 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$216.26
|
| Rate for Payer: Aetna Medicare |
$167.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.40
|
| Rate for Payer: BCBS Complete |
$441.60
|
| Rate for Payer: BCBS MAPPO |
$161.39
|
| Rate for Payer: BCN Medicare Advantage |
$161.39
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$232.40
|
| Rate for Payer: Cofinity Commercial |
$216.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.39
|
| Rate for Payer: Healthscope Commercial |
$258.22
|
| Rate for Payer: Healthscope Commercial |
$298.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$717.60
|
| Rate for Payer: Nomi Health Commercial |
$193.67
|
| Rate for Payer: PACE SWMI |
$161.39
|
| Rate for Payer: PHP Medicare Advantage |
$161.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$161.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.39
|
| Rate for Payer: UHC Medicare Advantage |
$161.39
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43250
|
| Min. Negotiated Rate |
$161.39 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$216.26
|
| Rate for Payer: Aetna Medicare |
$167.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.26
|
| Rate for Payer: BCBS Complete |
$441.60
|
| Rate for Payer: BCBS MAPPO |
$161.39
|
| Rate for Payer: BCN Medicare Advantage |
$161.39
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$232.40
|
| Rate for Payer: Cofinity Commercial |
$216.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.39
|
| Rate for Payer: Healthscope Commercial |
$258.22
|
| Rate for Payer: Healthscope Commercial |
$298.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$717.60
|
| Rate for Payer: Nomi Health Commercial |
$193.67
|
| Rate for Payer: PACE SWMI |
$161.39
|
| Rate for Payer: PHP Medicare Advantage |
$161.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$161.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.39
|
| Rate for Payer: UHC Medicare Advantage |
$161.39
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
IP
|
$1,104.00
|
|
|
Service Code
|
CPT 43250
|
| Hospital Charge Code |
43250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$695.52 |
| Max. Negotiated Rate |
$993.60 |
| Rate for Payer: Aetna Commercial |
$938.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.60
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$772.80
|
| Rate for Payer: Cofinity Commercial |
$949.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$772.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.20
|
| Rate for Payer: Healthscope Commercial |
$993.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$938.40
|
| Rate for Payer: PHP Commercial |
$938.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health SBD |
$695.52
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$1,104.00
|
|
|
Service Code
|
CPT 43250
|
| Hospital Charge Code |
43250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$695.52 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Commercial |
$938.40
|
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$772.80
|
| Rate for Payer: Cofinity Commercial |
$949.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$772.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$993.60
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$938.40
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$938.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health SBD |
$695.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$1,041.61
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
PR EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 43243
|
| Min. Negotiated Rate |
$224.75 |
| Max. Negotiated Rate |
$782.60 |
| Rate for Payer: Aetna Commercial |
$301.17
|
| Rate for Payer: Aetna Medicare |
$233.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.17
|
| Rate for Payer: BCBS Complete |
$481.60
|
| Rate for Payer: BCBS MAPPO |
$224.75
|
| Rate for Payer: BCN Medicare Advantage |
$224.75
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$323.64
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.75
|
| Rate for Payer: Healthscope Commercial |
$415.79
|
| Rate for Payer: Healthscope Commercial |
$359.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$782.60
|
| Rate for Payer: Nomi Health Commercial |
$269.70
|
| Rate for Payer: PACE SWMI |
$224.75
|
| Rate for Payer: PHP Medicare Advantage |
$224.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health Medicare |
$224.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.75
|
| Rate for Payer: UHC Medicare Advantage |
$224.75
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
IP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$556.92 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: Aetna Commercial |
$751.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.60
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$618.80
|
| Rate for Payer: Cofinity Commercial |
$760.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Healthscope Commercial |
$795.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: PHP Commercial |
$751.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health SBD |
$556.92
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Min. Negotiated Rate |
$156.41 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$162.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.59
|
| Rate for Payer: BCBS Complete |
$353.60
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Healthscope Commercial |
$250.26
|
| Rate for Payer: Healthscope Commercial |
$289.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.60
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health Medicare |
$156.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Hospital Charge Code |
43248
|
| Min. Negotiated Rate |
$156.41 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$162.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.23
|
| Rate for Payer: BCBS Complete |
$353.60
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Healthscope Commercial |
$250.26
|
| Rate for Payer: Healthscope Commercial |
$289.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.60
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health Medicare |
$156.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
OP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna Commercial |
$751.40
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$618.80
|
| Rate for Payer: Cofinity Commercial |
$760.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$795.60
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$751.40
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$556.92
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$514.80
|
| Rate for Payer: VA VA |
$914.38
|
|
|
PR EGD INTRALUMINAL TUBE/CATHETER INSERTION
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 43241
|
| Min. Negotiated Rate |
$134.61 |
| Max. Negotiated Rate |
$567.45 |
| Rate for Payer: Aetna Commercial |
$180.38
|
| Rate for Payer: Aetna Medicare |
$139.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.38
|
| Rate for Payer: BCBS Complete |
$349.20
|
| Rate for Payer: BCBS MAPPO |
$134.61
|
| Rate for Payer: BCN Medicare Advantage |
$134.61
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$193.84
|
| Rate for Payer: Cofinity Commercial |
$180.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.61
|
| Rate for Payer: Healthscope Commercial |
$249.03
|
| Rate for Payer: Healthscope Commercial |
$215.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.45
|
| Rate for Payer: Nomi Health Commercial |
$161.53
|
| Rate for Payer: PACE SWMI |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health Medicare |
$134.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.61
|
| Rate for Payer: UHC Medicare Advantage |
$134.61
|
|
|
PR EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 43242
|
| Min. Negotiated Rate |
$246.65 |
| Max. Negotiated Rate |
$671.45 |
| Rate for Payer: Aetna Commercial |
$330.51
|
| Rate for Payer: Aetna Medicare |
$256.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.51
|
| Rate for Payer: BCBS Complete |
$413.20
|
| Rate for Payer: BCBS MAPPO |
$246.65
|
| Rate for Payer: BCN Medicare Advantage |
$246.65
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$355.18
|
| Rate for Payer: Cofinity Commercial |
$330.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.65
|
| Rate for Payer: Healthscope Commercial |
$394.64
|
| Rate for Payer: Healthscope Commercial |
$456.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.45
|
| Rate for Payer: Nomi Health Commercial |
$295.98
|
| Rate for Payer: PACE SWMI |
$246.65
|
| Rate for Payer: PHP Medicare Advantage |
$246.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.45
|
| Rate for Payer: Priority Health Medicare |
$246.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.65
|
| Rate for Payer: UHC Medicare Advantage |
$246.65
|
|
|
PR EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 43238
|
| Min. Negotiated Rate |
$218.95 |
| Max. Negotiated Rate |
$673.40 |
| Rate for Payer: Aetna Commercial |
$293.39
|
| Rate for Payer: Aetna Medicare |
$227.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.39
|
| Rate for Payer: BCBS Complete |
$414.40
|
| Rate for Payer: BCBS MAPPO |
$218.95
|
| Rate for Payer: BCN Medicare Advantage |
$218.95
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$315.29
|
| Rate for Payer: Cofinity Commercial |
$293.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.95
|
| Rate for Payer: Healthscope Commercial |
$405.06
|
| Rate for Payer: Healthscope Commercial |
$350.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.40
|
| Rate for Payer: Nomi Health Commercial |
$262.74
|
| Rate for Payer: PACE SWMI |
$218.95
|
| Rate for Payer: PHP Medicare Advantage |
$218.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health Medicare |
$218.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.95
|
| Rate for Payer: UHC Medicare Advantage |
$218.95
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
IP
|
$1,446.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$910.98 |
| Max. Negotiated Rate |
$1,301.40 |
| Rate for Payer: Aetna Commercial |
$1,229.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.90
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,012.20
|
| Rate for Payer: Cofinity Commercial |
$1,243.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,012.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.80
|
| Rate for Payer: Healthscope Commercial |
$1,301.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,229.10
|
| Rate for Payer: PHP Commercial |
$1,229.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health SBD |
$910.98
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
OP
|
$1,446.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$910.98 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Commercial |
$1,229.10
|
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,012.20
|
| Rate for Payer: Cofinity Commercial |
$1,243.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,012.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$1,301.40
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,229.10
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$1,229.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health SBD |
$910.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$1,041.61
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
43246
|
| Min. Negotiated Rate |
$189.95 |
| Max. Negotiated Rate |
$939.90 |
| Rate for Payer: Aetna Commercial |
$254.53
|
| Rate for Payer: Aetna Medicare |
$197.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.53
|
| Rate for Payer: BCBS Complete |
$578.40
|
| Rate for Payer: BCBS MAPPO |
$189.95
|
| Rate for Payer: BCN Medicare Advantage |
$189.95
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$273.53
|
| Rate for Payer: Cofinity Commercial |
$254.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.95
|
| Rate for Payer: Healthscope Commercial |
$303.92
|
| Rate for Payer: Healthscope Commercial |
$351.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$939.90
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE SWMI |
$189.95
|
| Rate for Payer: PHP Medicare Advantage |
$189.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health Medicare |
$189.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.95
|
| Rate for Payer: UHC Medicare Advantage |
$189.95
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 43246
|
| Min. Negotiated Rate |
$189.95 |
| Max. Negotiated Rate |
$939.90 |
| Rate for Payer: Aetna Commercial |
$254.53
|
| Rate for Payer: Aetna Medicare |
$197.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.53
|
| Rate for Payer: BCBS Complete |
$578.40
|
| Rate for Payer: BCBS MAPPO |
$189.95
|
| Rate for Payer: BCN Medicare Advantage |
$189.95
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$273.53
|
| Rate for Payer: Cofinity Commercial |
$254.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.95
|
| Rate for Payer: Healthscope Commercial |
$303.92
|
| Rate for Payer: Healthscope Commercial |
$351.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$939.90
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE SWMI |
$189.95
|
| Rate for Payer: PHP Medicare Advantage |
$189.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health Medicare |
$189.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.95
|
| Rate for Payer: UHC Medicare Advantage |
$189.95
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
OP
|
$1,193.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$751.59 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Commercial |
$1,014.05
|
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.98
|
| Rate for Payer: Cofinity Commercial |
$835.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$835.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$1,073.70
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.05
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$1,014.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health SBD |
$751.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$1,041.61
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 43251
|
| Min. Negotiated Rate |
$184.55 |
| Max. Negotiated Rate |
$775.45 |
| Rate for Payer: Aetna Commercial |
$247.30
|
| Rate for Payer: Aetna Medicare |
$191.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.30
|
| Rate for Payer: BCBS Complete |
$477.20
|
| Rate for Payer: BCBS MAPPO |
$184.55
|
| Rate for Payer: BCN Medicare Advantage |
$184.55
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$265.75
|
| Rate for Payer: Cofinity Commercial |
$247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.55
|
| Rate for Payer: Healthscope Commercial |
$341.42
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$775.45
|
| Rate for Payer: Nomi Health Commercial |
$221.46
|
| Rate for Payer: PACE SWMI |
$184.55
|
| Rate for Payer: PHP Medicare Advantage |
$184.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health Medicare |
$184.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.55
|
| Rate for Payer: UHC Medicare Advantage |
$184.55
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
IP
|
$1,193.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$751.59 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Aetna Commercial |
$1,014.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.45
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.98
|
| Rate for Payer: Cofinity Commercial |
$835.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$835.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.40
|
| Rate for Payer: Healthscope Commercial |
$1,073.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.05
|
| Rate for Payer: PHP Commercial |
$1,014.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health SBD |
$751.59
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 43251
|
| Hospital Charge Code |
43251
|
| Min. Negotiated Rate |
$184.55 |
| Max. Negotiated Rate |
$775.45 |
| Rate for Payer: Aetna Commercial |
$247.30
|
| Rate for Payer: Aetna Medicare |
$191.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.75
|
| Rate for Payer: BCBS Complete |
$477.20
|
| Rate for Payer: BCBS MAPPO |
$184.55
|
| Rate for Payer: BCN Medicare Advantage |
$184.55
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$265.75
|
| Rate for Payer: Cofinity Commercial |
$247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.55
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Healthscope Commercial |
$341.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$775.45
|
| Rate for Payer: Nomi Health Commercial |
$221.46
|
| Rate for Payer: PACE SWMI |
$184.55
|
| Rate for Payer: PHP Medicare Advantage |
$184.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health Medicare |
$184.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.55
|
| Rate for Payer: UHC Medicare Advantage |
$184.55
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna Commercial |
$712.30
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$586.60
|
| Rate for Payer: Cofinity Commercial |
$720.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$586.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$754.20
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.30
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$712.30
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$527.94
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$514.80
|
| Rate for Payer: VA VA |
$914.38
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 43239
|
| Min. Negotiated Rate |
$130.16 |
| Max. Negotiated Rate |
$544.70 |
| Rate for Payer: Aetna Commercial |
$174.41
|
| Rate for Payer: Aetna Medicare |
$135.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.41
|
| Rate for Payer: BCBS Complete |
$335.20
|
| Rate for Payer: BCBS MAPPO |
$130.16
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Cofinity Commercial |
$174.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| Rate for Payer: Healthscope Commercial |
$208.26
|
| Rate for Payer: Healthscope Commercial |
$240.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.70
|
| Rate for Payer: Nomi Health Commercial |
$156.19
|
| Rate for Payer: PACE SWMI |
$130.16
|
| Rate for Payer: PHP Medicare Advantage |
$130.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health Medicare |
$130.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$527.94 |
| Max. Negotiated Rate |
$754.20 |
| Rate for Payer: Aetna Commercial |
$712.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.70
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$586.60
|
| Rate for Payer: Cofinity Commercial |
$720.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$586.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.40
|
| Rate for Payer: Healthscope Commercial |
$754.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.30
|
| Rate for Payer: PHP Commercial |
$712.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health SBD |
$527.94
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 43239
|
| Hospital Charge Code |
43239
|
| Min. Negotiated Rate |
$130.16 |
| Max. Negotiated Rate |
$544.70 |
| Rate for Payer: Aetna Commercial |
$174.41
|
| Rate for Payer: Aetna Medicare |
$135.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.43
|
| Rate for Payer: BCBS Complete |
$335.20
|
| Rate for Payer: BCBS MAPPO |
$130.16
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Cofinity Commercial |
$174.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| Rate for Payer: Healthscope Commercial |
$208.26
|
| Rate for Payer: Healthscope Commercial |
$240.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.70
|
| Rate for Payer: Nomi Health Commercial |
$156.19
|
| Rate for Payer: PACE SWMI |
$130.16
|
| Rate for Payer: PHP Medicare Advantage |
$130.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health Medicare |
$130.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
|
