|
CHG VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 75840
|
| Min. Negotiated Rate |
$118.54 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$158.84
|
| Rate for Payer: Aetna Medicare |
$123.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.84
|
| Rate for Payer: BCBS MAPPO |
$118.54
|
| Rate for Payer: BCN Commercial |
$191.23
|
| Rate for Payer: BCN Medicare Advantage |
$118.54
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$170.70
|
| Rate for Payer: Cofinity Commercial |
$158.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$219.30
|
| Rate for Payer: Healthscope Commercial |
$189.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.61
|
| Rate for Payer: Nomi Health Commercial |
$142.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.75
|
| Rate for Payer: PACE SWMI |
$118.54
|
| Rate for Payer: PHP Medicare Advantage |
$118.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.66
|
| Rate for Payer: Priority Health Medicare |
$118.54
|
| Rate for Payer: Priority Health SBD |
$192.66
|
| Rate for Payer: Priority Health Tiered Network |
$192.66
|
| Rate for Payer: Railroad Medicare Medicare |
$118.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.69
|
| Rate for Payer: UHC Core |
$200.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.54
|
| Rate for Payer: UHC Exchange |
$200.69
|
|
|
CHG VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 75825
|
| Min. Negotiated Rate |
$83.25 |
| Max. Negotiated Rate |
$199.65 |
| Rate for Payer: Aetna Commercial |
$144.61
|
| Rate for Payer: Aetna Medicare |
$112.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.40
|
| Rate for Payer: BCBS MAPPO |
$107.92
|
| Rate for Payer: BCN Commercial |
$170.31
|
| Rate for Payer: BCN Medicare Advantage |
$107.92
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$155.40
|
| Rate for Payer: Cofinity Commercial |
$144.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.92
|
| Rate for Payer: Healthscope Commercial |
$199.65
|
| Rate for Payer: Healthscope Commercial |
$172.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.75
|
| Rate for Payer: Nomi Health Commercial |
$129.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.25
|
| Rate for Payer: PACE SWMI |
$107.92
|
| Rate for Payer: PHP Medicare Advantage |
$107.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$107.92
|
| Rate for Payer: Priority Health SBD |
$171.60
|
| Rate for Payer: Priority Health Tiered Network |
$171.60
|
| Rate for Payer: Railroad Medicare Medicare |
$107.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$180.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.92
|
| Rate for Payer: UHC Exchange |
$180.35
|
|
|
CHG VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 75827
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$208.81 |
| Rate for Payer: Aetna Commercial |
$151.25
|
| Rate for Payer: Aetna Medicare |
$117.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.53
|
| Rate for Payer: BCBS MAPPO |
$112.87
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: BCN Medicare Advantage |
$112.87
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$162.53
|
| Rate for Payer: Cofinity Commercial |
$151.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.87
|
| Rate for Payer: Healthscope Commercial |
$208.81
|
| Rate for Payer: Healthscope Commercial |
$180.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$124.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.64
|
| Rate for Payer: Nomi Health Commercial |
$135.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: PACE SWMI |
$112.87
|
| Rate for Payer: PHP Medicare Advantage |
$112.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$176.61
|
| Rate for Payer: Priority Health Medicare |
$112.87
|
| Rate for Payer: Priority Health SBD |
$176.61
|
| Rate for Payer: Priority Health Tiered Network |
$176.61
|
| Rate for Payer: Railroad Medicare Medicare |
$112.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.27
|
| Rate for Payer: UHC Core |
$187.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.87
|
| Rate for Payer: UHC Exchange |
$187.27
|
|
|
CHG VENOGRAPHY EXTREMITY BILATERAL RS&I
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 75822
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$234.71 |
| Rate for Payer: Aetna Commercial |
$170.01
|
| Rate for Payer: Aetna Commercial |
$170.01
|
| Rate for Payer: Aetna Medicare |
$131.94
|
| Rate for Payer: Aetna Medicare |
$131.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.69
|
| Rate for Payer: BCBS MAPPO |
$126.87
|
| Rate for Payer: BCBS MAPPO |
$126.87
|
| Rate for Payer: BCN Commercial |
$198.19
|
| Rate for Payer: BCN Commercial |
$198.19
|
| Rate for Payer: BCN Medicare Advantage |
$126.87
|
| Rate for Payer: BCN Medicare Advantage |
$126.87
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$170.01
|
| Rate for Payer: Cofinity Commercial |
$182.69
|
| Rate for Payer: Cofinity Commercial |
$170.01
|
| Rate for Payer: Cofinity Commercial |
$182.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.87
|
| Rate for Payer: Healthscope Commercial |
$234.71
|
| Rate for Payer: Healthscope Commercial |
$234.71
|
| Rate for Payer: Healthscope Commercial |
$202.99
|
| Rate for Payer: Healthscope Commercial |
$202.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.51
|
| Rate for Payer: Nomi Health Commercial |
$152.24
|
| Rate for Payer: Nomi Health Commercial |
$152.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.50
|
| Rate for Payer: PACE SWMI |
$126.87
|
| Rate for Payer: PACE SWMI |
$126.87
|
| Rate for Payer: PHP Medicare Advantage |
$126.87
|
| Rate for Payer: PHP Medicare Advantage |
$126.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$199.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$199.69
|
| Rate for Payer: Priority Health Medicare |
$126.87
|
| Rate for Payer: Priority Health Medicare |
$126.87
|
| Rate for Payer: Priority Health SBD |
$199.69
|
| Rate for Payer: Priority Health SBD |
$199.69
|
| Rate for Payer: Priority Health Tiered Network |
$199.69
|
| Rate for Payer: Priority Health Tiered Network |
$199.69
|
| Rate for Payer: Railroad Medicare Medicare |
$126.87
|
| Rate for Payer: Railroad Medicare Medicare |
$126.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.33
|
| Rate for Payer: UHC Core |
$180.33
|
| Rate for Payer: UHC Core |
$180.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.87
|
| Rate for Payer: UHC Exchange |
$180.33
|
| Rate for Payer: UHC Exchange |
$180.33
|
|
|
CHG VENOGRAPHY EXTREMITY UNILATERAL RS&I
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 75820
|
| Min. Negotiated Rate |
$101.50 |
| Max. Negotiated Rate |
$188.32 |
| Rate for Payer: Aetna Commercial |
$136.01
|
| Rate for Payer: Aetna Commercial |
$136.01
|
| Rate for Payer: Aetna Medicare |
$105.56
|
| Rate for Payer: Aetna Medicare |
$105.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.01
|
| Rate for Payer: BCBS MAPPO |
$101.50
|
| Rate for Payer: BCBS MAPPO |
$101.50
|
| Rate for Payer: BCN Commercial |
$158.36
|
| Rate for Payer: BCN Commercial |
$158.36
|
| Rate for Payer: BCN Medicare Advantage |
$101.50
|
| Rate for Payer: BCN Medicare Advantage |
$101.50
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$146.16
|
| Rate for Payer: Cofinity Commercial |
$136.01
|
| Rate for Payer: Cofinity Commercial |
$136.01
|
| Rate for Payer: Cofinity Commercial |
$146.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.50
|
| Rate for Payer: Healthscope Commercial |
$187.78
|
| Rate for Payer: Healthscope Commercial |
$187.78
|
| Rate for Payer: Healthscope Commercial |
$162.40
|
| Rate for Payer: Healthscope Commercial |
$162.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.32
|
| Rate for Payer: Nomi Health Commercial |
$121.80
|
| Rate for Payer: Nomi Health Commercial |
$121.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.50
|
| Rate for Payer: PACE SWMI |
$101.50
|
| Rate for Payer: PACE SWMI |
$101.50
|
| Rate for Payer: PHP Medicare Advantage |
$101.50
|
| Rate for Payer: PHP Medicare Advantage |
$101.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.55
|
| Rate for Payer: Priority Health Medicare |
$101.50
|
| Rate for Payer: Priority Health Medicare |
$101.50
|
| Rate for Payer: Priority Health SBD |
$159.55
|
| Rate for Payer: Priority Health SBD |
$159.55
|
| Rate for Payer: Priority Health Tiered Network |
$159.55
|
| Rate for Payer: Priority Health Tiered Network |
$159.55
|
| Rate for Payer: Railroad Medicare Medicare |
$101.50
|
| Rate for Payer: Railroad Medicare Medicare |
$101.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.99
|
| Rate for Payer: UHC Core |
$152.99
|
| Rate for Payer: UHC Core |
$152.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.50
|
| Rate for Payer: UHC Exchange |
$152.99
|
| Rate for Payer: UHC Exchange |
$152.99
|
|
|
CHG VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 75833
|
| Min. Negotiated Rate |
$107.25 |
| Max. Negotiated Rate |
$275.32 |
| Rate for Payer: Aetna Commercial |
$199.42
|
| Rate for Payer: Aetna Medicare |
$154.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.30
|
| Rate for Payer: BCBS MAPPO |
$148.82
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.82
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$214.30
|
| Rate for Payer: Cofinity Commercial |
$199.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.82
|
| Rate for Payer: Healthscope Commercial |
$275.32
|
| Rate for Payer: Healthscope Commercial |
$238.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.61
|
| Rate for Payer: Nomi Health Commercial |
$178.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.25
|
| Rate for Payer: PACE SWMI |
$148.82
|
| Rate for Payer: PHP Medicare Advantage |
$148.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.76
|
| Rate for Payer: Priority Health Medicare |
$148.82
|
| Rate for Payer: Priority Health SBD |
$221.76
|
| Rate for Payer: Priority Health Tiered Network |
$221.76
|
| Rate for Payer: Railroad Medicare Medicare |
$148.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.51
|
| Rate for Payer: UHC Core |
$226.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$148.82
|
| Rate for Payer: UHC Exchange |
$226.51
|
|
|
CHG VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 75831
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$208.27 |
| Rate for Payer: Aetna Commercial |
$150.86
|
| Rate for Payer: Aetna Commercial |
$150.86
|
| Rate for Payer: Aetna Medicare |
$117.08
|
| Rate for Payer: Aetna Medicare |
$117.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.12
|
| Rate for Payer: BCBS MAPPO |
$112.58
|
| Rate for Payer: BCBS MAPPO |
$112.58
|
| Rate for Payer: BCN Commercial |
$178.77
|
| Rate for Payer: BCN Commercial |
$178.77
|
| Rate for Payer: BCN Medicare Advantage |
$112.58
|
| Rate for Payer: BCN Medicare Advantage |
$112.58
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$150.86
|
| Rate for Payer: Cofinity Commercial |
$162.12
|
| Rate for Payer: Cofinity Commercial |
$150.86
|
| Rate for Payer: Cofinity Commercial |
$162.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.58
|
| Rate for Payer: Healthscope Commercial |
$208.27
|
| Rate for Payer: Healthscope Commercial |
$208.27
|
| Rate for Payer: Healthscope Commercial |
$180.13
|
| Rate for Payer: Healthscope Commercial |
$180.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.99
|
| Rate for Payer: Nomi Health Commercial |
$135.10
|
| Rate for Payer: Nomi Health Commercial |
$135.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE SWMI |
$112.58
|
| Rate for Payer: PACE SWMI |
$112.58
|
| Rate for Payer: PHP Medicare Advantage |
$112.58
|
| Rate for Payer: PHP Medicare Advantage |
$112.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$180.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$180.12
|
| Rate for Payer: Priority Health Medicare |
$112.58
|
| Rate for Payer: Priority Health Medicare |
$112.58
|
| Rate for Payer: Priority Health SBD |
$180.12
|
| Rate for Payer: Priority Health SBD |
$180.12
|
| Rate for Payer: Priority Health Tiered Network |
$180.12
|
| Rate for Payer: Priority Health Tiered Network |
$180.12
|
| Rate for Payer: Railroad Medicare Medicare |
$112.58
|
| Rate for Payer: Railroad Medicare Medicare |
$112.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.58
|
| Rate for Payer: UHC Core |
$187.58
|
| Rate for Payer: UHC Core |
$187.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.58
|
| Rate for Payer: UHC Exchange |
$187.58
|
| Rate for Payer: UHC Exchange |
$187.58
|
|
|
CHG VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 75860
|
| Min. Negotiated Rate |
$122.48 |
| Max. Negotiated Rate |
$282.75 |
| Rate for Payer: Aetna Commercial |
$164.12
|
| Rate for Payer: Aetna Commercial |
$164.12
|
| Rate for Payer: Aetna Medicare |
$127.38
|
| Rate for Payer: Aetna Medicare |
$127.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.12
|
| Rate for Payer: BCBS MAPPO |
$122.48
|
| Rate for Payer: BCBS MAPPO |
$122.48
|
| Rate for Payer: BCN Commercial |
$188.74
|
| Rate for Payer: BCN Commercial |
$188.74
|
| Rate for Payer: BCN Medicare Advantage |
$122.48
|
| Rate for Payer: BCN Medicare Advantage |
$122.48
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$176.37
|
| Rate for Payer: Cofinity Commercial |
$164.12
|
| Rate for Payer: Cofinity Commercial |
$164.12
|
| Rate for Payer: Cofinity Commercial |
$176.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.48
|
| Rate for Payer: Healthscope Commercial |
$226.59
|
| Rate for Payer: Healthscope Commercial |
$226.59
|
| Rate for Payer: Healthscope Commercial |
$195.97
|
| Rate for Payer: Healthscope Commercial |
$195.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.44
|
| Rate for Payer: Nomi Health Commercial |
$146.98
|
| Rate for Payer: Nomi Health Commercial |
$146.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.75
|
| Rate for Payer: PACE SWMI |
$122.48
|
| Rate for Payer: PACE SWMI |
$122.48
|
| Rate for Payer: PHP Medicare Advantage |
$122.48
|
| Rate for Payer: PHP Medicare Advantage |
$122.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.15
|
| Rate for Payer: Priority Health Medicare |
$122.48
|
| Rate for Payer: Priority Health Medicare |
$122.48
|
| Rate for Payer: Priority Health SBD |
$190.15
|
| Rate for Payer: Priority Health SBD |
$190.15
|
| Rate for Payer: Priority Health Tiered Network |
$190.15
|
| Rate for Payer: Priority Health Tiered Network |
$190.15
|
| Rate for Payer: Railroad Medicare Medicare |
$122.48
|
| Rate for Payer: Railroad Medicare Medicare |
$122.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.94
|
| Rate for Payer: UHC Core |
$196.94
|
| Rate for Payer: UHC Core |
$196.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.48
|
| Rate for Payer: UHC Exchange |
$196.94
|
| Rate for Payer: UHC Exchange |
$196.94
|
|
|
CHG VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 75893
|
| Min. Negotiated Rate |
$103.06 |
| Max. Negotiated Rate |
$258.00 |
| Rate for Payer: Aetna Commercial |
$138.10
|
| Rate for Payer: Aetna Medicare |
$107.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.41
|
| Rate for Payer: BCBS MAPPO |
$103.06
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$103.06
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$148.41
|
| Rate for Payer: Cofinity Commercial |
$138.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.06
|
| Rate for Payer: Healthscope Commercial |
$190.66
|
| Rate for Payer: Healthscope Commercial |
$164.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.35
|
| Rate for Payer: Nomi Health Commercial |
$123.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PACE SWMI |
$103.06
|
| Rate for Payer: PHP Medicare Advantage |
$103.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$158.54
|
| Rate for Payer: Priority Health Medicare |
$103.06
|
| Rate for Payer: Priority Health SBD |
$158.54
|
| Rate for Payer: Priority Health Tiered Network |
$158.54
|
| Rate for Payer: Railroad Medicare Medicare |
$103.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.54
|
| Rate for Payer: UHC Core |
$162.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.06
|
| Rate for Payer: UHC Exchange |
$162.54
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 78457
|
| Min. Negotiated Rate |
$155.46 |
| Max. Negotiated Rate |
$287.60 |
| Rate for Payer: Aetna Commercial |
$208.32
|
| Rate for Payer: Aetna Commercial |
$208.32
|
| Rate for Payer: Aetna Medicare |
$161.68
|
| Rate for Payer: Aetna Medicare |
$161.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.86
|
| Rate for Payer: BCBS MAPPO |
$155.46
|
| Rate for Payer: BCBS MAPPO |
$155.46
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Medicare Advantage |
$155.46
|
| Rate for Payer: BCN Medicare Advantage |
$155.46
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$223.86
|
| Rate for Payer: Cofinity Commercial |
$208.32
|
| Rate for Payer: Cofinity Commercial |
$223.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.46
|
| Rate for Payer: Healthscope Commercial |
$287.60
|
| Rate for Payer: Healthscope Commercial |
$287.60
|
| Rate for Payer: Healthscope Commercial |
$248.74
|
| Rate for Payer: Healthscope Commercial |
$248.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.16
|
| Rate for Payer: Nomi Health Commercial |
$186.55
|
| Rate for Payer: Nomi Health Commercial |
$186.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.50
|
| Rate for Payer: PACE SWMI |
$155.46
|
| Rate for Payer: PACE SWMI |
$155.46
|
| Rate for Payer: PHP Medicare Advantage |
$155.46
|
| Rate for Payer: PHP Medicare Advantage |
$155.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$234.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$234.81
|
| Rate for Payer: Priority Health Medicare |
$155.46
|
| Rate for Payer: Priority Health Medicare |
$155.46
|
| Rate for Payer: Priority Health SBD |
$234.81
|
| Rate for Payer: Priority Health SBD |
$234.81
|
| Rate for Payer: Priority Health Tiered Network |
$234.81
|
| Rate for Payer: Priority Health Tiered Network |
$234.81
|
| Rate for Payer: Railroad Medicare Medicare |
$155.46
|
| Rate for Payer: Railroad Medicare Medicare |
$155.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.61
|
| Rate for Payer: UHC Core |
$250.61
|
| Rate for Payer: UHC Core |
$250.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.46
|
| Rate for Payer: UHC Exchange |
$250.61
|
| Rate for Payer: UHC Exchange |
$250.61
|
|
|
CHG X-RAY ABDOMEN 1 VW
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 74000
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
|
|
CHG X-RAY ABDOMEN 2 VW
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 74020
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$41.25 |
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
|
|
CHG X-RAY FEMUR 2 VW
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 73550
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna Medicare |
$48.50
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
|
|
CHG X-RAY HIPS 4 VW + PELVIS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 73520
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
|
|
CHG X-RAY HIP UNI 2+ VW
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 73510
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
|
|
CHG X-RAY HIP UNILAT 1 VW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73500
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
CHG X-RAY PELVIS/HIPS CHILD/INFANT
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 73540
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.00
|
|
|
CHG X-RAY SPINE SURVEY
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 72010
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
|
|
CHG X-RAY THOR-LUMB SP SCOLIOSIS
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 72090
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Medicare |
$68.50
|
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
|
|
CHG X-RAY TRUNK SPINE SCOLIOSIS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 72069
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$46.50 |
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.50
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$59,048.75
|
|
|
Service Code
|
APR-DRG 0111
|
| Min. Negotiated Rate |
$56,236.91 |
| Max. Negotiated Rate |
$59,048.75 |
| Rate for Payer: BCBS Complete |
$59,048.75
|
| Rate for Payer: Mclaren Medicaid |
$56,236.91
|
| Rate for Payer: Meridian Medicaid |
$59,048.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$56,236.91
|
| Rate for Payer: UHC Medicaid |
$56,236.91
|
| Rate for Payer: UHCCP Medicaid |
$56,236.91
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$127,967.44
|
|
|
Service Code
|
APR-DRG 0112
|
| Min. Negotiated Rate |
$121,873.75 |
| Max. Negotiated Rate |
$127,967.44 |
| Rate for Payer: BCBS Complete |
$127,967.44
|
| Rate for Payer: Mclaren Medicaid |
$121,873.75
|
| Rate for Payer: Meridian Medicaid |
$127,967.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$121,873.75
|
| Rate for Payer: UHC Medicaid |
$121,873.75
|
| Rate for Payer: UHCCP Medicaid |
$121,873.75
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$150,811.72
|
|
|
Service Code
|
APR-DRG 0113
|
| Min. Negotiated Rate |
$143,630.21 |
| Max. Negotiated Rate |
$150,811.72 |
| Rate for Payer: BCBS Complete |
$150,811.72
|
| Rate for Payer: Mclaren Medicaid |
$143,630.21
|
| Rate for Payer: Meridian Medicaid |
$150,811.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$143,630.21
|
| Rate for Payer: UHC Medicaid |
$143,630.21
|
| Rate for Payer: UHCCP Medicaid |
$143,630.21
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$195,732.07
|
|
|
Service Code
|
APR-DRG 0114
|
| Min. Negotiated Rate |
$186,411.50 |
| Max. Negotiated Rate |
$195,732.07 |
| Rate for Payer: BCBS Complete |
$195,732.07
|
| Rate for Payer: Mclaren Medicaid |
$186,411.50
|
| Rate for Payer: Meridian Medicaid |
$195,732.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$186,411.50
|
| Rate for Payer: UHC Medicaid |
$186,411.50
|
| Rate for Payer: UHCCP Medicaid |
$186,411.50
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$696,199.15
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$158,521.32 |
| Max. Negotiated Rate |
$696,199.15 |
| Rate for Payer: Aetna Medicare |
$347,677.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417,881.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417,881.85
|
| Rate for Payer: BCBS MAPPO |
$334,305.48
|
| Rate for Payer: BCBS Trust/PPO |
$158,521.32
|
| Rate for Payer: BCN Commercial |
$158,521.32
|
| Rate for Payer: BCN Medicare Advantage |
$334,305.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334,305.48
|
| Rate for Payer: Mclaren Medicare |
$334,305.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351,020.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384,451.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$367,736.03
|
| Rate for Payer: Nomi Health Commercial |
$557,058.12
|
| Rate for Payer: PACE Medicare |
$317,590.21
|
| Rate for Payer: PACE SWMI |
$334,305.48
|
| Rate for Payer: PHP Medicare Advantage |
$334,305.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$696,199.15
|
| Rate for Payer: Priority Health Medicare |
$334,305.48
|
| Rate for Payer: Priority Health Tiered Network |
$556,959.23
|
| Rate for Payer: Railroad Medicare Medicare |
$334,305.48
|
| Rate for Payer: VA VA |
$334,305.48
|
|
