|
PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 59076
|
| Min. Negotiated Rate |
$125.74 |
| Max. Negotiated Rate |
$93,940.00 |
| Rate for Payer: Aetna Commercial |
$682.58
|
| Rate for Payer: Aetna Medicare |
$529.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.52
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$509.39
|
| Rate for Payer: BCBS Trust/PPO |
$125.74
|
| Rate for Payer: BCN Commercial |
$759.41
|
| Rate for Payer: BCN Medicare Advantage |
$509.39
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cofinity Commercial |
$733.52
|
| Rate for Payer: Cofinity Commercial |
$682.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.39
|
| Rate for Payer: Healthscope Commercial |
$942.37
|
| Rate for Payer: Healthscope Commercial |
$815.02
|
| Rate for Payer: Mclaren Medicaid |
$332.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.86
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,940.00
|
| Rate for Payer: Nomi Health Commercial |
$611.27
|
| Rate for Payer: PACE SWMI |
$509.39
|
| Rate for Payer: PHP Medicare Advantage |
$509.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.06
|
| Rate for Payer: Priority Health Medicare |
$509.39
|
| Rate for Payer: Priority Health Narrow Network |
$727.06
|
| Rate for Payer: Priority Health SBD |
$727.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.39
|
| Rate for Payer: UHC Exchange |
$557.19
|
| Rate for Payer: UHC Medicare Advantage |
$509.39
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
|
|
PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE
|
Professional
|
Both
|
$1,293.00
|
|
|
Service Code
|
HCPCS 14350
|
| Min. Negotiated Rate |
$428.56 |
| Max. Negotiated Rate |
$118,807.00 |
| Rate for Payer: Aetna Commercial |
$848.90
|
| Rate for Payer: Aetna Medicare |
$658.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.25
|
| Rate for Payer: BCBS Complete |
$449.99
|
| Rate for Payer: BCBS MAPPO |
$633.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,240.72
|
| Rate for Payer: BCN Commercial |
$982.24
|
| Rate for Payer: BCN Medicare Advantage |
$633.51
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cofinity Commercial |
$912.25
|
| Rate for Payer: Cofinity Commercial |
$848.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.51
|
| Rate for Payer: Healthscope Commercial |
$1,171.99
|
| Rate for Payer: Healthscope Commercial |
$1,013.62
|
| Rate for Payer: Mclaren Medicaid |
$428.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.19
|
| Rate for Payer: Meridian Medicaid |
$449.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,807.00
|
| Rate for Payer: Nomi Health Commercial |
$760.21
|
| Rate for Payer: PACE SWMI |
$633.51
|
| Rate for Payer: PHP Medicare Advantage |
$633.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$916.12
|
| Rate for Payer: Priority Health Medicare |
$633.51
|
| Rate for Payer: Priority Health Narrow Network |
$916.12
|
| Rate for Payer: Priority Health SBD |
$916.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$713.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.51
|
| Rate for Payer: UHC Exchange |
$713.58
|
| Rate for Payer: UHC Medicare Advantage |
$633.51
|
| Rate for Payer: UHCCP Medicaid |
$428.56
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$19,341.00 |
| Rate for Payer: Aetna Commercial |
$137.97
|
| Rate for Payer: Aetna Commercial |
$137.97
|
| Rate for Payer: Aetna Medicare |
$107.08
|
| Rate for Payer: Aetna Medicare |
$107.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.97
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$102.96
|
| Rate for Payer: BCBS MAPPO |
$102.96
|
| Rate for Payer: BCBS Trust/PPO |
$405.74
|
| Rate for Payer: BCBS Trust/PPO |
$405.74
|
| Rate for Payer: BCN Commercial |
$513.21
|
| Rate for Payer: BCN Commercial |
$513.21
|
| Rate for Payer: BCN Medicare Advantage |
$102.96
|
| Rate for Payer: BCN Medicare Advantage |
$102.96
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$137.97
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$137.97
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.96
|
| Rate for Payer: Healthscope Commercial |
$164.74
|
| Rate for Payer: Healthscope Commercial |
$190.48
|
| Rate for Payer: Healthscope Commercial |
$190.48
|
| Rate for Payer: Healthscope Commercial |
$164.74
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.11
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,341.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,341.00
|
| Rate for Payer: Nomi Health Commercial |
$123.55
|
| Rate for Payer: Nomi Health Commercial |
$123.55
|
| Rate for Payer: PACE SWMI |
$102.96
|
| Rate for Payer: PACE SWMI |
$102.96
|
| Rate for Payer: PHP Medicare Advantage |
$102.96
|
| Rate for Payer: PHP Medicare Advantage |
$102.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.49
|
| Rate for Payer: Priority Health Medicare |
$102.96
|
| Rate for Payer: Priority Health Medicare |
$102.96
|
| Rate for Payer: Priority Health Narrow Network |
$144.49
|
| Rate for Payer: Priority Health Narrow Network |
$144.49
|
| Rate for Payer: Priority Health SBD |
$144.49
|
| Rate for Payer: Priority Health SBD |
$144.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 10021
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$9,758.00 |
| Rate for Payer: Aetna Commercial |
$70.83
|
| Rate for Payer: Aetna Medicare |
$54.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.12
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$52.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,585.00
|
| Rate for Payer: BCN Commercial |
$119.76
|
| Rate for Payer: BCN Medicare Advantage |
$52.86
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$76.12
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.86
|
| Rate for Payer: Healthscope Commercial |
$97.79
|
| Rate for Payer: Healthscope Commercial |
$84.58
|
| Rate for Payer: Mclaren Medicaid |
$35.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.50
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,758.00
|
| Rate for Payer: Nomi Health Commercial |
$63.43
|
| Rate for Payer: PACE SWMI |
$52.86
|
| Rate for Payer: PHP Medicare Advantage |
$52.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.60
|
| Rate for Payer: Priority Health Medicare |
$52.86
|
| Rate for Payer: Priority Health Narrow Network |
$73.60
|
| Rate for Payer: Priority Health SBD |
$73.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.86
|
| Rate for Payer: UHC Exchange |
$140.50
|
| Rate for Payer: UHC Medicare Advantage |
$52.86
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 10005
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$13,077.00 |
| Rate for Payer: Aetna Commercial |
$93.13
|
| Rate for Payer: Aetna Medicare |
$72.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.13
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$159.81
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$93.13
|
| Rate for Payer: Cofinity Commercial |
$100.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Healthscope Commercial |
$111.20
|
| Rate for Payer: Healthscope Commercial |
$128.58
|
| Rate for Payer: Mclaren Medicaid |
$46.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.98
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,077.00
|
| Rate for Payer: Nomi Health Commercial |
$83.40
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.53
|
| Rate for Payer: Priority Health Medicare |
$69.50
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health SBD |
$97.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.50
|
| Rate for Payer: UHC Medicare Advantage |
$69.50
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 10006
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$8,867.00 |
| Rate for Payer: Aetna Commercial |
$63.44
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.17
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$47.34
|
| Rate for Payer: BCBS Trust/PPO |
$349.63
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$47.34
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$68.17
|
| Rate for Payer: Cofinity Commercial |
$63.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.34
|
| Rate for Payer: Healthscope Commercial |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$87.58
|
| Rate for Payer: Mclaren Medicaid |
$31.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.71
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,867.00
|
| Rate for Payer: Nomi Health Commercial |
$56.81
|
| Rate for Payer: PACE SWMI |
$47.34
|
| Rate for Payer: PHP Medicare Advantage |
$47.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.83
|
| Rate for Payer: Priority Health Medicare |
$47.34
|
| Rate for Payer: Priority Health Narrow Network |
$66.83
|
| Rate for Payer: Priority Health SBD |
$66.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.34
|
| Rate for Payer: UHC Medicare Advantage |
$47.34
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
|
|
PR FINE NEEDLE ASP;W/IMAGING GUIDANCE
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10022
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$174.85 |
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
|
|
PR FINGER SPLINT, STATIC
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q4049
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 46200
|
| Min. Negotiated Rate |
$220.67 |
| Max. Negotiated Rate |
$58,955.00 |
| Rate for Payer: Aetna Commercial |
$429.74
|
| Rate for Payer: Aetna Medicare |
$333.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.81
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS MAPPO |
$320.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.50
|
| Rate for Payer: BCN Commercial |
$699.79
|
| Rate for Payer: BCN Medicare Advantage |
$320.70
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$461.81
|
| Rate for Payer: Cofinity Commercial |
$429.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.70
|
| Rate for Payer: Healthscope Commercial |
$593.30
|
| Rate for Payer: Healthscope Commercial |
$513.12
|
| Rate for Payer: Mclaren Medicaid |
$220.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.74
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,955.00
|
| Rate for Payer: Nomi Health Commercial |
$384.84
|
| Rate for Payer: PACE SWMI |
$320.70
|
| Rate for Payer: PHP Medicare Advantage |
$320.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.11
|
| Rate for Payer: Priority Health Medicare |
$320.70
|
| Rate for Payer: Priority Health Narrow Network |
$612.11
|
| Rate for Payer: Priority Health SBD |
$612.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.70
|
| Rate for Payer: UHC Exchange |
$344.09
|
| Rate for Payer: UHC Medicare Advantage |
$320.70
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
|
|
PR FIT CONTACT LENS TX OCULAR SURFACE DISEASE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 92071
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$4,692.00 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.08
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$29.92
|
| Rate for Payer: BCBS Trust/PPO |
$664.07
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Medicare Advantage |
$29.92
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$40.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.92
|
| Rate for Payer: Healthscope Commercial |
$47.87
|
| Rate for Payer: Healthscope Commercial |
$55.35
|
| Rate for Payer: Mclaren Medicaid |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,692.00
|
| Rate for Payer: Nomi Health Commercial |
$35.90
|
| Rate for Payer: PACE SWMI |
$29.92
|
| Rate for Payer: PHP Medicare Advantage |
$29.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$29.92
|
| Rate for Payer: Priority Health Narrow Network |
$39.44
|
| Rate for Payer: Priority Health SBD |
$39.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.92
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
|
|
PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 57160
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$8,237.00 |
| Rate for Payer: Aetna Commercial |
$59.63
|
| Rate for Payer: Aetna Medicare |
$46.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.08
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$44.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,269.05
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$44.50
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$64.08
|
| Rate for Payer: Cofinity Commercial |
$59.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.50
|
| Rate for Payer: Healthscope Commercial |
$82.32
|
| Rate for Payer: Healthscope Commercial |
$71.20
|
| Rate for Payer: Mclaren Medicaid |
$29.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.72
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,237.00
|
| Rate for Payer: Nomi Health Commercial |
$53.40
|
| Rate for Payer: PACE SWMI |
$44.50
|
| Rate for Payer: PHP Medicare Advantage |
$44.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.95
|
| Rate for Payer: Priority Health Medicare |
$44.50
|
| Rate for Payer: Priority Health Narrow Network |
$67.95
|
| Rate for Payer: Priority Health SBD |
$67.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.50
|
| Rate for Payer: UHC Exchange |
$87.17
|
| Rate for Payer: UHC Medicare Advantage |
$44.50
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
|
|
PR FITTING CONTACT LENS FOR MGMT OF KERATOCONUS 1ST
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 92072
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$13,782.00 |
| Rate for Payer: Aetna Commercial |
$116.02
|
| Rate for Payer: Aetna Medicare |
$90.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.68
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$86.58
|
| Rate for Payer: BCBS Trust/PPO |
$900.75
|
| Rate for Payer: BCN Commercial |
$183.25
|
| Rate for Payer: BCN Medicare Advantage |
$86.58
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$124.68
|
| Rate for Payer: Cofinity Commercial |
$116.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.58
|
| Rate for Payer: Healthscope Commercial |
$138.53
|
| Rate for Payer: Healthscope Commercial |
$160.17
|
| Rate for Payer: Mclaren Medicaid |
$58.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.91
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,782.00
|
| Rate for Payer: Nomi Health Commercial |
$103.90
|
| Rate for Payer: PACE SWMI |
$86.58
|
| Rate for Payer: PHP Medicare Advantage |
$86.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.19
|
| Rate for Payer: Priority Health Medicare |
$86.58
|
| Rate for Payer: Priority Health Narrow Network |
$114.19
|
| Rate for Payer: Priority Health SBD |
$114.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.58
|
| Rate for Payer: UHC Medicare Advantage |
$86.58
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 54620
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$52,538.00 |
| Rate for Payer: Aetna Commercial |
$382.24
|
| Rate for Payer: Aetna Medicare |
$296.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.76
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCBS MAPPO |
$285.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,422.86
|
| Rate for Payer: BCN Commercial |
$431.50
|
| Rate for Payer: BCN Medicare Advantage |
$285.25
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$410.76
|
| Rate for Payer: Cofinity Commercial |
$382.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.25
|
| Rate for Payer: Healthscope Commercial |
$527.71
|
| Rate for Payer: Healthscope Commercial |
$456.40
|
| Rate for Payer: Mclaren Medicaid |
$191.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.51
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,538.00
|
| Rate for Payer: Nomi Health Commercial |
$342.30
|
| Rate for Payer: PACE SWMI |
$285.25
|
| Rate for Payer: PHP Medicare Advantage |
$285.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.62
|
| Rate for Payer: Priority Health Medicare |
$285.25
|
| Rate for Payer: Priority Health Narrow Network |
$475.62
|
| Rate for Payer: Priority Health SBD |
$475.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.25
|
| Rate for Payer: UHC Exchange |
$389.20
|
| Rate for Payer: UHC Medicare Advantage |
$285.25
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
|
|
PR FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 15740
|
| Min. Negotiated Rate |
$543.58 |
| Max. Negotiated Rate |
$147,478.00 |
| Rate for Payer: Aetna Commercial |
$1,074.45
|
| Rate for Payer: Aetna Medicare |
$833.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,154.64
|
| Rate for Payer: BCBS Complete |
$570.76
|
| Rate for Payer: BCBS MAPPO |
$801.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.25
|
| Rate for Payer: BCN Commercial |
$1,478.74
|
| Rate for Payer: BCN Medicare Advantage |
$801.83
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.64
|
| Rate for Payer: Cofinity Commercial |
$1,074.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.83
|
| Rate for Payer: Healthscope Commercial |
$1,483.39
|
| Rate for Payer: Healthscope Commercial |
$1,282.93
|
| Rate for Payer: Mclaren Medicaid |
$543.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.92
|
| Rate for Payer: Meridian Medicaid |
$570.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,478.00
|
| Rate for Payer: Nomi Health Commercial |
$962.20
|
| Rate for Payer: PACE SWMI |
$801.83
|
| Rate for Payer: PHP Medicare Advantage |
$801.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$543.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$801.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,142.33
|
| Rate for Payer: Priority Health SBD |
$1,142.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$801.83
|
| Rate for Payer: UHC Exchange |
$938.99
|
| Rate for Payer: UHC Medicare Advantage |
$801.83
|
| Rate for Payer: UHCCP Medicaid |
$543.58
|
|
|
PR FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 92230
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$5,028.00 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.87
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$29.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.66
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Medicare Advantage |
$29.77
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.77
|
| Rate for Payer: Healthscope Commercial |
$55.07
|
| Rate for Payer: Healthscope Commercial |
$47.63
|
| Rate for Payer: Mclaren Medicaid |
$20.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.26
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,028.00
|
| Rate for Payer: Nomi Health Commercial |
$35.72
|
| Rate for Payer: PACE SWMI |
$29.77
|
| Rate for Payer: PHP Medicare Advantage |
$29.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.35
|
| Rate for Payer: Priority Health Medicare |
$29.77
|
| Rate for Payer: Priority Health Narrow Network |
$42.35
|
| Rate for Payer: Priority Health SBD |
$42.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.77
|
| Rate for Payer: UHC Exchange |
$91.25
|
| Rate for Payer: UHC Medicare Advantage |
$29.77
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
|
|
PR FLUPHENAZINE DECANOATE 25 MG
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS J2680
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$987.00 |
| Rate for Payer: Aetna Commercial |
$10.09
|
| Rate for Payer: Aetna Medicare |
$7.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.85
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$7.53
|
| Rate for Payer: BCBS Trust/PPO |
$5.22
|
| Rate for Payer: BCN Commercial |
$5.76
|
| Rate for Payer: BCN Medicare Advantage |
$7.53
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$10.85
|
| Rate for Payer: Cofinity Commercial |
$10.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.53
|
| Rate for Payer: Healthscope Commercial |
$13.93
|
| Rate for Payer: Healthscope Commercial |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$987.00
|
| Rate for Payer: Nomi Health Commercial |
$9.04
|
| Rate for Payer: PACE SWMI |
$7.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$7.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.53
|
| Rate for Payer: UHC Exchange |
$9.97
|
| Rate for Payer: UHC Medicare Advantage |
$7.53
|
|
|
PR FLUVIRIN VACC, 3 YRS & >, IM
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS Q2037
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$1,713.00 |
| Rate for Payer: Aetna Commercial |
$18.62
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.62
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,713.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.74
|
| Rate for Payer: UHC Exchange |
$19.74
|
|
|
PR FLUZONE VACC, 3 YRS & >, IM
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS Q2038
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$1,436.00 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.68
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,436.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.60
|
| Rate for Payer: UHC Exchange |
$52.60
|
|
|
PR FOLLOW-UP/REASSESSMENT
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS S0316
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$20.00
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Trust/PPO |
$53.36
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
|
|
PR FO NONTORSION JOINT CF
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS L3935
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$23,056.00 |
| Rate for Payer: BCBS Complete |
$82.80
|
| Rate for Payer: BCN Commercial |
$190.90
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,056.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.55
|
|
|
PR FOOT ARCH SUPP LONGITUD/META
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS L3060
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$8,459.00 |
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCN Commercial |
$65.84
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,459.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
|
|
PR FOOT PLAS HEEL STABI PRE OTS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS L3170
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$5,833.00 |
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCN Commercial |
$48.29
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,833.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
|
|
PR FO PIP DIP JNT/SPRNG PRE OTS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS L3925
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$6,856.00 |
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCN Commercial |
$56.76
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,856.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
|
|
PR FOREARM/ARM CUFFS FREE MOTIO
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS L3720
|
| Min. Negotiated Rate |
$255.20 |
| Max. Negotiated Rate |
$71,314.00 |
| Rate for Payer: BCBS Complete |
$255.20
|
| Rate for Payer: BCN Commercial |
$590.45
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,314.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.70
|
|
|
PR FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE
|
Professional
|
Both
|
$2,259.00
|
|
|
Service Code
|
HCPCS 15731
|
| Min. Negotiated Rate |
$640.92 |
| Max. Negotiated Rate |
$175,378.00 |
| Rate for Payer: Aetna Commercial |
$1,268.04
|
| Rate for Payer: Aetna Medicare |
$984.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,268.04
|
| Rate for Payer: BCBS Complete |
$672.97
|
| Rate for Payer: BCBS MAPPO |
$946.30
|
| Rate for Payer: BCBS Trust/PPO |
$852.18
|
| Rate for Payer: BCN Commercial |
$1,643.91
|
| Rate for Payer: BCN Medicare Advantage |
$946.30
|
| Rate for Payer: Cash Price |
$1,807.20
|
| Rate for Payer: Cash Price |
$1,807.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.67
|
| Rate for Payer: Cofinity Commercial |
$1,268.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.30
|
| Rate for Payer: Healthscope Commercial |
$1,750.66
|
| Rate for Payer: Healthscope Commercial |
$1,514.08
|
| Rate for Payer: Mclaren Medicaid |
$640.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.62
|
| Rate for Payer: Meridian Medicaid |
$672.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,378.00
|
| Rate for Payer: Nomi Health Commercial |
$1,135.56
|
| Rate for Payer: PACE SWMI |
$946.30
|
| Rate for Payer: PHP Medicare Advantage |
$946.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$640.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,468.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.94
|
| Rate for Payer: Priority Health Medicare |
$946.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,350.94
|
| Rate for Payer: Priority Health SBD |
$1,350.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,143.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$946.30
|
| Rate for Payer: UHC Exchange |
$1,143.80
|
| Rate for Payer: UHC Medicare Advantage |
$946.30
|
| Rate for Payer: UHCCP Medicaid |
$640.92
|
|
