|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 42720
|
| Min. Negotiated Rate |
$330.80 |
| Max. Negotiated Rate |
$682.82 |
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna Medicare |
$383.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.58
|
| Rate for Payer: BCBS Complete |
$330.80
|
| Rate for Payer: BCBS MAPPO |
$369.09
|
| Rate for Payer: BCN Medicare Advantage |
$369.09
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$531.49
|
| Rate for Payer: Cofinity Commercial |
$494.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.09
|
| Rate for Payer: Healthscope Commercial |
$590.54
|
| Rate for Payer: Healthscope Commercial |
$682.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.55
|
| Rate for Payer: Nomi Health Commercial |
$442.91
|
| Rate for Payer: PACE SWMI |
$369.09
|
| Rate for Payer: PHP Medicare Advantage |
$369.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.55
|
| Rate for Payer: Priority Health Medicare |
$369.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$369.09
|
| Rate for Payer: UHC Medicare Advantage |
$369.09
|
|
|
PR I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR
|
Professional
|
Both
|
$1,478.00
|
|
|
Service Code
|
HCPCS 42725
|
| Min. Negotiated Rate |
$591.20 |
| Max. Negotiated Rate |
$1,415.31 |
| Rate for Payer: Aetna Commercial |
$1,025.14
|
| Rate for Payer: Aetna Medicare |
$795.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,101.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.14
|
| Rate for Payer: BCBS Complete |
$591.20
|
| Rate for Payer: BCBS MAPPO |
$765.03
|
| Rate for Payer: BCN Medicare Advantage |
$765.03
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cash Price |
$1,182.40
|
| Rate for Payer: Cofinity Commercial |
$1,101.64
|
| Rate for Payer: Cofinity Commercial |
$1,025.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.03
|
| Rate for Payer: Healthscope Commercial |
$1,415.31
|
| Rate for Payer: Healthscope Commercial |
$1,224.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$960.70
|
| Rate for Payer: Nomi Health Commercial |
$918.04
|
| Rate for Payer: PACE SWMI |
$765.03
|
| Rate for Payer: PHP Medicare Advantage |
$765.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$960.70
|
| Rate for Payer: Priority Health Medicare |
$765.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.03
|
| Rate for Payer: UHC Medicare Advantage |
$765.03
|
|
|
PR I&D BELOW FASCIA FOOT 1 BURSAL SPACE
|
Professional
|
Both
|
$868.00
|
|
|
Service Code
|
HCPCS 28002
|
| Min. Negotiated Rate |
$134.12 |
| Max. Negotiated Rate |
$564.20 |
| Rate for Payer: Aetna Commercial |
$179.72
|
| Rate for Payer: Aetna Medicare |
$139.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.72
|
| Rate for Payer: BCBS Complete |
$347.20
|
| Rate for Payer: BCBS MAPPO |
$134.12
|
| Rate for Payer: BCN Medicare Advantage |
$134.12
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cash Price |
$694.40
|
| Rate for Payer: Cofinity Commercial |
$193.13
|
| Rate for Payer: Cofinity Commercial |
$179.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.12
|
| Rate for Payer: Healthscope Commercial |
$214.59
|
| Rate for Payer: Healthscope Commercial |
$248.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.20
|
| Rate for Payer: Nomi Health Commercial |
$160.94
|
| Rate for Payer: PACE SWMI |
$134.12
|
| Rate for Payer: PHP Medicare Advantage |
$134.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.20
|
| Rate for Payer: Priority Health Medicare |
$134.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.12
|
| Rate for Payer: UHC Medicare Advantage |
$134.12
|
|
|
PR I&D BELOW FASCIA FOOT MULTIPLE AREAS
|
Professional
|
Both
|
$1,243.00
|
|
|
Service Code
|
HCPCS 28003
|
| Min. Negotiated Rate |
$246.97 |
| Max. Negotiated Rate |
$807.95 |
| Rate for Payer: Aetna Commercial |
$330.94
|
| Rate for Payer: Aetna Medicare |
$256.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.94
|
| Rate for Payer: BCBS Complete |
$497.20
|
| Rate for Payer: BCBS MAPPO |
$246.97
|
| Rate for Payer: BCN Medicare Advantage |
$246.97
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cash Price |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$355.64
|
| Rate for Payer: Cofinity Commercial |
$330.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.97
|
| Rate for Payer: Healthscope Commercial |
$456.89
|
| Rate for Payer: Healthscope Commercial |
$395.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.95
|
| Rate for Payer: Nomi Health Commercial |
$296.36
|
| Rate for Payer: PACE SWMI |
$246.97
|
| Rate for Payer: PHP Medicare Advantage |
$246.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.95
|
| Rate for Payer: Priority Health Medicare |
$246.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.97
|
| Rate for Payer: UHC Medicare Advantage |
$246.97
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$491.92 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$659.17
|
| Rate for Payer: Aetna Medicare |
$511.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.36
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$491.92
|
| Rate for Payer: BCN Medicare Advantage |
$491.92
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$708.36
|
| Rate for Payer: Cofinity Commercial |
$659.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.92
|
| Rate for Payer: Healthscope Commercial |
$787.07
|
| Rate for Payer: Healthscope Commercial |
$910.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.25
|
| Rate for Payer: Nomi Health Commercial |
$590.30
|
| Rate for Payer: PACE SWMI |
$491.92
|
| Rate for Payer: PHP Medicare Advantage |
$491.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$491.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.92
|
| Rate for Payer: UHC Medicare Advantage |
$491.92
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$1,048.95 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.50
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,165.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,048.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 27301
|
| Hospital Charge Code |
27301
|
| Min. Negotiated Rate |
$1,048.95 |
| Max. Negotiated Rate |
$1,498.50 |
| Rate for Payer: Aetna Commercial |
$1,415.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.25
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,165.50
|
| Rate for Payer: Cofinity Commercial |
$1,431.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,165.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Healthscope Commercial |
$1,498.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: PHP Commercial |
$1,415.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health SBD |
$1,048.95
|
|
|
PR I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 27301
|
| Min. Negotiated Rate |
$491.92 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$659.17
|
| Rate for Payer: Aetna Medicare |
$511.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$659.17
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$491.92
|
| Rate for Payer: BCN Medicare Advantage |
$491.92
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$708.36
|
| Rate for Payer: Cofinity Commercial |
$659.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.92
|
| Rate for Payer: Healthscope Commercial |
$787.07
|
| Rate for Payer: Healthscope Commercial |
$910.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.25
|
| Rate for Payer: Nomi Health Commercial |
$590.30
|
| Rate for Payer: PACE SWMI |
$491.92
|
| Rate for Payer: PHP Medicare Advantage |
$491.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$491.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.92
|
| Rate for Payer: UHC Medicare Advantage |
$491.92
|
|
|
PR I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 22010
|
| Min. Negotiated Rate |
$950.04 |
| Max. Negotiated Rate |
$1,757.57 |
| Rate for Payer: Aetna Commercial |
$1,273.05
|
| Rate for Payer: Aetna Medicare |
$988.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.05
|
| Rate for Payer: BCBS Complete |
$984.00
|
| Rate for Payer: BCBS MAPPO |
$950.04
|
| Rate for Payer: BCN Medicare Advantage |
$950.04
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$1,368.06
|
| Rate for Payer: Cofinity Commercial |
$1,273.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.04
|
| Rate for Payer: Healthscope Commercial |
$1,757.57
|
| Rate for Payer: Healthscope Commercial |
$1,520.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.00
|
| Rate for Payer: Nomi Health Commercial |
$1,140.05
|
| Rate for Payer: PACE SWMI |
$950.04
|
| Rate for Payer: PHP Medicare Advantage |
$950.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,599.00
|
| Rate for Payer: Priority Health Medicare |
$950.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.04
|
| Rate for Payer: UHC Medicare Advantage |
$950.04
|
|
|
PR I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC
|
Professional
|
Both
|
$1,725.00
|
|
|
Service Code
|
HCPCS 22015
|
| Min. Negotiated Rate |
$690.00 |
| Max. Negotiated Rate |
$1,708.12 |
| Rate for Payer: Aetna Commercial |
$1,237.24
|
| Rate for Payer: Aetna Medicare |
$960.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.24
|
| Rate for Payer: BCBS Complete |
$690.00
|
| Rate for Payer: BCBS MAPPO |
$923.31
|
| Rate for Payer: BCN Medicare Advantage |
$923.31
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cofinity Commercial |
$1,329.57
|
| Rate for Payer: Cofinity Commercial |
$1,237.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.31
|
| Rate for Payer: Healthscope Commercial |
$1,477.30
|
| Rate for Payer: Healthscope Commercial |
$1,708.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,121.25
|
| Rate for Payer: Nomi Health Commercial |
$1,107.97
|
| Rate for Payer: PACE SWMI |
$923.31
|
| Rate for Payer: PHP Medicare Advantage |
$923.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.25
|
| Rate for Payer: Priority Health Medicare |
$923.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.31
|
| Rate for Payer: UHC Medicare Advantage |
$923.31
|
|
|
PR I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 21501
|
| Min. Negotiated Rate |
$323.69 |
| Max. Negotiated Rate |
$759.20 |
| Rate for Payer: Aetna Commercial |
$433.74
|
| Rate for Payer: Aetna Medicare |
$336.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.74
|
| Rate for Payer: BCBS Complete |
$467.20
|
| Rate for Payer: BCBS MAPPO |
$323.69
|
| Rate for Payer: BCN Medicare Advantage |
$323.69
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Cofinity Commercial |
$433.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.69
|
| Rate for Payer: Healthscope Commercial |
$598.83
|
| Rate for Payer: Healthscope Commercial |
$517.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.20
|
| Rate for Payer: Nomi Health Commercial |
$388.43
|
| Rate for Payer: PACE SWMI |
$323.69
|
| Rate for Payer: PHP Medicare Advantage |
$323.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.20
|
| Rate for Payer: Priority Health Medicare |
$323.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.69
|
| Rate for Payer: UHC Medicare Advantage |
$323.69
|
|
|
PR I&D DP ABSC/HMTMA SFT TIS NCK/THRX PRTL RIB OSTC
|
Professional
|
Both
|
$957.00
|
|
|
Service Code
|
HCPCS 21502
|
| Min. Negotiated Rate |
$382.80 |
| Max. Negotiated Rate |
$909.61 |
| Rate for Payer: Aetna Commercial |
$658.85
|
| Rate for Payer: Aetna Medicare |
$511.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.85
|
| Rate for Payer: BCBS Complete |
$382.80
|
| Rate for Payer: BCBS MAPPO |
$491.68
|
| Rate for Payer: BCN Medicare Advantage |
$491.68
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cofinity Commercial |
$708.02
|
| Rate for Payer: Cofinity Commercial |
$658.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.68
|
| Rate for Payer: Healthscope Commercial |
$786.69
|
| Rate for Payer: Healthscope Commercial |
$909.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$622.05
|
| Rate for Payer: Nomi Health Commercial |
$590.02
|
| Rate for Payer: PACE SWMI |
$491.68
|
| Rate for Payer: PHP Medicare Advantage |
$491.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.05
|
| Rate for Payer: Priority Health Medicare |
$491.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.68
|
| Rate for Payer: UHC Medicare Advantage |
$491.68
|
|
|
PR I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 45020
|
| Min. Negotiated Rate |
$552.25 |
| Max. Negotiated Rate |
$1,064.05 |
| Rate for Payer: Aetna Commercial |
$740.01
|
| Rate for Payer: Aetna Medicare |
$574.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$740.01
|
| Rate for Payer: BCBS Complete |
$654.80
|
| Rate for Payer: BCBS MAPPO |
$552.25
|
| Rate for Payer: BCN Medicare Advantage |
$552.25
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$795.24
|
| Rate for Payer: Cofinity Commercial |
$740.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.25
|
| Rate for Payer: Healthscope Commercial |
$883.60
|
| Rate for Payer: Healthscope Commercial |
$1,021.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,064.05
|
| Rate for Payer: Nomi Health Commercial |
$662.70
|
| Rate for Payer: PACE SWMI |
$552.25
|
| Rate for Payer: PHP Medicare Advantage |
$552.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,064.05
|
| Rate for Payer: Priority Health Medicare |
$552.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$552.25
|
| Rate for Payer: UHC Medicare Advantage |
$552.25
|
|
|
PR I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 54700
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$379.42 |
| Rate for Payer: Aetna Commercial |
$274.82
|
| Rate for Payer: Aetna Medicare |
$213.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.82
|
| Rate for Payer: BCBS Complete |
$162.00
|
| Rate for Payer: BCBS MAPPO |
$205.09
|
| Rate for Payer: BCN Medicare Advantage |
$205.09
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$295.33
|
| Rate for Payer: Cofinity Commercial |
$274.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.09
|
| Rate for Payer: Healthscope Commercial |
$328.14
|
| Rate for Payer: Healthscope Commercial |
$379.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.25
|
| Rate for Payer: Nomi Health Commercial |
$246.11
|
| Rate for Payer: PACE SWMI |
$205.09
|
| Rate for Payer: PHP Medicare Advantage |
$205.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.25
|
| Rate for Payer: Priority Health Medicare |
$205.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.09
|
| Rate for Payer: UHC Medicare Advantage |
$205.09
|
|
|
PR I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$931.00
|
|
|
Service Code
|
HCPCS 25028
|
| Min. Negotiated Rate |
$372.40 |
| Max. Negotiated Rate |
$1,178.30 |
| Rate for Payer: Aetna Commercial |
$853.47
|
| Rate for Payer: Aetna Medicare |
$662.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.47
|
| Rate for Payer: BCBS Complete |
$372.40
|
| Rate for Payer: BCBS MAPPO |
$636.92
|
| Rate for Payer: BCN Medicare Advantage |
$636.92
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cash Price |
$744.80
|
| Rate for Payer: Cofinity Commercial |
$917.16
|
| Rate for Payer: Cofinity Commercial |
$853.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.92
|
| Rate for Payer: Healthscope Commercial |
$1,178.30
|
| Rate for Payer: Healthscope Commercial |
$1,019.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$605.15
|
| Rate for Payer: Nomi Health Commercial |
$764.30
|
| Rate for Payer: PACE SWMI |
$636.92
|
| Rate for Payer: PHP Medicare Advantage |
$636.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.15
|
| Rate for Payer: Priority Health Medicare |
$636.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.92
|
| Rate for Payer: UHC Medicare Advantage |
$636.92
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$207.96 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$116.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.87
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Healthscope Commercial |
$179.86
|
| Rate for Payer: Healthscope Commercial |
$207.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.85
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Medicare |
$112.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.47 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Aetna Commercial |
$228.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.85
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$188.30
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Healthscope Commercial |
$242.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.65
|
| Rate for Payer: PHP Commercial |
$228.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health SBD |
$169.47
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
OP
|
$269.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$169.47 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$228.65
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$188.30
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$242.10
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.65
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$228.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$169.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$207.96 |
| Rate for Payer: Aetna Commercial |
$150.63
|
| Rate for Payer: Aetna Medicare |
$116.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.63
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCBS MAPPO |
$112.41
|
| Rate for Payer: BCN Medicare Advantage |
$112.41
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$150.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.41
|
| Rate for Payer: Healthscope Commercial |
$179.86
|
| Rate for Payer: Healthscope Commercial |
$207.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.85
|
| Rate for Payer: Nomi Health Commercial |
$134.89
|
| Rate for Payer: PACE SWMI |
$112.41
|
| Rate for Payer: PHP Medicare Advantage |
$112.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Medicare |
$112.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.41
|
| Rate for Payer: UHC Medicare Advantage |
$112.41
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$463.68 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Cofinity Commercial |
$515.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$515.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$463.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$463.68 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.40
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$515.20
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$515.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$625.60
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health SBD |
$463.68
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$779.96 |
| Rate for Payer: Aetna Commercial |
$564.94
|
| Rate for Payer: Aetna Medicare |
$438.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.94
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS MAPPO |
$421.60
|
| Rate for Payer: BCN Medicare Advantage |
$421.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$607.10
|
| Rate for Payer: Cofinity Commercial |
$564.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.60
|
| Rate for Payer: Healthscope Commercial |
$779.96
|
| Rate for Payer: Healthscope Commercial |
$674.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.40
|
| Rate for Payer: Nomi Health Commercial |
$505.92
|
| Rate for Payer: PACE SWMI |
$421.60
|
| Rate for Payer: PHP Medicare Advantage |
$421.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$421.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.60
|
| Rate for Payer: UHC Medicare Advantage |
$421.60
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$779.96 |
| Rate for Payer: Aetna Commercial |
$564.94
|
| Rate for Payer: Aetna Medicare |
$438.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$607.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.94
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS MAPPO |
$421.60
|
| Rate for Payer: BCN Medicare Advantage |
$421.60
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$607.10
|
| Rate for Payer: Cofinity Commercial |
$564.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.60
|
| Rate for Payer: Healthscope Commercial |
$779.96
|
| Rate for Payer: Healthscope Commercial |
$674.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.40
|
| Rate for Payer: Nomi Health Commercial |
$505.92
|
| Rate for Payer: PACE SWMI |
$421.60
|
| Rate for Payer: PHP Medicare Advantage |
$421.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$421.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.60
|
| Rate for Payer: UHC Medicare Advantage |
$421.60
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,127.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$466.27 |
| Max. Negotiated Rate |
$1,382.55 |
| Rate for Payer: Aetna Commercial |
$624.80
|
| Rate for Payer: Aetna Medicare |
$484.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.80
|
| Rate for Payer: BCBS Complete |
$850.80
|
| Rate for Payer: BCBS MAPPO |
$466.27
|
| Rate for Payer: BCN Medicare Advantage |
$466.27
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cofinity Commercial |
$671.43
|
| Rate for Payer: Cofinity Commercial |
$624.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.27
|
| Rate for Payer: Healthscope Commercial |
$746.03
|
| Rate for Payer: Healthscope Commercial |
$862.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,382.55
|
| Rate for Payer: Nomi Health Commercial |
$559.52
|
| Rate for Payer: PACE SWMI |
$466.27
|
| Rate for Payer: PHP Medicare Advantage |
$466.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.55
|
| Rate for Payer: Priority Health Medicare |
$466.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.27
|
| Rate for Payer: UHC Medicare Advantage |
$466.27
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$369.60 |
| Max. Negotiated Rate |
$758.59 |
| Rate for Payer: Aetna Commercial |
$549.47
|
| Rate for Payer: Aetna Medicare |
$426.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.47
|
| Rate for Payer: BCBS Complete |
$369.60
|
| Rate for Payer: BCBS MAPPO |
$410.05
|
| Rate for Payer: BCN Medicare Advantage |
$410.05
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$590.47
|
| Rate for Payer: Cofinity Commercial |
$549.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.05
|
| Rate for Payer: Healthscope Commercial |
$758.59
|
| Rate for Payer: Healthscope Commercial |
$656.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.60
|
| Rate for Payer: Nomi Health Commercial |
$492.06
|
| Rate for Payer: PACE SWMI |
$410.05
|
| Rate for Payer: PHP Medicare Advantage |
$410.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Medicare |
$410.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.05
|
| Rate for Payer: UHC Medicare Advantage |
$410.05
|
|
