|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
IP
|
$352.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$214.68 |
| Max. Negotiated Rate |
$316.80 |
| Rate for Payer: Aetna Commercial |
$299.20
|
| Rate for Payer: BCBS Trust/PPO |
$272.03
|
| Rate for Payer: BCN Commercial |
$272.03
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$302.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.60
|
| Rate for Payer: Healthscope Commercial |
$316.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.20
|
| Rate for Payer: PHP Commercial |
$299.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.76
|
| Rate for Payer: UHC Core |
$293.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.00
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$352.00
|
|
|
Service Code
|
HCPCS 20200
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$125.75
|
| Rate for Payer: Aetna Medicare |
$97.59
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS Trust/PPO |
$672.75
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$125.75
|
| Rate for Payer: Cofinity Commercial |
$135.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.51
|
| Rate for Payer: Priority Health Medicare |
$93.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.84
|
| Rate for Payer: UHC Medicare Advantage |
$96.66
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
OP
|
$352.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$299.20
|
| Rate for Payer: Aetna Medicare |
$91.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.00
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$88.00
|
| Rate for Payer: BCBS Trust/PPO |
$273.68
|
| Rate for Payer: BCN Commercial |
$273.68
|
| Rate for Payer: BCN Medicare Advantage |
$88.00
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$302.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$316.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.00
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.20
|
| Rate for Payer: PACE Senior Care Partners |
$83.60
|
| Rate for Payer: PACE SWMI |
$88.00
|
| Rate for Payer: PHP Commercial |
$299.20
|
| Rate for Payer: PHP Medicare Advantage |
$88.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.24
|
| Rate for Payer: Priority Health Medicare |
$88.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.68
|
| Rate for Payer: Railroad Medicare Medicare |
$88.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.76
|
| Rate for Payer: UHC Core |
$293.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.00
|
| Rate for Payer: UHC Medicare Advantage |
$90.64
|
| Rate for Payer: VA VA |
$88.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.00
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$352.00
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$125.75
|
| Rate for Payer: Aetna Medicare |
$97.59
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS Trust/PPO |
$672.75
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$135.13
|
| Rate for Payer: Cofinity Commercial |
$125.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.51
|
| Rate for Payer: Priority Health Medicare |
$93.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.84
|
| Rate for Payer: UHC Medicare Advantage |
$96.66
|
|
|
PR BIOPSY NAIL UNIT SEPARATE PROCEDURE
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 11755
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$79.85
|
| Rate for Payer: Aetna Medicare |
$61.97
|
| Rate for Payer: BCBS Complete |
$40.26
|
| Rate for Payer: BCBS MAPPO |
$59.59
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$144.11
|
| Rate for Payer: BCN Medicare Advantage |
$59.59
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$79.85
|
| Rate for Payer: Cofinity Commercial |
$85.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.59
|
| Rate for Payer: Mclaren Medicaid |
$38.34
|
| Rate for Payer: Meridian Medicaid |
$40.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.57
|
| Rate for Payer: PACE SWMI |
$59.59
|
| Rate for Payer: PHP Medicare Advantage |
$59.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.58
|
| Rate for Payer: Priority Health Medicare |
$59.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.59
|
| Rate for Payer: UHC Medicare Advantage |
$61.38
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$575.40 |
| Rate for Payer: Aetna Commercial |
$159.70
|
| Rate for Payer: Aetna Medicare |
$123.95
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$119.18
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$319.11
|
| Rate for Payer: BCN Medicare Advantage |
$119.18
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$171.62
|
| Rate for Payer: Cofinity Commercial |
$159.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.18
|
| Rate for Payer: Mclaren Medicaid |
$79.66
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.14
|
| Rate for Payer: PACE SWMI |
$119.18
|
| Rate for Payer: PHP Medicare Advantage |
$119.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.55
|
| Rate for Payer: Priority Health Medicare |
$119.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.18
|
| Rate for Payer: UHC Medicare Advantage |
$122.76
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$708.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$495.60 |
| Rate for Payer: Aetna Commercial |
$257.27
|
| Rate for Payer: Aetna Medicare |
$199.67
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$191.99
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$282.46
|
| Rate for Payer: BCN Medicare Advantage |
$191.99
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cofinity Commercial |
$257.27
|
| Rate for Payer: Cofinity Commercial |
$276.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.99
|
| Rate for Payer: Mclaren Medicaid |
$124.82
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.59
|
| Rate for Payer: PACE SWMI |
$191.99
|
| Rate for Payer: PHP Medicare Advantage |
$191.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.28
|
| Rate for Payer: Priority Health Medicare |
$191.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$327.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.99
|
| Rate for Payer: UHC Medicare Advantage |
$197.75
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$637.13 |
| Rate for Payer: Aetna Commercial |
$90.64
|
| Rate for Payer: Aetna Medicare |
$70.35
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$67.64
|
| Rate for Payer: BCBS Trust/PPO |
$637.13
|
| Rate for Payer: BCN Commercial |
$144.50
|
| Rate for Payer: BCN Medicare Advantage |
$67.64
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$97.40
|
| Rate for Payer: Cofinity Commercial |
$90.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.64
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.02
|
| Rate for Payer: PACE SWMI |
$67.64
|
| Rate for Payer: PHP Medicare Advantage |
$67.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.54
|
| Rate for Payer: Priority Health Medicare |
$67.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.64
|
| Rate for Payer: UHC Medicare Advantage |
$69.67
|
|
|
PR BIOPSY OF SKIN LESION
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 11100
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$117.60 |
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
|
|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$233.59 |
| Rate for Payer: Aetna Commercial |
$152.10
|
| Rate for Payer: Aetna Medicare |
$118.05
|
| Rate for Payer: BCBS Complete |
$79.40
|
| Rate for Payer: BCBS MAPPO |
$113.51
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$113.51
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$163.45
|
| Rate for Payer: Cofinity Commercial |
$152.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.51
|
| Rate for Payer: Mclaren Medicaid |
$75.62
|
| Rate for Payer: Meridian Medicaid |
$79.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.19
|
| Rate for Payer: PACE SWMI |
$113.51
|
| Rate for Payer: PHP Medicare Advantage |
$113.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.80
|
| Rate for Payer: Priority Health Medicare |
$113.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.51
|
| Rate for Payer: UHC Medicare Advantage |
$116.92
|
|
|
PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,585.00
|
|
|
Service Code
|
HCPCS 58900
|
| Min. Negotiated Rate |
$170.11 |
| Max. Negotiated Rate |
$1,109.50 |
| Rate for Payer: Aetna Commercial |
$580.51
|
| Rate for Payer: Aetna Medicare |
$450.55
|
| Rate for Payer: BCBS Complete |
$296.34
|
| Rate for Payer: BCBS MAPPO |
$433.22
|
| Rate for Payer: BCBS Trust/PPO |
$170.11
|
| Rate for Payer: BCN Commercial |
$644.57
|
| Rate for Payer: BCN Medicare Advantage |
$433.22
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cofinity Commercial |
$623.84
|
| Rate for Payer: Cofinity Commercial |
$580.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.22
|
| Rate for Payer: Mclaren Medicaid |
$282.23
|
| Rate for Payer: Meridian Medicaid |
$296.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$454.88
|
| Rate for Payer: PACE SWMI |
$433.22
|
| Rate for Payer: PHP Medicare Advantage |
$433.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,109.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.44
|
| Rate for Payer: Priority Health Medicare |
$433.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$624.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.22
|
| Rate for Payer: UHC Medicare Advantage |
$446.22
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$70.93 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$143.35
|
| Rate for Payer: Aetna Medicare |
$111.26
|
| Rate for Payer: BCBS Complete |
$74.48
|
| Rate for Payer: BCBS MAPPO |
$106.98
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: BCN Commercial |
$216.00
|
| Rate for Payer: BCN Medicare Advantage |
$106.98
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$154.05
|
| Rate for Payer: Cofinity Commercial |
$143.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.98
|
| Rate for Payer: Mclaren Medicaid |
$70.93
|
| Rate for Payer: Meridian Medicaid |
$74.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.33
|
| Rate for Payer: PACE SWMI |
$106.98
|
| Rate for Payer: PHP Medicare Advantage |
$106.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.03
|
| Rate for Payer: Priority Health Medicare |
$106.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.98
|
| Rate for Payer: UHC Medicare Advantage |
$110.19
|
|
|
PR BIOPSY PANCREAS OPEN
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 48100
|
| Min. Negotiated Rate |
$571.48 |
| Max. Negotiated Rate |
$2,117.43 |
| Rate for Payer: Aetna Commercial |
$1,182.11
|
| Rate for Payer: Aetna Medicare |
$917.46
|
| Rate for Payer: BCBS Complete |
$600.05
|
| Rate for Payer: BCBS MAPPO |
$882.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,117.43
|
| Rate for Payer: BCN Commercial |
$1,296.95
|
| Rate for Payer: BCN Medicare Advantage |
$882.17
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,270.32
|
| Rate for Payer: Cofinity Commercial |
$1,182.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.17
|
| Rate for Payer: Mclaren Medicaid |
$571.48
|
| Rate for Payer: Meridian Medicaid |
$600.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$926.28
|
| Rate for Payer: PACE SWMI |
$882.17
|
| Rate for Payer: PHP Medicare Advantage |
$882.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,560.49
|
| Rate for Payer: Priority Health Medicare |
$882.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,560.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$882.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$882.17
|
| Rate for Payer: UHC Medicare Advantage |
$908.64
|
|
|
PR BIOPSY PENIS DEEP STRUCTURES
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 54105
|
| Min. Negotiated Rate |
$136.11 |
| Max. Negotiated Rate |
$1,906.11 |
| Rate for Payer: Aetna Commercial |
$277.65
|
| Rate for Payer: Aetna Medicare |
$215.49
|
| Rate for Payer: BCBS Complete |
$142.92
|
| Rate for Payer: BCBS MAPPO |
$207.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,906.11
|
| Rate for Payer: BCN Commercial |
$401.69
|
| Rate for Payer: BCN Medicare Advantage |
$207.20
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$298.37
|
| Rate for Payer: Cofinity Commercial |
$277.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.20
|
| Rate for Payer: Mclaren Medicaid |
$136.11
|
| Rate for Payer: Meridian Medicaid |
$142.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.56
|
| Rate for Payer: PACE SWMI |
$207.20
|
| Rate for Payer: PHP Medicare Advantage |
$207.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.88
|
| Rate for Payer: Priority Health Medicare |
$207.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$339.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.20
|
| Rate for Payer: UHC Medicare Advantage |
$213.42
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$157.28
|
| Rate for Payer: Aetna Medicare |
$122.06
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$117.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$296.14
|
| Rate for Payer: BCN Medicare Advantage |
$117.37
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Cofinity Commercial |
$169.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.37
|
| Rate for Payer: Mclaren Medicaid |
$77.32
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.24
|
| Rate for Payer: PACE SWMI |
$117.37
|
| Rate for Payer: PHP Medicare Advantage |
$117.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.45
|
| Rate for Payer: Priority Health Medicare |
$117.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.37
|
| Rate for Payer: UHC Medicare Advantage |
$120.89
|
|
|
PR BIOPSY PROSTATE INCISIONAL ANY APPROACH
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$1,436.98 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna Medicare |
$269.05
|
| Rate for Payer: BCBS Complete |
$177.14
|
| Rate for Payer: BCBS MAPPO |
$258.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: BCN Commercial |
$382.64
|
| Rate for Payer: BCN Medicare Advantage |
$258.70
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cofinity Commercial |
$346.66
|
| Rate for Payer: Cofinity Commercial |
$372.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.70
|
| Rate for Payer: Mclaren Medicaid |
$168.70
|
| Rate for Payer: Meridian Medicaid |
$177.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.64
|
| Rate for Payer: PACE SWMI |
$258.70
|
| Rate for Payer: PHP Medicare Advantage |
$258.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$327.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.11
|
| Rate for Payer: Priority Health Medicare |
$258.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.70
|
| Rate for Payer: UHC Medicare Advantage |
$266.46
|
|
|
PR BIOPSY SALIVARY GLAND INCISIONAL
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 42405
|
| Min. Negotiated Rate |
$146.12 |
| Max. Negotiated Rate |
$448.61 |
| Rate for Payer: Aetna Commercial |
$298.66
|
| Rate for Payer: Aetna Medicare |
$231.80
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$222.88
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: BCN Medicare Advantage |
$222.88
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cofinity Commercial |
$298.66
|
| Rate for Payer: Cofinity Commercial |
$320.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.88
|
| Rate for Payer: Mclaren Medicaid |
$146.12
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$234.02
|
| Rate for Payer: PACE SWMI |
$222.88
|
| Rate for Payer: PHP Medicare Advantage |
$222.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.41
|
| Rate for Payer: Priority Health Medicare |
$222.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$400.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.88
|
| Rate for Payer: UHC Medicare Advantage |
$229.57
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK DEEP
|
Professional
|
Both
|
$902.00
|
|
|
Service Code
|
HCPCS 21925
|
| Min. Negotiated Rate |
$245.59 |
| Max. Negotiated Rate |
$727.15 |
| Rate for Payer: Aetna Commercial |
$495.99
|
| Rate for Payer: Aetna Medicare |
$384.95
|
| Rate for Payer: BCBS Complete |
$257.87
|
| Rate for Payer: BCBS MAPPO |
$370.14
|
| Rate for Payer: BCBS Trust/PPO |
$280.06
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: BCN Medicare Advantage |
$370.14
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cofinity Commercial |
$533.00
|
| Rate for Payer: Cofinity Commercial |
$495.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.14
|
| Rate for Payer: Mclaren Medicaid |
$245.59
|
| Rate for Payer: Meridian Medicaid |
$257.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$388.65
|
| Rate for Payer: PACE SWMI |
$370.14
|
| Rate for Payer: PHP Medicare Advantage |
$370.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.10
|
| Rate for Payer: Priority Health Medicare |
$370.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.14
|
| Rate for Payer: UHC Medicare Advantage |
$381.24
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$99.47 |
| Max. Negotiated Rate |
$625.34 |
| Rate for Payer: Aetna Commercial |
$202.30
|
| Rate for Payer: Aetna Medicare |
$157.01
|
| Rate for Payer: BCBS Complete |
$104.44
|
| Rate for Payer: BCBS MAPPO |
$150.97
|
| Rate for Payer: BCBS Trust/PPO |
$625.34
|
| Rate for Payer: BCN Commercial |
$377.26
|
| Rate for Payer: BCN Medicare Advantage |
$150.97
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cofinity Commercial |
$217.40
|
| Rate for Payer: Cofinity Commercial |
$202.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.97
|
| Rate for Payer: Mclaren Medicaid |
$99.47
|
| Rate for Payer: Meridian Medicaid |
$104.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.52
|
| Rate for Payer: PACE SWMI |
$150.97
|
| Rate for Payer: PHP Medicare Advantage |
$150.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.43
|
| Rate for Payer: Priority Health Medicare |
$150.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.97
|
| Rate for Payer: UHC Medicare Advantage |
$155.50
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$240.26 |
| Max. Negotiated Rate |
$1,010.64 |
| Rate for Payer: Aetna Commercial |
$484.65
|
| Rate for Payer: Aetna Medicare |
$376.15
|
| Rate for Payer: BCBS Complete |
$252.27
|
| Rate for Payer: BCBS MAPPO |
$361.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.64
|
| Rate for Payer: BCN Commercial |
$544.87
|
| Rate for Payer: BCN Medicare Advantage |
$361.68
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$520.82
|
| Rate for Payer: Cofinity Commercial |
$484.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.68
|
| Rate for Payer: Mclaren Medicaid |
$240.26
|
| Rate for Payer: Meridian Medicaid |
$252.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$379.76
|
| Rate for Payer: PACE SWMI |
$361.68
|
| Rate for Payer: PHP Medicare Advantage |
$361.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$569.37
|
| Rate for Payer: Priority Health Medicare |
$361.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.68
|
| Rate for Payer: UHC Medicare Advantage |
$372.53
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 25065
|
| Min. Negotiated Rate |
$101.81 |
| Max. Negotiated Rate |
$376.28 |
| Rate for Payer: Aetna Commercial |
$206.09
|
| Rate for Payer: Aetna Medicare |
$159.95
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS MAPPO |
$153.80
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$376.28
|
| Rate for Payer: BCN Medicare Advantage |
$153.80
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$221.47
|
| Rate for Payer: Cofinity Commercial |
$206.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.80
|
| Rate for Payer: Mclaren Medicaid |
$101.81
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.49
|
| Rate for Payer: PACE SWMI |
$153.80
|
| Rate for Payer: PHP Medicare Advantage |
$153.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.54
|
| Rate for Payer: Priority Health Medicare |
$153.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.80
|
| Rate for Payer: UHC Medicare Advantage |
$158.41
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 27614
|
| Min. Negotiated Rate |
$269.02 |
| Max. Negotiated Rate |
$1,061.35 |
| Rate for Payer: Aetna Commercial |
$548.22
|
| Rate for Payer: Aetna Medicare |
$425.48
|
| Rate for Payer: BCBS Complete |
$282.47
|
| Rate for Payer: BCBS MAPPO |
$409.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.35
|
| Rate for Payer: BCN Commercial |
$865.94
|
| Rate for Payer: BCN Medicare Advantage |
$409.12
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cofinity Commercial |
$548.22
|
| Rate for Payer: Cofinity Commercial |
$589.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.12
|
| Rate for Payer: Mclaren Medicaid |
$269.02
|
| Rate for Payer: Meridian Medicaid |
$282.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.58
|
| Rate for Payer: PACE SWMI |
$409.12
|
| Rate for Payer: PHP Medicare Advantage |
$409.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.82
|
| Rate for Payer: Priority Health Medicare |
$409.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$638.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.12
|
| Rate for Payer: UHC Medicare Advantage |
$421.39
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
IP
|
$437.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$266.53 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Aetna Commercial |
$371.45
|
| Rate for Payer: BCBS Trust/PPO |
$337.71
|
| Rate for Payer: BCN Commercial |
$337.71
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$375.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.60
|
| Rate for Payer: Healthscope Commercial |
$393.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$371.45
|
| Rate for Payer: PHP Commercial |
$371.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$380.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.56
|
| Rate for Payer: UHC Core |
$364.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.75
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$209.78
|
| Rate for Payer: Aetna Medicare |
$162.81
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$156.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$156.55
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$225.43
|
| Rate for Payer: Cofinity Commercial |
$209.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.55
|
| Rate for Payer: Mclaren Medicaid |
$104.16
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$164.38
|
| Rate for Payer: PACE SWMI |
$156.55
|
| Rate for Payer: PHP Medicare Advantage |
$156.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.11
|
| Rate for Payer: Priority Health Medicare |
$156.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.55
|
| Rate for Payer: UHC Medicare Advantage |
$161.25
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
OP
|
$437.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$103.79 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$371.45
|
| Rate for Payer: Aetna Medicare |
$113.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.56
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$109.25
|
| Rate for Payer: BCBS Trust/PPO |
$339.77
|
| Rate for Payer: BCN Commercial |
$339.77
|
| Rate for Payer: BCN Medicare Advantage |
$109.25
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$375.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.25
|
| Rate for Payer: Healthscope Commercial |
$393.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.75
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$371.45
|
| Rate for Payer: PACE Senior Care Partners |
$103.79
|
| Rate for Payer: PACE SWMI |
$109.25
|
| Rate for Payer: PHP Commercial |
$371.45
|
| Rate for Payer: PHP Medicare Advantage |
$109.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$380.19
|
| Rate for Payer: Priority Health Medicare |
$109.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.53
|
| Rate for Payer: Railroad Medicare Medicare |
$109.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.56
|
| Rate for Payer: UHC Core |
$364.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.25
|
| Rate for Payer: UHC Medicare Advantage |
$112.53
|
| Rate for Payer: VA VA |
$109.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.75
|
|
