|
PR CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES
|
Professional
|
Both
|
$2,941.00
|
|
|
Service Code
|
HCPCS 52352
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$2,058.70 |
| Rate for Payer: Aetna Commercial |
$460.60
|
| Rate for Payer: Aetna Medicare |
$357.48
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$343.73
|
| Rate for Payer: BCBS Trust/PPO |
$677.97
|
| Rate for Payer: BCN Commercial |
$504.80
|
| Rate for Payer: BCN Medicare Advantage |
$343.73
|
| Rate for Payer: Cash Price |
$2,352.80
|
| Rate for Payer: Cash Price |
$2,352.80
|
| Rate for Payer: Cofinity Commercial |
$494.97
|
| Rate for Payer: Cofinity Commercial |
$460.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.73
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$360.92
|
| Rate for Payer: PACE SWMI |
$343.73
|
| Rate for Payer: PHP Medicare Advantage |
$343.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.18
|
| Rate for Payer: Priority Health Medicare |
$343.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$558.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$343.73
|
| Rate for Payer: UHC Medicare Advantage |
$354.04
|
|
|
PR CYSTO W/URTROSCOPY&/PYELOSCOPY DX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 52351
|
| Min. Negotiated Rate |
$190.21 |
| Max. Negotiated Rate |
$476.60 |
| Rate for Payer: Aetna Commercial |
$393.12
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: BCBS Complete |
$199.72
|
| Rate for Payer: BCBS MAPPO |
$293.37
|
| Rate for Payer: BCBS Trust/PPO |
$393.43
|
| Rate for Payer: BCN Commercial |
$431.01
|
| Rate for Payer: BCN Medicare Advantage |
$293.37
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$422.45
|
| Rate for Payer: Cofinity Commercial |
$393.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.37
|
| Rate for Payer: Mclaren Medicaid |
$190.21
|
| Rate for Payer: Meridian Medicaid |
$199.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$308.04
|
| Rate for Payer: PACE SWMI |
$293.37
|
| Rate for Payer: PHP Medicare Advantage |
$293.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$476.60
|
| Rate for Payer: Priority Health Medicare |
$293.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.37
|
| Rate for Payer: UHC Medicare Advantage |
$302.17
|
|
|
PR CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 52346
|
| Min. Negotiated Rate |
$279.88 |
| Max. Negotiated Rate |
$2,753.98 |
| Rate for Payer: Aetna Commercial |
$580.10
|
| Rate for Payer: Aetna Medicare |
$450.23
|
| Rate for Payer: BCBS Complete |
$293.87
|
| Rate for Payer: BCBS MAPPO |
$432.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,753.98
|
| Rate for Payer: BCN Commercial |
$635.28
|
| Rate for Payer: BCN Medicare Advantage |
$432.91
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$580.10
|
| Rate for Payer: Cofinity Commercial |
$623.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.91
|
| Rate for Payer: Mclaren Medicaid |
$279.88
|
| Rate for Payer: Meridian Medicaid |
$293.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$454.56
|
| Rate for Payer: PACE SWMI |
$432.91
|
| Rate for Payer: PHP Medicare Advantage |
$432.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$279.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$702.46
|
| Rate for Payer: Priority Health Medicare |
$432.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$432.91
|
| Rate for Payer: UHC Medicare Advantage |
$445.90
|
|
|
PR CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 52344
|
| Min. Negotiated Rate |
$231.96 |
| Max. Negotiated Rate |
$3,736.67 |
| Rate for Payer: Aetna Commercial |
$479.41
|
| Rate for Payer: Aetna Medicare |
$372.08
|
| Rate for Payer: BCBS Complete |
$243.56
|
| Rate for Payer: BCBS MAPPO |
$357.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,736.67
|
| Rate for Payer: BCN Commercial |
$525.33
|
| Rate for Payer: BCN Medicare Advantage |
$357.77
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$479.41
|
| Rate for Payer: Cofinity Commercial |
$515.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.77
|
| Rate for Payer: Mclaren Medicaid |
$231.96
|
| Rate for Payer: Meridian Medicaid |
$243.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$375.66
|
| Rate for Payer: PACE SWMI |
$357.77
|
| Rate for Payer: PHP Medicare Advantage |
$357.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.89
|
| Rate for Payer: Priority Health Medicare |
$357.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.77
|
| Rate for Payer: UHC Medicare Advantage |
$368.50
|
|
|
PR CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX
|
Professional
|
Both
|
$1,105.00
|
|
|
Service Code
|
HCPCS 52345
|
| Min. Negotiated Rate |
$247.51 |
| Max. Negotiated Rate |
$3,934.25 |
| Rate for Payer: Aetna Commercial |
$512.56
|
| Rate for Payer: Aetna Medicare |
$397.81
|
| Rate for Payer: BCBS Complete |
$259.89
|
| Rate for Payer: BCBS MAPPO |
$382.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.25
|
| Rate for Payer: BCN Commercial |
$561.49
|
| Rate for Payer: BCN Medicare Advantage |
$382.51
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$550.81
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.51
|
| Rate for Payer: Mclaren Medicaid |
$247.51
|
| Rate for Payer: Meridian Medicaid |
$259.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.64
|
| Rate for Payer: PACE SWMI |
$382.51
|
| Rate for Payer: PHP Medicare Advantage |
$382.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$620.86
|
| Rate for Payer: Priority Health Medicare |
$382.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$620.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.51
|
| Rate for Payer: UHC Medicare Advantage |
$393.99
|
|
|
PR DACRYOCSTORHINOSTOMY
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 68720
|
| Min. Negotiated Rate |
$245.66 |
| Max. Negotiated Rate |
$1,405.01 |
| Rate for Payer: Aetna Commercial |
$1,039.06
|
| Rate for Payer: Aetna Medicare |
$806.44
|
| Rate for Payer: BCBS Complete |
$539.89
|
| Rate for Payer: BCBS MAPPO |
$775.42
|
| Rate for Payer: BCBS Trust/PPO |
$245.66
|
| Rate for Payer: BCN Commercial |
$1,172.83
|
| Rate for Payer: BCN Medicare Advantage |
$775.42
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cofinity Commercial |
$1,039.06
|
| Rate for Payer: Cofinity Commercial |
$1,116.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.42
|
| Rate for Payer: Mclaren Medicaid |
$514.18
|
| Rate for Payer: Meridian Medicaid |
$539.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$814.19
|
| Rate for Payer: PACE SWMI |
$775.42
|
| Rate for Payer: PHP Medicare Advantage |
$775.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,405.01
|
| Rate for Payer: Priority Health Medicare |
$775.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,405.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.42
|
| Rate for Payer: UHC Medicare Advantage |
$798.68
|
|
|
PR DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01996
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$133.50 |
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.50
|
|
|
PR DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 11000
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$35.82
|
| Rate for Payer: Aetna Medicare |
$27.80
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$26.73
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$67.93
|
| Rate for Payer: BCN Medicare Advantage |
$26.73
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$38.49
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.73
|
| Rate for Payer: Mclaren Medicaid |
$17.47
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.07
|
| Rate for Payer: PACE SWMI |
$26.73
|
| Rate for Payer: PHP Medicare Advantage |
$26.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.88
|
| Rate for Payer: Priority Health Medicare |
$26.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.73
|
| Rate for Payer: UHC Medicare Advantage |
$27.53
|
|
|
PR DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 11001
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$19.71
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS MAPPO |
$14.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.75
|
| Rate for Payer: BCN Commercial |
$32.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.71
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$19.71
|
| Rate for Payer: Cofinity Commercial |
$21.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.71
|
| Rate for Payer: Mclaren Medicaid |
$9.37
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.45
|
| Rate for Payer: PACE SWMI |
$14.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.09
|
| Rate for Payer: Priority Health Medicare |
$14.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.71
|
| Rate for Payer: UHC Medicare Advantage |
$15.15
|
|
|
PR DBRDMT FX&/DISLC SUBQ T/M/F BONE
|
Professional
|
Both
|
$1,194.00
|
|
|
Service Code
|
HCPCS 11012
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$955.37 |
| Rate for Payer: Aetna Commercial |
$548.46
|
| Rate for Payer: Aetna Medicare |
$425.67
|
| Rate for Payer: BCBS Complete |
$277.33
|
| Rate for Payer: BCBS MAPPO |
$409.30
|
| Rate for Payer: BCBS Trust/PPO |
$25.40
|
| Rate for Payer: BCN Commercial |
$955.37
|
| Rate for Payer: BCN Medicare Advantage |
$409.30
|
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Cofinity Commercial |
$589.39
|
| Rate for Payer: Cofinity Commercial |
$548.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.30
|
| Rate for Payer: Mclaren Medicaid |
$264.12
|
| Rate for Payer: Meridian Medicaid |
$277.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.76
|
| Rate for Payer: PACE SWMI |
$409.30
|
| Rate for Payer: PHP Medicare Advantage |
$409.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$835.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$507.64
|
| Rate for Payer: Priority Health Medicare |
$409.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.30
|
| Rate for Payer: UHC Medicare Advantage |
$421.58
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Facility
|
IP
|
$1,395.00
|
|
|
Service Code
|
CPT 11005
|
| Hospital Charge Code |
11005
|
| Min. Negotiated Rate |
$850.81 |
| Max. Negotiated Rate |
$1,255.50 |
| Rate for Payer: Aetna Commercial |
$1,185.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,078.06
|
| Rate for Payer: BCN Commercial |
$1,078.06
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cofinity Commercial |
$1,199.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,116.00
|
| Rate for Payer: Healthscope Commercial |
$1,255.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,046.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,185.75
|
| Rate for Payer: PHP Commercial |
$1,185.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,213.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,227.60
|
| Rate for Payer: UHC Core |
$1,164.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,046.25
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Facility
|
OP
|
$1,395.00
|
|
|
Service Code
|
CPT 11005
|
| Hospital Charge Code |
11005
|
| Min. Negotiated Rate |
$331.31 |
| Max. Negotiated Rate |
$1,255.50 |
| Rate for Payer: Aetna Commercial |
$1,185.75
|
| Rate for Payer: Aetna Medicare |
$362.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.94
|
| Rate for Payer: BCBS Complete |
$558.00
|
| Rate for Payer: BCBS MAPPO |
$348.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.61
|
| Rate for Payer: BCN Commercial |
$1,084.61
|
| Rate for Payer: BCN Medicare Advantage |
$348.75
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cofinity Commercial |
$1,199.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,116.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.75
|
| Rate for Payer: Healthscope Commercial |
$1,255.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,046.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$366.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$401.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,185.75
|
| Rate for Payer: PACE Senior Care Partners |
$331.31
|
| Rate for Payer: PACE SWMI |
$348.75
|
| Rate for Payer: PHP Commercial |
$1,185.75
|
| Rate for Payer: PHP Medicare Advantage |
$348.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,213.65
|
| Rate for Payer: Priority Health Medicare |
$348.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.81
|
| Rate for Payer: Railroad Medicare Medicare |
$348.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,227.60
|
| Rate for Payer: UHC Core |
$1,164.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.75
|
| Rate for Payer: UHC Medicare Advantage |
$359.21
|
| Rate for Payer: VA VA |
$348.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,046.25
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Professional
|
Both
|
$1,395.00
|
|
|
Service Code
|
HCPCS 11005
|
| Min. Negotiated Rate |
$488.84 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$1,029.25
|
| Rate for Payer: Aetna Medicare |
$798.82
|
| Rate for Payer: BCBS Complete |
$513.28
|
| Rate for Payer: BCBS MAPPO |
$768.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,118.58
|
| Rate for Payer: BCN Medicare Advantage |
$768.10
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cofinity Commercial |
$1,029.25
|
| Rate for Payer: Cofinity Commercial |
$1,106.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.10
|
| Rate for Payer: Mclaren Medicaid |
$488.84
|
| Rate for Payer: Meridian Medicaid |
$513.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$806.50
|
| Rate for Payer: PACE SWMI |
$768.10
|
| Rate for Payer: PHP Medicare Advantage |
$768.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.87
|
| Rate for Payer: Priority Health Medicare |
$768.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$940.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$768.10
|
| Rate for Payer: UHC Medicare Advantage |
$791.14
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Professional
|
Both
|
$1,395.00
|
|
|
Service Code
|
HCPCS 11005
|
| Hospital Charge Code |
11005
|
| Min. Negotiated Rate |
$488.84 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$1,029.25
|
| Rate for Payer: Aetna Medicare |
$798.82
|
| Rate for Payer: BCBS Complete |
$513.28
|
| Rate for Payer: BCBS MAPPO |
$768.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,118.58
|
| Rate for Payer: BCN Medicare Advantage |
$768.10
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cofinity Commercial |
$1,029.25
|
| Rate for Payer: Cofinity Commercial |
$1,106.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.10
|
| Rate for Payer: Mclaren Medicaid |
$488.84
|
| Rate for Payer: Meridian Medicaid |
$513.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$806.50
|
| Rate for Payer: PACE SWMI |
$768.10
|
| Rate for Payer: PHP Medicare Advantage |
$768.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$940.87
|
| Rate for Payer: Priority Health Medicare |
$768.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$940.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$768.10
|
| Rate for Payer: UHC Medicare Advantage |
$791.14
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 11006
|
| Min. Negotiated Rate |
$442.19 |
| Max. Negotiated Rate |
$2,187.45 |
| Rate for Payer: Aetna Commercial |
$930.19
|
| Rate for Payer: Aetna Medicare |
$721.94
|
| Rate for Payer: BCBS Complete |
$464.30
|
| Rate for Payer: BCBS MAPPO |
$694.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,187.45
|
| Rate for Payer: BCN Commercial |
$1,012.05
|
| Rate for Payer: BCN Medicare Advantage |
$694.17
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$999.60
|
| Rate for Payer: Cofinity Commercial |
$930.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.17
|
| Rate for Payer: Mclaren Medicaid |
$442.19
|
| Rate for Payer: Meridian Medicaid |
$464.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$728.88
|
| Rate for Payer: PACE SWMI |
$694.17
|
| Rate for Payer: PHP Medicare Advantage |
$694.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.26
|
| Rate for Payer: Priority Health Medicare |
$694.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$851.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.17
|
| Rate for Payer: UHC Medicare Advantage |
$715.00
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 11004
|
| Min. Negotiated Rate |
$358.69 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$753.91
|
| Rate for Payer: Aetna Medicare |
$585.12
|
| Rate for Payer: BCBS Complete |
$376.62
|
| Rate for Payer: BCBS MAPPO |
$562.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.75
|
| Rate for Payer: BCN Commercial |
$820.97
|
| Rate for Payer: BCN Medicare Advantage |
$562.62
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$753.91
|
| Rate for Payer: Cofinity Commercial |
$810.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.62
|
| Rate for Payer: Mclaren Medicaid |
$358.69
|
| Rate for Payer: Meridian Medicaid |
$376.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$590.75
|
| Rate for Payer: PACE SWMI |
$562.62
|
| Rate for Payer: PHP Medicare Advantage |
$562.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.54
|
| Rate for Payer: Priority Health Medicare |
$562.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$562.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$562.62
|
| Rate for Payer: UHC Medicare Advantage |
$579.50
|
|
|
PR DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 11045
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$111.72 |
| Rate for Payer: Aetna Commercial |
$33.65
|
| Rate for Payer: Aetna Medicare |
$26.11
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$25.11
|
| Rate for Payer: BCBS Trust/PPO |
$111.72
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$25.11
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$36.16
|
| Rate for Payer: Cofinity Commercial |
$33.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.11
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.37
|
| Rate for Payer: PACE SWMI |
$25.11
|
| Rate for Payer: PHP Medicare Advantage |
$25.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.83
|
| Rate for Payer: Priority Health Medicare |
$25.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.11
|
| Rate for Payer: UHC Medicare Advantage |
$25.86
|
|
|
PR DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11010
|
| Min. Negotiated Rate |
$145.28 |
| Max. Negotiated Rate |
$664.60 |
| Rate for Payer: Aetna Commercial |
$362.93
|
| Rate for Payer: Aetna Medicare |
$281.67
|
| Rate for Payer: BCBS Complete |
$184.74
|
| Rate for Payer: BCBS MAPPO |
$270.84
|
| Rate for Payer: BCBS Trust/PPO |
$145.28
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$270.84
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$390.01
|
| Rate for Payer: Cofinity Commercial |
$362.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$270.84
|
| Rate for Payer: Mclaren Medicaid |
$175.94
|
| Rate for Payer: Meridian Medicaid |
$184.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$284.38
|
| Rate for Payer: PACE SWMI |
$270.84
|
| Rate for Payer: PHP Medicare Advantage |
$270.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.28
|
| Rate for Payer: Priority Health Medicare |
$270.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$338.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$270.84
|
| Rate for Payer: UHC Medicare Advantage |
$278.97
|
|
|
PR DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 11011
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$729.59 |
| Rate for Payer: Aetna Commercial |
$390.70
|
| Rate for Payer: Aetna Medicare |
$303.23
|
| Rate for Payer: BCBS Complete |
$198.60
|
| Rate for Payer: BCBS MAPPO |
$291.57
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$729.59
|
| Rate for Payer: BCN Medicare Advantage |
$291.57
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$419.86
|
| Rate for Payer: Cofinity Commercial |
$390.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.57
|
| Rate for Payer: Mclaren Medicaid |
$189.14
|
| Rate for Payer: Meridian Medicaid |
$198.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$306.15
|
| Rate for Payer: PACE SWMI |
$291.57
|
| Rate for Payer: PHP Medicare Advantage |
$291.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$361.30
|
| Rate for Payer: Priority Health Medicare |
$291.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$361.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$291.57
|
| Rate for Payer: UHC Medicare Advantage |
$300.32
|
|
|
PR DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 27057
|
| Min. Negotiated Rate |
$647.95 |
| Max. Negotiated Rate |
$4,478.93 |
| Rate for Payer: Aetna Commercial |
$1,333.69
|
| Rate for Payer: Aetna Medicare |
$1,035.10
|
| Rate for Payer: BCBS Complete |
$680.35
|
| Rate for Payer: BCBS MAPPO |
$995.29
|
| Rate for Payer: BCBS Trust/PPO |
$4,478.93
|
| Rate for Payer: BCN Commercial |
$1,477.76
|
| Rate for Payer: BCN Medicare Advantage |
$995.29
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,333.69
|
| Rate for Payer: Cofinity Commercial |
$1,433.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.29
|
| Rate for Payer: Mclaren Medicaid |
$647.95
|
| Rate for Payer: Meridian Medicaid |
$680.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,045.05
|
| Rate for Payer: PACE SWMI |
$995.29
|
| Rate for Payer: PHP Medicare Advantage |
$995.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.21
|
| Rate for Payer: Priority Health Medicare |
$995.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,544.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$995.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.15
|
|
|
PR DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS
|
Professional
|
Both
|
$1,314.00
|
|
|
Service Code
|
HCPCS 27498
|
| Min. Negotiated Rate |
$427.07 |
| Max. Negotiated Rate |
$1,135.85 |
| Rate for Payer: Aetna Commercial |
$869.18
|
| Rate for Payer: Aetna Medicare |
$674.59
|
| Rate for Payer: BCBS Complete |
$448.42
|
| Rate for Payer: BCBS MAPPO |
$648.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.85
|
| Rate for Payer: BCN Commercial |
$970.03
|
| Rate for Payer: BCN Medicare Advantage |
$648.64
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cofinity Commercial |
$869.18
|
| Rate for Payer: Cofinity Commercial |
$934.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.64
|
| Rate for Payer: Mclaren Medicaid |
$427.07
|
| Rate for Payer: Meridian Medicaid |
$448.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$681.07
|
| Rate for Payer: PACE SWMI |
$648.64
|
| Rate for Payer: PHP Medicare Advantage |
$648.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.64
|
| Rate for Payer: Priority Health Medicare |
$648.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,013.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$648.64
|
| Rate for Payer: UHC Medicare Advantage |
$668.10
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT
|
Professional
|
Both
|
$2,138.00
|
|
|
Service Code
|
HCPCS 25025
|
| Min. Negotiated Rate |
$788.95 |
| Max. Negotiated Rate |
$1,877.66 |
| Rate for Payer: Aetna Commercial |
$1,620.56
|
| Rate for Payer: Aetna Medicare |
$1,257.74
|
| Rate for Payer: BCBS Complete |
$828.40
|
| Rate for Payer: BCBS MAPPO |
$1,209.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.18
|
| Rate for Payer: BCN Commercial |
$1,796.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,209.37
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cash Price |
$1,710.40
|
| Rate for Payer: Cofinity Commercial |
$1,620.56
|
| Rate for Payer: Cofinity Commercial |
$1,741.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,209.37
|
| Rate for Payer: Mclaren Medicaid |
$788.95
|
| Rate for Payer: Meridian Medicaid |
$828.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,269.84
|
| Rate for Payer: PACE SWMI |
$1,209.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,209.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,877.66
|
| Rate for Payer: Priority Health Medicare |
$1,209.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,877.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,209.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,209.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,245.65
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 25023
|
| Min. Negotiated Rate |
$842.63 |
| Max. Negotiated Rate |
$2,015.03 |
| Rate for Payer: Aetna Commercial |
$1,709.01
|
| Rate for Payer: Aetna Medicare |
$1,326.40
|
| Rate for Payer: BCBS Complete |
$884.76
|
| Rate for Payer: BCBS MAPPO |
$1,275.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.13
|
| Rate for Payer: BCN Commercial |
$1,928.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.38
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$1,836.55
|
| Rate for Payer: Cofinity Commercial |
$1,709.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.38
|
| Rate for Payer: Mclaren Medicaid |
$842.63
|
| Rate for Payer: Meridian Medicaid |
$884.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,339.15
|
| Rate for Payer: PACE SWMI |
$1,275.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$842.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,351.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,015.03
|
| Rate for Payer: Priority Health Medicare |
$1,275.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,015.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,275.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,313.64
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 25024
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$1,250.90 |
| Rate for Payer: Aetna Commercial |
$1,024.03
|
| Rate for Payer: Aetna Medicare |
$794.77
|
| Rate for Payer: BCBS Complete |
$529.83
|
| Rate for Payer: BCBS MAPPO |
$764.20
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$1,139.60
|
| Rate for Payer: BCN Medicare Advantage |
$764.20
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,024.03
|
| Rate for Payer: Cofinity Commercial |
$1,100.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.20
|
| Rate for Payer: Mclaren Medicaid |
$504.60
|
| Rate for Payer: Meridian Medicaid |
$529.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$802.41
|
| Rate for Payer: PACE SWMI |
$764.20
|
| Rate for Payer: PHP Medicare Advantage |
$764.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,250.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,190.84
|
| Rate for Payer: Priority Health Medicare |
$764.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,190.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$764.20
|
| Rate for Payer: UHC Medicare Advantage |
$787.13
|
|
|
PR DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT
|
Professional
|
Both
|
$1,390.00
|
|
|
Service Code
|
HCPCS 25020
|
| Min. Negotiated Rate |
$160.07 |
| Max. Negotiated Rate |
$1,150.50 |
| Rate for Payer: Aetna Commercial |
$964.96
|
| Rate for Payer: Aetna Medicare |
$748.92
|
| Rate for Payer: BCBS Complete |
$501.20
|
| Rate for Payer: BCBS MAPPO |
$720.12
|
| Rate for Payer: BCBS Trust/PPO |
$160.07
|
| Rate for Payer: BCN Commercial |
$1,100.99
|
| Rate for Payer: BCN Medicare Advantage |
$720.12
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cash Price |
$1,112.00
|
| Rate for Payer: Cofinity Commercial |
$1,036.97
|
| Rate for Payer: Cofinity Commercial |
$964.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$720.12
|
| Rate for Payer: Mclaren Medicaid |
$477.33
|
| Rate for Payer: Meridian Medicaid |
$501.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$756.13
|
| Rate for Payer: PACE SWMI |
$720.12
|
| Rate for Payer: PHP Medicare Advantage |
$720.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.50
|
| Rate for Payer: Priority Health Medicare |
$720.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$720.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$720.12
|
| Rate for Payer: UHC Medicare Advantage |
$741.72
|
|
