|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
25447
|
| Min. Negotiated Rate |
$1,975.35 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Aetna Commercial |
$2,583.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,480.74
|
| Rate for Payer: BCN Commercial |
$2,348.54
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cofinity Commercial |
$2,613.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,431.20
|
| Rate for Payer: Healthscope Commercial |
$2,735.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,279.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,583.15
|
| Rate for Payer: Nomi Health Commercial |
$2,491.98
|
| Rate for Payer: PHP Commercial |
$2,583.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,643.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,036.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,674.32
|
| Rate for Payer: UHC Core |
$2,537.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,279.25
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
25447
|
| Min. Negotiated Rate |
$721.76 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Aetna Commercial |
$2,583.15
|
| Rate for Payer: Aetna Medicare |
$790.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$949.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$949.69
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$759.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,498.36
|
| Rate for Payer: BCN Commercial |
$2,362.82
|
| Rate for Payer: BCN Medicare Advantage |
$759.75
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cofinity Commercial |
$2,613.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,431.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.75
|
| Rate for Payer: Healthscope Commercial |
$2,735.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,279.25
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.74
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$873.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,583.15
|
| Rate for Payer: Nomi Health Commercial |
$2,491.98
|
| Rate for Payer: PACE Senior Care Partners |
$721.76
|
| Rate for Payer: PACE SWMI |
$759.75
|
| Rate for Payer: PHP Commercial |
$2,583.15
|
| Rate for Payer: PHP Medicare Advantage |
$759.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,643.93
|
| Rate for Payer: Priority Health Medicare |
$767.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,036.13
|
| Rate for Payer: Railroad Medicare Medicare |
$759.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,674.32
|
| Rate for Payer: UHC Core |
$2,537.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.75
|
| Rate for Payer: UHC Exchange |
$759.75
|
| Rate for Payer: UHC Medicare Advantage |
$759.75
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$759.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,279.25
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION
|
Professional
|
Both
|
$3,039.00
|
|
|
Service Code
|
HCPCS 25447
|
| Hospital Charge Code |
25447
|
| Min. Negotiated Rate |
$771.24 |
| Max. Negotiated Rate |
$1,975.35 |
| Rate for Payer: Aetna Commercial |
$1,033.46
|
| Rate for Payer: Aetna Medicare |
$802.09
|
| Rate for Payer: BCBS Complete |
$1,215.60
|
| Rate for Payer: BCBS MAPPO |
$771.24
|
| Rate for Payer: BCN Medicare Advantage |
$771.24
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cash Price |
$2,431.20
|
| Rate for Payer: Cofinity Commercial |
$1,110.59
|
| Rate for Payer: Cofinity Commercial |
$1,033.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.80
|
| Rate for Payer: Nomi Health Commercial |
$925.49
|
| Rate for Payer: PACE SWMI |
$771.24
|
| Rate for Payer: PHP Medicare Advantage |
$771.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,975.35
|
| Rate for Payer: Priority Health Medicare |
$778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.24
|
| Rate for Payer: UHC Exchange |
$771.24
|
| Rate for Payer: UHC Medicare Advantage |
$771.24
|
|
|
PR ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION
|
Professional
|
Both
|
$2,560.00
|
|
|
Service Code
|
HCPCS 25448
|
| Min. Negotiated Rate |
$852.77 |
| Max. Negotiated Rate |
$1,664.00 |
| Rate for Payer: Aetna Commercial |
$1,142.71
|
| Rate for Payer: Aetna Medicare |
$886.88
|
| Rate for Payer: BCBS Complete |
$1,024.00
|
| Rate for Payer: BCBS MAPPO |
$852.77
|
| Rate for Payer: BCN Medicare Advantage |
$852.77
|
| Rate for Payer: Cash Price |
$2,048.00
|
| Rate for Payer: Cash Price |
$2,048.00
|
| Rate for Payer: Cofinity Commercial |
$1,227.99
|
| Rate for Payer: Cofinity Commercial |
$1,142.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$852.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.41
|
| Rate for Payer: Nomi Health Commercial |
$1,023.32
|
| Rate for Payer: PACE SWMI |
$852.77
|
| Rate for Payer: PHP Medicare Advantage |
$852.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,664.00
|
| Rate for Payer: Priority Health Medicare |
$861.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$852.77
|
| Rate for Payer: UHC Exchange |
$852.77
|
| Rate for Payer: UHC Medicare Advantage |
$852.77
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Facility
|
IP
|
$5,007.00
|
|
|
Service Code
|
CPT 27447
|
| Hospital Charge Code |
27447
|
| Min. Negotiated Rate |
$3,254.55 |
| Max. Negotiated Rate |
$4,506.30 |
| Rate for Payer: Aetna Commercial |
$4,255.95
|
| Rate for Payer: BCBS Trust/PPO |
$4,087.21
|
| Rate for Payer: BCN Commercial |
$3,869.41
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cofinity Commercial |
$4,306.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.60
|
| Rate for Payer: Healthscope Commercial |
$4,506.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,755.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.95
|
| Rate for Payer: Nomi Health Commercial |
$4,105.74
|
| Rate for Payer: PHP Commercial |
$4,255.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health HMO/PPO |
$4,356.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,354.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,406.16
|
| Rate for Payer: UHC Core |
$4,180.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,755.25
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Professional
|
Both
|
$5,007.00
|
|
|
Service Code
|
HCPCS 27447
|
| Min. Negotiated Rate |
$1,235.86 |
| Max. Negotiated Rate |
$3,254.55 |
| Rate for Payer: Aetna Commercial |
$1,656.05
|
| Rate for Payer: Aetna Medicare |
$1,285.29
|
| Rate for Payer: BCBS Complete |
$2,002.80
|
| Rate for Payer: BCBS MAPPO |
$1,235.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.86
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cofinity Commercial |
$1,779.64
|
| Rate for Payer: Cofinity Commercial |
$1,656.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,297.65
|
| Rate for Payer: Nomi Health Commercial |
$1,483.03
|
| Rate for Payer: PACE SWMI |
$1,235.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health Medicare |
$1,248.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,235.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,235.86
|
| Rate for Payer: UHC Exchange |
$1,235.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,235.86
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Facility
|
OP
|
$5,007.00
|
|
|
Service Code
|
CPT 27447
|
| Hospital Charge Code |
27447
|
| Min. Negotiated Rate |
$1,189.16 |
| Max. Negotiated Rate |
$9,768.49 |
| Rate for Payer: Aetna Commercial |
$4,255.95
|
| Rate for Payer: Aetna Medicare |
$1,301.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,564.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,564.69
|
| Rate for Payer: BCBS Complete |
$9,768.49
|
| Rate for Payer: BCBS MAPPO |
$1,251.75
|
| Rate for Payer: BCBS Trust/PPO |
$4,116.25
|
| Rate for Payer: BCN Commercial |
$3,892.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,251.75
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cofinity Commercial |
$4,306.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,251.75
|
| Rate for Payer: Healthscope Commercial |
$4,506.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,755.25
|
| Rate for Payer: Mclaren Medicaid |
$9,302.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,314.34
|
| Rate for Payer: Meridian Medicaid |
$9,768.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,439.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.95
|
| Rate for Payer: Nomi Health Commercial |
$4,105.74
|
| Rate for Payer: PACE Senior Care Partners |
$1,189.16
|
| Rate for Payer: PACE SWMI |
$1,251.75
|
| Rate for Payer: PHP Commercial |
$4,255.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,251.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,302.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health HMO/PPO |
$4,356.09
|
| Rate for Payer: Priority Health Medicare |
$1,264.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,354.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,251.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,406.16
|
| Rate for Payer: UHC Core |
$4,180.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,251.75
|
| Rate for Payer: UHC Exchange |
$1,251.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,251.75
|
| Rate for Payer: UHCCP Medicaid |
$9,302.71
|
| Rate for Payer: VA VA |
$1,251.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,755.25
|
|
|
PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS
|
Professional
|
Both
|
$5,007.00
|
|
|
Service Code
|
HCPCS 27447
|
| Hospital Charge Code |
27447
|
| Min. Negotiated Rate |
$1,235.86 |
| Max. Negotiated Rate |
$3,254.55 |
| Rate for Payer: Aetna Commercial |
$1,656.05
|
| Rate for Payer: Aetna Medicare |
$1,285.29
|
| Rate for Payer: BCBS Complete |
$2,002.80
|
| Rate for Payer: BCBS MAPPO |
$1,235.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.86
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cash Price |
$4,005.60
|
| Rate for Payer: Cofinity Commercial |
$1,779.64
|
| Rate for Payer: Cofinity Commercial |
$1,656.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,297.65
|
| Rate for Payer: Nomi Health Commercial |
$1,483.03
|
| Rate for Payer: PACE SWMI |
$1,235.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,254.55
|
| Rate for Payer: Priority Health Medicare |
$1,248.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,235.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,235.86
|
| Rate for Payer: UHC Exchange |
$1,235.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,235.86
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$3,221.00
|
|
|
Service Code
|
HCPCS 27446
|
| Min. Negotiated Rate |
$1,106.26 |
| Max. Negotiated Rate |
$2,093.65 |
| Rate for Payer: Aetna Commercial |
$1,482.39
|
| Rate for Payer: Aetna Medicare |
$1,150.51
|
| Rate for Payer: BCBS Complete |
$1,288.40
|
| Rate for Payer: BCBS MAPPO |
$1,106.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.26
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$1,593.01
|
| Rate for Payer: Cofinity Commercial |
$1,482.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.57
|
| Rate for Payer: Nomi Health Commercial |
$1,327.51
|
| Rate for Payer: PACE SWMI |
$1,106.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health Medicare |
$1,117.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.26
|
| Rate for Payer: UHC Exchange |
$1,106.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.26
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Professional
|
Both
|
$3,221.00
|
|
|
Service Code
|
HCPCS 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$1,106.26 |
| Max. Negotiated Rate |
$2,093.65 |
| Rate for Payer: Aetna Commercial |
$1,482.39
|
| Rate for Payer: Aetna Medicare |
$1,150.51
|
| Rate for Payer: BCBS Complete |
$1,288.40
|
| Rate for Payer: BCBS MAPPO |
$1,106.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.26
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$1,593.01
|
| Rate for Payer: Cofinity Commercial |
$1,482.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.57
|
| Rate for Payer: Nomi Health Commercial |
$1,327.51
|
| Rate for Payer: PACE SWMI |
$1,106.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health Medicare |
$1,117.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,106.26
|
| Rate for Payer: UHC Exchange |
$1,106.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.26
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Facility
|
OP
|
$3,221.00
|
|
|
Service Code
|
CPT 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$764.99 |
| Max. Negotiated Rate |
$9,768.49 |
| Rate for Payer: Aetna Commercial |
$2,737.85
|
| Rate for Payer: Aetna Medicare |
$837.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,006.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,006.56
|
| Rate for Payer: BCBS Complete |
$9,768.49
|
| Rate for Payer: BCBS MAPPO |
$805.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,647.98
|
| Rate for Payer: BCN Commercial |
$2,504.33
|
| Rate for Payer: BCN Medicare Advantage |
$805.25
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$2,770.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.25
|
| Rate for Payer: Healthscope Commercial |
$2,898.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,415.75
|
| Rate for Payer: Mclaren Medicaid |
$9,302.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.51
|
| Rate for Payer: Meridian Medicaid |
$9,768.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,737.85
|
| Rate for Payer: Nomi Health Commercial |
$2,641.22
|
| Rate for Payer: PACE Senior Care Partners |
$764.99
|
| Rate for Payer: PACE SWMI |
$805.25
|
| Rate for Payer: PHP Commercial |
$2,737.85
|
| Rate for Payer: PHP Medicare Advantage |
$805.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,302.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,802.27
|
| Rate for Payer: Priority Health Medicare |
$813.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,158.07
|
| Rate for Payer: Railroad Medicare Medicare |
$805.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,834.48
|
| Rate for Payer: UHC Core |
$2,689.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.25
|
| Rate for Payer: UHC Exchange |
$805.25
|
| Rate for Payer: UHC Medicare Advantage |
$805.25
|
| Rate for Payer: UHCCP Medicaid |
$9,302.71
|
| Rate for Payer: VA VA |
$805.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,415.75
|
|
|
PR ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT
|
Facility
|
IP
|
$3,221.00
|
|
|
Service Code
|
CPT 27446
|
| Hospital Charge Code |
27446
|
| Min. Negotiated Rate |
$2,093.65 |
| Max. Negotiated Rate |
$2,898.90 |
| Rate for Payer: Aetna Commercial |
$2,737.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,629.30
|
| Rate for Payer: BCN Commercial |
$2,489.19
|
| Rate for Payer: Cash Price |
$2,576.80
|
| Rate for Payer: Cofinity Commercial |
$2,770.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.80
|
| Rate for Payer: Healthscope Commercial |
$2,898.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,415.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,737.85
|
| Rate for Payer: Nomi Health Commercial |
$2,641.22
|
| Rate for Payer: PHP Commercial |
$2,737.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,093.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,802.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,158.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,834.48
|
| Rate for Payer: UHC Core |
$2,689.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,415.75
|
|
|
PR ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT
|
Professional
|
Both
|
$1,690.00
|
|
|
Service Code
|
HCPCS 27441
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$1,147.23 |
| Rate for Payer: Aetna Commercial |
$1,067.56
|
| Rate for Payer: Aetna Medicare |
$828.56
|
| Rate for Payer: BCBS Complete |
$676.00
|
| Rate for Payer: BCBS MAPPO |
$796.69
|
| Rate for Payer: BCN Medicare Advantage |
$796.69
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cash Price |
$1,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,147.23
|
| Rate for Payer: Cofinity Commercial |
$1,067.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.52
|
| Rate for Payer: Nomi Health Commercial |
$956.03
|
| Rate for Payer: PACE SWMI |
$796.69
|
| Rate for Payer: PHP Medicare Advantage |
$796.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.50
|
| Rate for Payer: Priority Health Medicare |
$804.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.69
|
| Rate for Payer: UHC Exchange |
$796.69
|
| Rate for Payer: UHC Medicare Advantage |
$796.69
|
|
|
PR ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 26531
|
| Min. Negotiated Rate |
$612.08 |
| Max. Negotiated Rate |
$1,417.65 |
| Rate for Payer: Aetna Commercial |
$820.19
|
| Rate for Payer: Aetna Medicare |
$636.56
|
| Rate for Payer: BCBS Complete |
$872.40
|
| Rate for Payer: BCBS MAPPO |
$612.08
|
| Rate for Payer: BCN Medicare Advantage |
$612.08
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$881.40
|
| Rate for Payer: Cofinity Commercial |
$820.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$612.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.68
|
| Rate for Payer: Nomi Health Commercial |
$734.50
|
| Rate for Payer: PACE SWMI |
$612.08
|
| Rate for Payer: PHP Medicare Advantage |
$612.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health Medicare |
$618.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$612.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$612.08
|
| Rate for Payer: UHC Exchange |
$612.08
|
| Rate for Payer: UHC Medicare Advantage |
$612.08
|
|
|
PR ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/ENTIR CARPS
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 25446
|
| Min. Negotiated Rate |
$837.60 |
| Max. Negotiated Rate |
$1,626.19 |
| Rate for Payer: Aetna Commercial |
$1,513.26
|
| Rate for Payer: Aetna Medicare |
$1,174.47
|
| Rate for Payer: BCBS Complete |
$837.60
|
| Rate for Payer: BCBS MAPPO |
$1,129.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,129.30
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cofinity Commercial |
$1,626.19
|
| Rate for Payer: Cofinity Commercial |
$1,513.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,129.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.77
|
| Rate for Payer: Nomi Health Commercial |
$1,355.16
|
| Rate for Payer: PACE SWMI |
$1,129.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,129.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.10
|
| Rate for Payer: Priority Health Medicare |
$1,140.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,129.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,129.30
|
| Rate for Payer: UHC Exchange |
$1,129.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,129.30
|
|
|
PR ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ
|
Professional
|
Both
|
$3,684.00
|
|
|
Service Code
|
HCPCS 25332
|
| Min. Negotiated Rate |
$816.50 |
| Max. Negotiated Rate |
$2,394.60 |
| Rate for Payer: Aetna Commercial |
$1,094.11
|
| Rate for Payer: Aetna Medicare |
$849.16
|
| Rate for Payer: BCBS Complete |
$1,473.60
|
| Rate for Payer: BCBS MAPPO |
$816.50
|
| Rate for Payer: BCN Medicare Advantage |
$816.50
|
| Rate for Payer: Cash Price |
$2,947.20
|
| Rate for Payer: Cash Price |
$2,947.20
|
| Rate for Payer: Cofinity Commercial |
$1,175.76
|
| Rate for Payer: Cofinity Commercial |
$1,094.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.33
|
| Rate for Payer: Nomi Health Commercial |
$979.80
|
| Rate for Payer: PACE SWMI |
$816.50
|
| Rate for Payer: PHP Medicare Advantage |
$816.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,394.60
|
| Rate for Payer: Priority Health Medicare |
$824.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$816.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.50
|
| Rate for Payer: UHC Exchange |
$816.50
|
| Rate for Payer: UHC Medicare Advantage |
$816.50
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,078.00
|
|
|
Service Code
|
HCPCS 29888
|
| Min. Negotiated Rate |
$936.55 |
| Max. Negotiated Rate |
$2,650.70 |
| Rate for Payer: Aetna Commercial |
$1,254.98
|
| Rate for Payer: Aetna Medicare |
$974.01
|
| Rate for Payer: BCBS Complete |
$1,631.20
|
| Rate for Payer: BCBS MAPPO |
$936.55
|
| Rate for Payer: BCN Medicare Advantage |
$936.55
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$1,348.63
|
| Rate for Payer: Cofinity Commercial |
$1,254.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.38
|
| Rate for Payer: Nomi Health Commercial |
$1,123.86
|
| Rate for Payer: PACE SWMI |
$936.55
|
| Rate for Payer: PHP Medicare Advantage |
$936.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health Medicare |
$945.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.55
|
| Rate for Payer: UHC Exchange |
$936.55
|
| Rate for Payer: UHC Medicare Advantage |
$936.55
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,078.00
|
|
|
Service Code
|
HCPCS 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$936.55 |
| Max. Negotiated Rate |
$2,650.70 |
| Rate for Payer: Aetna Commercial |
$1,254.98
|
| Rate for Payer: Aetna Medicare |
$974.01
|
| Rate for Payer: BCBS Complete |
$1,631.20
|
| Rate for Payer: BCBS MAPPO |
$936.55
|
| Rate for Payer: BCN Medicare Advantage |
$936.55
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$1,348.63
|
| Rate for Payer: Cofinity Commercial |
$1,254.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.38
|
| Rate for Payer: Nomi Health Commercial |
$1,123.86
|
| Rate for Payer: PACE SWMI |
$936.55
|
| Rate for Payer: PHP Medicare Advantage |
$936.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health Medicare |
$945.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.55
|
| Rate for Payer: UHC Exchange |
$936.55
|
| Rate for Payer: UHC Medicare Advantage |
$936.55
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Facility
|
IP
|
$4,078.00
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$2,650.70 |
| Max. Negotiated Rate |
$3,670.20 |
| Rate for Payer: Aetna Commercial |
$3,466.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,328.87
|
| Rate for Payer: BCN Commercial |
$3,151.48
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$3,507.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,262.40
|
| Rate for Payer: Healthscope Commercial |
$3,670.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,058.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.30
|
| Rate for Payer: Nomi Health Commercial |
$3,343.96
|
| Rate for Payer: PHP Commercial |
$3,466.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3,547.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,588.64
|
| Rate for Payer: UHC Core |
$3,405.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,058.50
|
|
|
PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Facility
|
OP
|
$4,078.00
|
|
|
Service Code
|
CPT 29888
|
| Hospital Charge Code |
29888
|
| Min. Negotiated Rate |
$968.52 |
| Max. Negotiated Rate |
$5,423.52 |
| Rate for Payer: Aetna Commercial |
$3,466.30
|
| Rate for Payer: Aetna Medicare |
$1,060.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,274.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,274.38
|
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: BCBS MAPPO |
$1,019.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,352.52
|
| Rate for Payer: BCN Commercial |
$3,170.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,019.50
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cash Price |
$3,262.40
|
| Rate for Payer: Cofinity Commercial |
$3,507.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,262.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,019.50
|
| Rate for Payer: Healthscope Commercial |
$3,670.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,058.50
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,070.47
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,172.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,466.30
|
| Rate for Payer: Nomi Health Commercial |
$3,343.96
|
| Rate for Payer: PACE Senior Care Partners |
$968.52
|
| Rate for Payer: PACE SWMI |
$1,019.50
|
| Rate for Payer: PHP Commercial |
$3,466.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,019.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3,547.86
|
| Rate for Payer: Priority Health Medicare |
$1,029.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,019.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,588.64
|
| Rate for Payer: UHC Core |
$3,405.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,019.50
|
| Rate for Payer: UHC Exchange |
$1,019.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,019.50
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
| Rate for Payer: VA VA |
$1,019.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,058.50
|
|
|
PR ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ
|
Professional
|
Both
|
$4,237.00
|
|
|
Service Code
|
HCPCS 29889
|
| Min. Negotiated Rate |
$1,180.44 |
| Max. Negotiated Rate |
$2,754.05 |
| Rate for Payer: Aetna Commercial |
$1,581.79
|
| Rate for Payer: Aetna Medicare |
$1,227.66
|
| Rate for Payer: BCBS Complete |
$1,694.80
|
| Rate for Payer: BCBS MAPPO |
$1,180.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,180.44
|
| Rate for Payer: Cash Price |
$3,389.60
|
| Rate for Payer: Cash Price |
$3,389.60
|
| Rate for Payer: Cofinity Commercial |
$1,699.83
|
| Rate for Payer: Cofinity Commercial |
$1,581.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,180.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,239.46
|
| Rate for Payer: Nomi Health Commercial |
$1,416.53
|
| Rate for Payer: PACE SWMI |
$1,180.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,180.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,754.05
|
| Rate for Payer: Priority Health Medicare |
$1,192.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,180.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,180.44
|
| Rate for Payer: UHC Exchange |
$1,180.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,180.44
|
|
|
PR ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX
|
Professional
|
Both
|
$2,688.00
|
|
|
Service Code
|
HCPCS 29892
|
| Min. Negotiated Rate |
$616.76 |
| Max. Negotiated Rate |
$1,747.20 |
| Rate for Payer: Aetna Commercial |
$826.46
|
| Rate for Payer: Aetna Medicare |
$641.43
|
| Rate for Payer: BCBS Complete |
$1,075.20
|
| Rate for Payer: BCBS MAPPO |
$616.76
|
| Rate for Payer: BCN Medicare Advantage |
$616.76
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cofinity Commercial |
$888.13
|
| Rate for Payer: Cofinity Commercial |
$826.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.60
|
| Rate for Payer: Nomi Health Commercial |
$740.11
|
| Rate for Payer: PACE SWMI |
$616.76
|
| Rate for Payer: PHP Medicare Advantage |
$616.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,747.20
|
| Rate for Payer: Priority Health Medicare |
$622.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.76
|
| Rate for Payer: UHC Exchange |
$616.76
|
| Rate for Payer: UHC Medicare Advantage |
$616.76
|
|
|
PR ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR
|
Professional
|
Both
|
$2,542.00
|
|
|
Service Code
|
HCPCS 29855
|
| Min. Negotiated Rate |
$753.01 |
| Max. Negotiated Rate |
$1,652.30 |
| Rate for Payer: Aetna Commercial |
$1,009.03
|
| Rate for Payer: Aetna Medicare |
$783.13
|
| Rate for Payer: BCBS Complete |
$1,016.80
|
| Rate for Payer: BCBS MAPPO |
$753.01
|
| Rate for Payer: BCN Medicare Advantage |
$753.01
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cash Price |
$2,033.60
|
| Rate for Payer: Cofinity Commercial |
$1,084.33
|
| Rate for Payer: Cofinity Commercial |
$1,009.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$753.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.66
|
| Rate for Payer: Nomi Health Commercial |
$903.61
|
| Rate for Payer: PACE SWMI |
$753.01
|
| Rate for Payer: PHP Medicare Advantage |
$753.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,652.30
|
| Rate for Payer: Priority Health Medicare |
$760.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$753.01
|
| Rate for Payer: UHC Exchange |
$753.01
|
| Rate for Payer: UHC Medicare Advantage |
$753.01
|
|
|
PR ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 29856
|
| Min. Negotiated Rate |
$714.40 |
| Max. Negotiated Rate |
$1,380.14 |
| Rate for Payer: Aetna Commercial |
$1,284.30
|
| Rate for Payer: Aetna Medicare |
$996.77
|
| Rate for Payer: BCBS Complete |
$714.40
|
| Rate for Payer: BCBS MAPPO |
$958.43
|
| Rate for Payer: BCN Medicare Advantage |
$958.43
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,380.14
|
| Rate for Payer: Cofinity Commercial |
$1,284.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$958.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,006.35
|
| Rate for Payer: Nomi Health Commercial |
$1,150.12
|
| Rate for Payer: PACE SWMI |
$958.43
|
| Rate for Payer: PHP Medicare Advantage |
$958.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,160.90
|
| Rate for Payer: Priority Health Medicare |
$968.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$958.43
|
| Rate for Payer: UHC Exchange |
$958.43
|
| Rate for Payer: UHC Medicare Advantage |
$958.43
|
|
|
PR ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 29891
|
| Min. Negotiated Rate |
$648.68 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$869.23
|
| Rate for Payer: Aetna Medicare |
$674.63
|
| Rate for Payer: BCBS Complete |
$971.20
|
| Rate for Payer: BCBS MAPPO |
$648.68
|
| Rate for Payer: BCN Medicare Advantage |
$648.68
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$934.10
|
| Rate for Payer: Cofinity Commercial |
$869.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.11
|
| Rate for Payer: Nomi Health Commercial |
$778.42
|
| Rate for Payer: PACE SWMI |
$648.68
|
| Rate for Payer: PHP Medicare Advantage |
$648.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health Medicare |
$655.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$648.68
|
| Rate for Payer: UHC Exchange |
$648.68
|
| Rate for Payer: UHC Medicare Advantage |
$648.68
|
|
