|
PR MARSUPIALIZATION CST/ABSC LVR
|
Professional
|
Both
|
$2,296.00
|
|
|
Service Code
|
HCPCS 47300
|
| Min. Negotiated Rate |
$727.40 |
| Max. Negotiated Rate |
$2,350.41 |
| Rate for Payer: Aetna Commercial |
$1,512.43
|
| Rate for Payer: Aetna Medicare |
$1,173.83
|
| Rate for Payer: BCBS Complete |
$763.77
|
| Rate for Payer: BCBS MAPPO |
$1,128.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,350.41
|
| Rate for Payer: BCN Commercial |
$1,661.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.68
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cofinity Commercial |
$1,512.43
|
| Rate for Payer: Cofinity Commercial |
$1,625.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.68
|
| Rate for Payer: Mclaren Medicaid |
$727.40
|
| Rate for Payer: Meridian Medicaid |
$763.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,185.11
|
| Rate for Payer: PACE SWMI |
$1,128.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,998.53
|
| Rate for Payer: Priority Health Medicare |
$1,128.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,998.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,128.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,162.54
|
|
|
PR MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA
|
Professional
|
Both
|
$682.00
|
|
|
Service Code
|
HCPCS 42409
|
| Min. Negotiated Rate |
$150.38 |
| Max. Negotiated Rate |
$641.36 |
| Rate for Payer: Aetna Commercial |
$303.66
|
| Rate for Payer: Aetna Medicare |
$235.67
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS MAPPO |
$226.61
|
| Rate for Payer: BCBS Trust/PPO |
$641.36
|
| Rate for Payer: BCN Commercial |
$586.41
|
| Rate for Payer: BCN Medicare Advantage |
$226.61
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cofinity Commercial |
$326.32
|
| Rate for Payer: Cofinity Commercial |
$303.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.61
|
| Rate for Payer: Mclaren Medicaid |
$150.38
|
| Rate for Payer: Meridian Medicaid |
$157.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.94
|
| Rate for Payer: PACE SWMI |
$226.61
|
| Rate for Payer: PHP Medicare Advantage |
$226.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$410.40
|
| Rate for Payer: Priority Health Medicare |
$226.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.61
|
| Rate for Payer: UHC Medicare Advantage |
$233.41
|
|
|
PR MASTECTOMY GYNECOMASTIA
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
CPT 19300
|
| Hospital Charge Code |
19300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$380.00 |
| Max. Negotiated Rate |
$2,625.49 |
| Rate for Payer: Aetna Commercial |
$1,360.00
|
| Rate for Payer: Aetna Medicare |
$416.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$500.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$500.00
|
| Rate for Payer: BCBS Complete |
$2,625.49
|
| Rate for Payer: BCBS MAPPO |
$400.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.00
|
| Rate for Payer: BCN Commercial |
$1,244.00
|
| Rate for Payer: BCN Medicare Advantage |
$400.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,376.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.00
|
| Rate for Payer: Healthscope Commercial |
$1,440.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.00
|
| Rate for Payer: Mclaren Medicaid |
$2,500.47
|
| Rate for Payer: Meridian Medicaid |
$2,625.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$420.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$460.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,360.00
|
| Rate for Payer: PACE Senior Care Partners |
$380.00
|
| Rate for Payer: PACE SWMI |
$400.00
|
| Rate for Payer: PHP Commercial |
$1,360.00
|
| Rate for Payer: PHP Medicare Advantage |
$400.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,500.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,392.00
|
| Rate for Payer: Priority Health Medicare |
$400.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$975.84
|
| Rate for Payer: Railroad Medicare Medicare |
$400.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.00
|
| Rate for Payer: UHC Core |
$1,336.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$400.00
|
| Rate for Payer: UHC Medicare Advantage |
$412.00
|
| Rate for Payer: VA VA |
$400.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.00
|
|
|
PR MASTECTOMY GYNECOMASTIA
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 19300
|
| Hospital Charge Code |
19300
|
| Min. Negotiated Rate |
$278.39 |
| Max. Negotiated Rate |
$1,120.00 |
| Rate for Payer: Aetna Commercial |
$570.18
|
| Rate for Payer: Aetna Medicare |
$442.53
|
| Rate for Payer: BCBS Complete |
$292.31
|
| Rate for Payer: BCBS MAPPO |
$425.51
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$858.11
|
| Rate for Payer: BCN Medicare Advantage |
$425.51
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Commercial |
$612.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.51
|
| Rate for Payer: Mclaren Medicaid |
$278.39
|
| Rate for Payer: Meridian Medicaid |
$292.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$446.79
|
| Rate for Payer: PACE SWMI |
$425.51
|
| Rate for Payer: PHP Medicare Advantage |
$425.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.00
|
| Rate for Payer: Priority Health Medicare |
$425.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.51
|
| Rate for Payer: UHC Medicare Advantage |
$438.28
|
|
|
PR MASTECTOMY GYNECOMASTIA
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
CPT 19300
|
| Hospital Charge Code |
19300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$975.84 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Aetna Commercial |
$1,360.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.48
|
| Rate for Payer: BCN Commercial |
$1,236.48
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$1,376.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.00
|
| Rate for Payer: Healthscope Commercial |
$1,440.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,360.00
|
| Rate for Payer: PHP Commercial |
$1,360.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,392.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$975.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.00
|
| Rate for Payer: UHC Core |
$1,336.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.00
|
|
|
PR MASTECTOMY GYNECOMASTIA
|
Professional
|
Both
|
$1,600.00
|
|
|
Service Code
|
HCPCS 19300
|
| Min. Negotiated Rate |
$278.39 |
| Max. Negotiated Rate |
$1,120.00 |
| Rate for Payer: Aetna Commercial |
$570.18
|
| Rate for Payer: Aetna Medicare |
$442.53
|
| Rate for Payer: BCBS Complete |
$292.31
|
| Rate for Payer: BCBS MAPPO |
$425.51
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$858.11
|
| Rate for Payer: BCN Medicare Advantage |
$425.51
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cash Price |
$1,280.00
|
| Rate for Payer: Cofinity Commercial |
$612.73
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.51
|
| Rate for Payer: Mclaren Medicaid |
$278.39
|
| Rate for Payer: Meridian Medicaid |
$292.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$446.79
|
| Rate for Payer: PACE SWMI |
$425.51
|
| Rate for Payer: PHP Medicare Advantage |
$425.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.00
|
| Rate for Payer: Priority Health Medicare |
$425.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$536.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.51
|
| Rate for Payer: UHC Medicare Advantage |
$438.28
|
|
|
PR MASTECTOMY PARTIAL
|
Facility
|
IP
|
$1,087.00
|
|
|
Service Code
|
CPT 19301
|
| Hospital Charge Code |
19301
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$662.96 |
| Max. Negotiated Rate |
$978.30 |
| Rate for Payer: Aetna Commercial |
$923.95
|
| Rate for Payer: BCBS Trust/PPO |
$840.03
|
| Rate for Payer: BCN Commercial |
$840.03
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cofinity Commercial |
$934.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.60
|
| Rate for Payer: Healthscope Commercial |
$978.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$815.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$923.95
|
| Rate for Payer: PHP Commercial |
$923.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$945.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$662.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$956.56
|
| Rate for Payer: UHC Core |
$907.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$815.25
|
|
|
PR MASTECTOMY PARTIAL
|
Facility
|
OP
|
$1,087.00
|
|
|
Service Code
|
CPT 19301
|
| Hospital Charge Code |
19301
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$258.16 |
| Max. Negotiated Rate |
$2,625.49 |
| Rate for Payer: Aetna Commercial |
$923.95
|
| Rate for Payer: Aetna Medicare |
$282.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$339.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$339.69
|
| Rate for Payer: BCBS Complete |
$2,625.49
|
| Rate for Payer: BCBS MAPPO |
$271.75
|
| Rate for Payer: BCBS Trust/PPO |
$845.14
|
| Rate for Payer: BCN Commercial |
$845.14
|
| Rate for Payer: BCN Medicare Advantage |
$271.75
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cofinity Commercial |
$934.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.75
|
| Rate for Payer: Healthscope Commercial |
$978.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$815.25
|
| Rate for Payer: Mclaren Medicaid |
$2,500.47
|
| Rate for Payer: Meridian Medicaid |
$2,625.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$285.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$923.95
|
| Rate for Payer: PACE Senior Care Partners |
$258.16
|
| Rate for Payer: PACE SWMI |
$271.75
|
| Rate for Payer: PHP Commercial |
$923.95
|
| Rate for Payer: PHP Medicare Advantage |
$271.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,500.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$945.69
|
| Rate for Payer: Priority Health Medicare |
$271.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$662.96
|
| Rate for Payer: Railroad Medicare Medicare |
$271.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$956.56
|
| Rate for Payer: UHC Core |
$907.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.75
|
| Rate for Payer: UHC Medicare Advantage |
$279.90
|
| Rate for Payer: VA VA |
$271.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$815.25
|
|
|
PR MASTECTOMY PARTIAL
|
Professional
|
Both
|
$1,087.00
|
|
|
Service Code
|
HCPCS 19301
|
| Min. Negotiated Rate |
$424.51 |
| Max. Negotiated Rate |
$967.10 |
| Rate for Payer: Aetna Commercial |
$878.18
|
| Rate for Payer: Aetna Medicare |
$681.57
|
| Rate for Payer: BCBS Complete |
$445.74
|
| Rate for Payer: BCBS MAPPO |
$655.36
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$967.10
|
| Rate for Payer: BCN Medicare Advantage |
$655.36
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cofinity Commercial |
$943.72
|
| Rate for Payer: Cofinity Commercial |
$878.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.36
|
| Rate for Payer: Mclaren Medicaid |
$424.51
|
| Rate for Payer: Meridian Medicaid |
$445.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$688.13
|
| Rate for Payer: PACE SWMI |
$655.36
|
| Rate for Payer: PHP Medicare Advantage |
$655.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.45
|
| Rate for Payer: Priority Health Medicare |
$655.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$655.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$655.36
|
| Rate for Payer: UHC Medicare Advantage |
$675.02
|
|
|
PR MASTECTOMY PARTIAL
|
Professional
|
Both
|
$1,087.00
|
|
|
Service Code
|
HCPCS 19301
|
| Hospital Charge Code |
19301
|
| Min. Negotiated Rate |
$424.51 |
| Max. Negotiated Rate |
$967.10 |
| Rate for Payer: Aetna Commercial |
$878.18
|
| Rate for Payer: Aetna Medicare |
$681.57
|
| Rate for Payer: BCBS Complete |
$445.74
|
| Rate for Payer: BCBS MAPPO |
$655.36
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$967.10
|
| Rate for Payer: BCN Medicare Advantage |
$655.36
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cash Price |
$869.60
|
| Rate for Payer: Cofinity Commercial |
$943.72
|
| Rate for Payer: Cofinity Commercial |
$878.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.36
|
| Rate for Payer: Mclaren Medicaid |
$424.51
|
| Rate for Payer: Meridian Medicaid |
$445.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$688.13
|
| Rate for Payer: PACE SWMI |
$655.36
|
| Rate for Payer: PHP Medicare Advantage |
$655.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$424.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.45
|
| Rate for Payer: Priority Health Medicare |
$655.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$655.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$655.36
|
| Rate for Payer: UHC Medicare Advantage |
$675.02
|
|
|
PR MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY
|
Professional
|
Both
|
$1,314.00
|
|
|
Service Code
|
HCPCS 19302
|
| Min. Negotiated Rate |
$582.77 |
| Max. Negotiated Rate |
$1,422.75 |
| Rate for Payer: Aetna Commercial |
$1,206.27
|
| Rate for Payer: Aetna Medicare |
$936.21
|
| Rate for Payer: BCBS Complete |
$611.91
|
| Rate for Payer: BCBS MAPPO |
$900.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.75
|
| Rate for Payer: BCN Commercial |
$1,327.74
|
| Rate for Payer: BCN Medicare Advantage |
$900.20
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cofinity Commercial |
$1,296.29
|
| Rate for Payer: Cofinity Commercial |
$1,206.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.20
|
| Rate for Payer: Mclaren Medicaid |
$582.77
|
| Rate for Payer: Meridian Medicaid |
$611.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$945.21
|
| Rate for Payer: PACE SWMI |
$900.20
|
| Rate for Payer: PHP Medicare Advantage |
$900.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.80
|
| Rate for Payer: Priority Health Medicare |
$900.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,116.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$900.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$900.20
|
| Rate for Payer: UHC Medicare Advantage |
$927.21
|
|
|
PR MASTECTOMY SIMPLE COMPLETE
|
Professional
|
Both
|
$1,854.00
|
|
|
Service Code
|
HCPCS 19303
|
| Hospital Charge Code |
19303
|
| Min. Negotiated Rate |
$615.14 |
| Max. Negotiated Rate |
$1,401.52 |
| Rate for Payer: Aetna Commercial |
$1,274.54
|
| Rate for Payer: Aetna Medicare |
$989.20
|
| Rate for Payer: BCBS Complete |
$645.90
|
| Rate for Payer: BCBS MAPPO |
$951.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: BCN Commercial |
$1,401.52
|
| Rate for Payer: BCN Medicare Advantage |
$951.15
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cofinity Commercial |
$1,369.66
|
| Rate for Payer: Cofinity Commercial |
$1,274.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$951.15
|
| Rate for Payer: Mclaren Medicaid |
$615.14
|
| Rate for Payer: Meridian Medicaid |
$645.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$998.71
|
| Rate for Payer: PACE SWMI |
$951.15
|
| Rate for Payer: PHP Medicare Advantage |
$951.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.85
|
| Rate for Payer: Priority Health Medicare |
$951.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,178.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$951.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$951.15
|
| Rate for Payer: UHC Medicare Advantage |
$979.68
|
|
|
PR MASTECTOMY SIMPLE COMPLETE
|
Facility
|
IP
|
$1,854.00
|
|
|
Service Code
|
CPT 19303
|
| Hospital Charge Code |
19303
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,130.75 |
| Max. Negotiated Rate |
$1,668.60 |
| Rate for Payer: Aetna Commercial |
$1,575.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,432.77
|
| Rate for Payer: BCN Commercial |
$1,432.77
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cofinity Commercial |
$1,594.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,483.20
|
| Rate for Payer: Healthscope Commercial |
$1,668.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,390.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,575.90
|
| Rate for Payer: PHP Commercial |
$1,575.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,612.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,130.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,631.52
|
| Rate for Payer: UHC Core |
$1,548.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,390.50
|
|
|
PR MASTECTOMY SIMPLE COMPLETE
|
Professional
|
Both
|
$1,854.00
|
|
|
Service Code
|
HCPCS 19303
|
| Min. Negotiated Rate |
$615.14 |
| Max. Negotiated Rate |
$1,401.52 |
| Rate for Payer: Aetna Commercial |
$1,274.54
|
| Rate for Payer: Aetna Medicare |
$989.20
|
| Rate for Payer: BCBS Complete |
$645.90
|
| Rate for Payer: BCBS MAPPO |
$951.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.25
|
| Rate for Payer: BCN Commercial |
$1,401.52
|
| Rate for Payer: BCN Medicare Advantage |
$951.15
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cofinity Commercial |
$1,274.54
|
| Rate for Payer: Cofinity Commercial |
$1,369.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$951.15
|
| Rate for Payer: Mclaren Medicaid |
$615.14
|
| Rate for Payer: Meridian Medicaid |
$645.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$998.71
|
| Rate for Payer: PACE SWMI |
$951.15
|
| Rate for Payer: PHP Medicare Advantage |
$951.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.85
|
| Rate for Payer: Priority Health Medicare |
$951.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,178.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$951.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$951.15
|
| Rate for Payer: UHC Medicare Advantage |
$979.68
|
|
|
PR MASTECTOMY SIMPLE COMPLETE
|
Facility
|
OP
|
$1,854.00
|
|
|
Service Code
|
CPT 19303
|
| Hospital Charge Code |
19303
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$440.32 |
| Max. Negotiated Rate |
$4,491.68 |
| Rate for Payer: Aetna Commercial |
$1,575.90
|
| Rate for Payer: Aetna Medicare |
$482.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$579.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$579.38
|
| Rate for Payer: BCBS Complete |
$4,491.68
|
| Rate for Payer: BCBS MAPPO |
$463.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.48
|
| Rate for Payer: BCN Commercial |
$1,441.48
|
| Rate for Payer: BCN Medicare Advantage |
$463.50
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cash Price |
$1,483.20
|
| Rate for Payer: Cofinity Commercial |
$1,594.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,483.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$463.50
|
| Rate for Payer: Healthscope Commercial |
$1,668.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,390.50
|
| Rate for Payer: Mclaren Medicaid |
$4,277.79
|
| Rate for Payer: Meridian Medicaid |
$4,491.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$486.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$533.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,575.90
|
| Rate for Payer: PACE Senior Care Partners |
$440.32
|
| Rate for Payer: PACE SWMI |
$463.50
|
| Rate for Payer: PHP Commercial |
$1,575.90
|
| Rate for Payer: PHP Medicare Advantage |
$463.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,277.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,612.98
|
| Rate for Payer: Priority Health Medicare |
$463.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,130.75
|
| Rate for Payer: Railroad Medicare Medicare |
$463.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,631.52
|
| Rate for Payer: UHC Core |
$1,548.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$463.50
|
| Rate for Payer: UHC Medicare Advantage |
$477.40
|
| Rate for Payer: VA VA |
$463.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,390.50
|
|
|
PR MASTECTOMY, SUBCUTANEOUS
|
Facility
|
IP
|
$1,080.00
|
|
|
Service Code
|
CPT 19304
|
| Hospital Charge Code |
19304
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$658.69 |
| Max. Negotiated Rate |
$972.00 |
| Rate for Payer: Aetna Commercial |
$918.00
|
| Rate for Payer: BCBS Trust/PPO |
$834.62
|
| Rate for Payer: BCN Commercial |
$834.62
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cofinity Commercial |
$928.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$864.00
|
| Rate for Payer: Healthscope Commercial |
$972.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$810.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$918.00
|
| Rate for Payer: PHP Commercial |
$918.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$658.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$950.40
|
| Rate for Payer: UHC Core |
$901.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$810.00
|
|
|
PR MASTECTOMY, SUBCUTANEOUS
|
Professional
|
Both
|
$1,080.00
|
|
|
Service Code
|
HCPCS 19304
|
| Min. Negotiated Rate |
$432.00 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: BCBS Complete |
$432.00
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.00
|
|
|
PR MASTECTOMY, SUBCUTANEOUS
|
Professional
|
Both
|
$1,080.00
|
|
|
Service Code
|
HCPCS 19304
|
| Hospital Charge Code |
19304
|
| Min. Negotiated Rate |
$432.00 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: BCBS Complete |
$432.00
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.00
|
|
|
PR MASTECTOMY, SUBCUTANEOUS
|
Facility
|
OP
|
$1,080.00
|
|
|
Service Code
|
CPT 19304
|
| Hospital Charge Code |
19304
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$256.50 |
| Max. Negotiated Rate |
$972.00 |
| Rate for Payer: Aetna Commercial |
$918.00
|
| Rate for Payer: Aetna Medicare |
$280.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$337.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$337.50
|
| Rate for Payer: BCBS Complete |
$432.00
|
| Rate for Payer: BCBS MAPPO |
$270.00
|
| Rate for Payer: BCBS Trust/PPO |
$839.70
|
| Rate for Payer: BCN Commercial |
$839.70
|
| Rate for Payer: BCN Medicare Advantage |
$270.00
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: Cofinity Commercial |
$928.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$864.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$972.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$810.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$283.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$310.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$918.00
|
| Rate for Payer: PACE Senior Care Partners |
$256.50
|
| Rate for Payer: PACE SWMI |
$270.00
|
| Rate for Payer: PHP Commercial |
$918.00
|
| Rate for Payer: PHP Medicare Advantage |
$270.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.60
|
| Rate for Payer: Priority Health Medicare |
$270.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$658.69
|
| Rate for Payer: Railroad Medicare Medicare |
$270.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$950.40
|
| Rate for Payer: UHC Core |
$901.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$270.00
|
| Rate for Payer: UHC Medicare Advantage |
$278.10
|
| Rate for Payer: VA VA |
$270.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$810.00
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Professional
|
Both
|
$2,004.00
|
|
|
Service Code
|
HCPCS 19307
|
| Hospital Charge Code |
19307
|
| Min. Negotiated Rate |
$757.22 |
| Max. Negotiated Rate |
$18,089.98 |
| Rate for Payer: Aetna Commercial |
$1,568.24
|
| Rate for Payer: Aetna Medicare |
$1,217.14
|
| Rate for Payer: BCBS Complete |
$795.08
|
| Rate for Payer: BCBS MAPPO |
$1,170.33
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,727.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,170.33
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cofinity Commercial |
$1,685.28
|
| Rate for Payer: Cofinity Commercial |
$1,568.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,170.33
|
| Rate for Payer: Mclaren Medicaid |
$757.22
|
| Rate for Payer: Meridian Medicaid |
$795.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,228.85
|
| Rate for Payer: PACE SWMI |
$1,170.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,170.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$757.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,453.02
|
| Rate for Payer: Priority Health Medicare |
$1,170.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,453.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,170.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,170.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,205.44
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Professional
|
Both
|
$2,004.00
|
|
|
Service Code
|
HCPCS 19307
|
| Min. Negotiated Rate |
$757.22 |
| Max. Negotiated Rate |
$18,089.98 |
| Rate for Payer: Aetna Commercial |
$1,568.24
|
| Rate for Payer: Aetna Medicare |
$1,217.14
|
| Rate for Payer: BCBS Complete |
$795.08
|
| Rate for Payer: BCBS MAPPO |
$1,170.33
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,727.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,170.33
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cofinity Commercial |
$1,685.28
|
| Rate for Payer: Cofinity Commercial |
$1,568.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,170.33
|
| Rate for Payer: Mclaren Medicaid |
$757.22
|
| Rate for Payer: Meridian Medicaid |
$795.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,228.85
|
| Rate for Payer: PACE SWMI |
$1,170.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,170.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$757.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,453.02
|
| Rate for Payer: Priority Health Medicare |
$1,170.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,453.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,170.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,170.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,205.44
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Facility
|
IP
|
$2,004.00
|
|
|
Service Code
|
CPT 19307
|
| Hospital Charge Code |
19307
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,222.24 |
| Max. Negotiated Rate |
$1,803.60 |
| Rate for Payer: Aetna Commercial |
$1,703.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.69
|
| Rate for Payer: BCN Commercial |
$1,548.69
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cofinity Commercial |
$1,723.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.20
|
| Rate for Payer: Healthscope Commercial |
$1,803.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,703.40
|
| Rate for Payer: PHP Commercial |
$1,703.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,743.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,222.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.52
|
| Rate for Payer: UHC Core |
$1,673.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.00
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Facility
|
OP
|
$2,004.00
|
|
|
Service Code
|
CPT 19307
|
| Hospital Charge Code |
19307
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$475.95 |
| Max. Negotiated Rate |
$4,491.68 |
| Rate for Payer: Aetna Commercial |
$1,703.40
|
| Rate for Payer: Aetna Medicare |
$521.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$626.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$626.25
|
| Rate for Payer: BCBS Complete |
$4,491.68
|
| Rate for Payer: BCBS MAPPO |
$501.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,558.11
|
| Rate for Payer: BCN Commercial |
$1,558.11
|
| Rate for Payer: BCN Medicare Advantage |
$501.00
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cash Price |
$1,603.20
|
| Rate for Payer: Cofinity Commercial |
$1,723.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.00
|
| Rate for Payer: Healthscope Commercial |
$1,803.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.00
|
| Rate for Payer: Mclaren Medicaid |
$4,277.79
|
| Rate for Payer: Meridian Medicaid |
$4,491.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$526.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$576.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,703.40
|
| Rate for Payer: PACE Senior Care Partners |
$475.95
|
| Rate for Payer: PACE SWMI |
$501.00
|
| Rate for Payer: PHP Commercial |
$1,703.40
|
| Rate for Payer: PHP Medicare Advantage |
$501.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,277.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,402.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,743.48
|
| Rate for Payer: Priority Health Medicare |
$501.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,222.24
|
| Rate for Payer: Railroad Medicare Medicare |
$501.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.52
|
| Rate for Payer: UHC Core |
$1,673.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$501.00
|
| Rate for Payer: UHC Medicare Advantage |
$516.03
|
| Rate for Payer: VA VA |
$501.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.00
|
|
|
PR MASTOIDECTOMY COMPLETE
|
Professional
|
Both
|
$2,651.00
|
|
|
Service Code
|
HCPCS 69502
|
| Min. Negotiated Rate |
$606.84 |
| Max. Negotiated Rate |
$4,242.78 |
| Rate for Payer: Aetna Commercial |
$1,243.48
|
| Rate for Payer: Aetna Medicare |
$965.09
|
| Rate for Payer: BCBS Complete |
$637.18
|
| Rate for Payer: BCBS MAPPO |
$927.97
|
| Rate for Payer: BCBS Trust/PPO |
$4,242.78
|
| Rate for Payer: BCN Commercial |
$1,393.22
|
| Rate for Payer: BCN Medicare Advantage |
$927.97
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cash Price |
$2,120.80
|
| Rate for Payer: Cofinity Commercial |
$1,243.48
|
| Rate for Payer: Cofinity Commercial |
$1,336.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$927.97
|
| Rate for Payer: Mclaren Medicaid |
$606.84
|
| Rate for Payer: Meridian Medicaid |
$637.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$974.37
|
| Rate for Payer: PACE SWMI |
$927.97
|
| Rate for Payer: PHP Medicare Advantage |
$927.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$606.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,855.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,344.13
|
| Rate for Payer: Priority Health Medicare |
$927.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,344.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$927.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$927.97
|
| Rate for Payer: UHC Medicare Advantage |
$955.81
|
|
|
PR MASTOID OBLITERATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,411.00
|
|
|
Service Code
|
HCPCS 69670
|
| Min. Negotiated Rate |
$606.62 |
| Max. Negotiated Rate |
$3,570.25 |
| Rate for Payer: Aetna Commercial |
$1,240.13
|
| Rate for Payer: Aetna Medicare |
$962.49
|
| Rate for Payer: BCBS Complete |
$636.95
|
| Rate for Payer: BCBS MAPPO |
$925.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,570.25
|
| Rate for Payer: BCN Commercial |
$1,394.20
|
| Rate for Payer: BCN Medicare Advantage |
$925.47
|
| Rate for Payer: Cash Price |
$2,728.80
|
| Rate for Payer: Cash Price |
$2,728.80
|
| Rate for Payer: Cofinity Commercial |
$1,332.68
|
| Rate for Payer: Cofinity Commercial |
$1,240.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.47
|
| Rate for Payer: Mclaren Medicaid |
$606.62
|
| Rate for Payer: Meridian Medicaid |
$636.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$971.74
|
| Rate for Payer: PACE SWMI |
$925.47
|
| Rate for Payer: PHP Medicare Advantage |
$925.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$606.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,387.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,345.07
|
| Rate for Payer: Priority Health Medicare |
$925.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,345.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.47
|
| Rate for Payer: UHC Medicare Advantage |
$953.23
|
|
