|
PR DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 38222
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$367.17 |
| Rate for Payer: Aetna Commercial |
$94.70
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS MAPPO |
$70.67
|
| Rate for Payer: BCBS Trust/PPO |
$367.17
|
| Rate for Payer: BCN Commercial |
$255.58
|
| Rate for Payer: BCN Medicare Advantage |
$70.67
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$94.70
|
| Rate for Payer: Cofinity Commercial |
$101.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.67
|
| Rate for Payer: Mclaren Medicaid |
$47.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.20
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Nomi Health Commercial |
$84.80
|
| Rate for Payer: PACE SWMI |
$70.67
|
| Rate for Payer: PHP Medicare Advantage |
$70.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.20
|
| Rate for Payer: Priority Health HMO/PPO |
$147.80
|
| Rate for Payer: Priority Health Medicare |
$71.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.67
|
| Rate for Payer: UHC Exchange |
$70.67
|
| Rate for Payer: UHC Medicare Advantage |
$70.67
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE
|
Professional
|
Both
|
$566.00
|
|
|
Service Code
|
HCPCS 62270
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$874.34 |
| Rate for Payer: Aetna Commercial |
$84.10
|
| Rate for Payer: Aetna Medicare |
$65.27
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$62.76
|
| Rate for Payer: BCBS Trust/PPO |
$874.34
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$62.76
|
| Rate for Payer: Cash Price |
$452.80
|
| Rate for Payer: Cash Price |
$452.80
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Commercial |
$84.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.76
|
| Rate for Payer: Mclaren Medicaid |
$41.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.90
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Nomi Health Commercial |
$75.31
|
| Rate for Payer: PACE SWMI |
$62.76
|
| Rate for Payer: PHP Medicare Advantage |
$62.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.90
|
| Rate for Payer: Priority Health HMO/PPO |
$108.06
|
| Rate for Payer: Priority Health Medicare |
$63.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.76
|
| Rate for Payer: UHC Exchange |
$62.76
|
| Rate for Payer: UHC Medicare Advantage |
$62.76
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 62328
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$1,578.56 |
| Rate for Payer: Aetna Commercial |
$108.39
|
| Rate for Payer: Aetna Medicare |
$84.13
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$80.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,578.56
|
| Rate for Payer: BCN Commercial |
$339.63
|
| Rate for Payer: BCN Medicare Advantage |
$80.89
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$116.48
|
| Rate for Payer: Cofinity Commercial |
$108.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.89
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.93
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$97.07
|
| Rate for Payer: PACE SWMI |
$80.89
|
| Rate for Payer: PHP Medicare Advantage |
$80.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.05
|
| Rate for Payer: Priority Health HMO/PPO |
$143.31
|
| Rate for Payer: Priority Health Medicare |
$81.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.89
|
| Rate for Payer: UHC Exchange |
$80.89
|
| Rate for Payer: UHC Medicare Advantage |
$80.89
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
PR DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 36909
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$2,818.21 |
| Rate for Payer: Aetna Commercial |
$254.77
|
| Rate for Payer: Aetna Medicare |
$197.74
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$190.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,517.28
|
| Rate for Payer: BCN Commercial |
$2,818.21
|
| Rate for Payer: BCN Medicare Advantage |
$190.13
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$273.79
|
| Rate for Payer: Cofinity Commercial |
$254.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.13
|
| Rate for Payer: Mclaren Medicaid |
$124.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.64
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Nomi Health Commercial |
$228.16
|
| Rate for Payer: PACE SWMI |
$190.13
|
| Rate for Payer: PHP Medicare Advantage |
$190.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,002.30
|
| Rate for Payer: Priority Health HMO/PPO |
$311.11
|
| Rate for Payer: Priority Health Medicare |
$192.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.13
|
| Rate for Payer: UHC Exchange |
$190.13
|
| Rate for Payer: UHC Medicare Advantage |
$190.13
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
|
|
PR DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 90945
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$370.34 |
| Rate for Payer: Aetna Commercial |
$108.63
|
| Rate for Payer: Aetna Medicare |
$84.31
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS MAPPO |
$81.07
|
| Rate for Payer: BCBS Trust/PPO |
$370.34
|
| Rate for Payer: BCN Commercial |
$123.15
|
| Rate for Payer: BCN Medicare Advantage |
$81.07
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$108.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.07
|
| Rate for Payer: Mclaren Medicaid |
$54.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.12
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Nomi Health Commercial |
$97.28
|
| Rate for Payer: PACE SWMI |
$81.07
|
| Rate for Payer: PHP Medicare Advantage |
$81.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO |
$114.89
|
| Rate for Payer: Priority Health Medicare |
$81.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.07
|
| Rate for Payer: UHC Exchange |
$81.07
|
| Rate for Payer: UHC Medicare Advantage |
$81.07
|
| Rate for Payer: UHCCP Medicaid |
$54.74
|
|
|
PR DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 90947
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$319.62 |
| Rate for Payer: Aetna Commercial |
$154.98
|
| Rate for Payer: Aetna Medicare |
$120.29
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$115.66
|
| Rate for Payer: BCBS Trust/PPO |
$319.62
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$115.66
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$166.55
|
| Rate for Payer: Cofinity Commercial |
$154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.66
|
| Rate for Payer: Mclaren Medicaid |
$77.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.44
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: PACE SWMI |
$115.66
|
| Rate for Payer: PHP Medicare Advantage |
$115.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health HMO/PPO |
$163.74
|
| Rate for Payer: Priority Health Medicare |
$116.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.66
|
| Rate for Payer: UHC Exchange |
$115.66
|
| Rate for Payer: UHC Medicare Advantage |
$115.66
|
| Rate for Payer: UHCCP Medicaid |
$77.32
|
|
|
PR DIAPHRAGM
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS A4266
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCN Commercial |
$80.00
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
|
|
PR DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 57170
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$2,039.77 |
| Rate for Payer: Aetna Commercial |
$61.40
|
| Rate for Payer: Aetna Medicare |
$47.65
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$45.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.77
|
| Rate for Payer: BCN Commercial |
$115.33
|
| Rate for Payer: BCN Medicare Advantage |
$45.82
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$65.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.82
|
| Rate for Payer: Mclaren Medicaid |
$30.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.11
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Nomi Health Commercial |
$54.98
|
| Rate for Payer: PACE SWMI |
$45.82
|
| Rate for Payer: PHP Medicare Advantage |
$45.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.55
|
| Rate for Payer: Priority Health HMO/PPO |
$69.95
|
| Rate for Payer: Priority Health Medicare |
$46.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.82
|
| Rate for Payer: UHC Exchange |
$45.82
|
| Rate for Payer: UHC Medicare Advantage |
$45.82
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
|
|
PR DIGITAL ANALYSIS ELECTROENCEPHALOGRAM
|
Professional
|
Both
|
$778.00
|
|
|
Service Code
|
HCPCS 95957
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$505.70 |
| Rate for Payer: Aetna Commercial |
$352.82
|
| Rate for Payer: Aetna Medicare |
$273.83
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$263.30
|
| Rate for Payer: BCBS Trust/PPO |
$346.56
|
| Rate for Payer: BCN Commercial |
$401.69
|
| Rate for Payer: BCN Medicare Advantage |
$263.30
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cash Price |
$622.40
|
| Rate for Payer: Cofinity Commercial |
$379.15
|
| Rate for Payer: Cofinity Commercial |
$352.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.30
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.46
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Nomi Health Commercial |
$315.96
|
| Rate for Payer: PACE SWMI |
$263.30
|
| Rate for Payer: PHP Medicare Advantage |
$263.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.70
|
| Rate for Payer: Priority Health HMO/PPO |
$135.24
|
| Rate for Payer: Priority Health Medicare |
$265.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.30
|
| Rate for Payer: UHC Exchange |
$263.30
|
| Rate for Payer: UHC Medicare Advantage |
$263.30
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 45905
|
| Min. Negotiated Rate |
$110.33 |
| Max. Negotiated Rate |
$585.88 |
| Rate for Payer: Aetna Commercial |
$218.49
|
| Rate for Payer: Aetna Medicare |
$169.57
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS MAPPO |
$163.05
|
| Rate for Payer: BCBS Trust/PPO |
$585.88
|
| Rate for Payer: BCN Commercial |
$249.22
|
| Rate for Payer: BCN Medicare Advantage |
$163.05
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$234.79
|
| Rate for Payer: Cofinity Commercial |
$218.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.05
|
| Rate for Payer: Mclaren Medicaid |
$110.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.20
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Nomi Health Commercial |
$195.66
|
| Rate for Payer: PACE SWMI |
$163.05
|
| Rate for Payer: PHP Medicare Advantage |
$163.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO |
$306.65
|
| Rate for Payer: Priority Health Medicare |
$164.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.05
|
| Rate for Payer: UHC Exchange |
$163.05
|
| Rate for Payer: UHC Medicare Advantage |
$163.05
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR DILAT&CATHJ SALIVARY DUCT W/WO INJECTION
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 42660
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$1,102.03 |
| Rate for Payer: Aetna Commercial |
$100.55
|
| Rate for Payer: Aetna Medicare |
$78.04
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS MAPPO |
$75.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.03
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: BCN Medicare Advantage |
$75.04
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$108.06
|
| Rate for Payer: Cofinity Commercial |
$100.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.04
|
| Rate for Payer: Mclaren Medicaid |
$50.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.79
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Nomi Health Commercial |
$90.05
|
| Rate for Payer: PACE SWMI |
$75.04
|
| Rate for Payer: PHP Medicare Advantage |
$75.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.55
|
| Rate for Payer: Priority Health HMO/PPO |
$155.12
|
| Rate for Payer: Priority Health Medicare |
$75.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.04
|
| Rate for Payer: UHC Exchange |
$75.04
|
| Rate for Payer: UHC Medicare Advantage |
$75.04
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR DILATE ESOPHAGUS,BALLOON RETROGRADE
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 43456
|
| Min. Negotiated Rate |
$331.20 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Aetna Medicare |
$414.00
|
| Rate for Payer: BCBS Complete |
$331.20
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.20
|
|
|
PR DILATE ESOPH,BALLN,>30MM ACHALASIA
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 43458
|
| Min. Negotiated Rate |
$411.60 |
| Max. Negotiated Rate |
$668.85 |
| Rate for Payer: Aetna Medicare |
$514.50
|
| Rate for Payer: BCBS Complete |
$411.60
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
|
|
PR DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 53665
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$59.65 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: BCBS Complete |
$24.82
|
| Rate for Payer: BCBS MAPPO |
$35.58
|
| Rate for Payer: BCN Commercial |
$54.73
|
| Rate for Payer: BCN Medicare Advantage |
$35.58
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$51.24
|
| Rate for Payer: Cofinity Commercial |
$47.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.58
|
| Rate for Payer: Mclaren Medicaid |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.36
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: Nomi Health Commercial |
$42.70
|
| Rate for Payer: PACE SWMI |
$35.58
|
| Rate for Payer: PHP Medicare Advantage |
$35.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO |
$59.65
|
| Rate for Payer: Priority Health Medicare |
$35.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.58
|
| Rate for Payer: UHC Exchange |
$35.58
|
| Rate for Payer: UHC Medicare Advantage |
$35.58
|
| Rate for Payer: UHCCP Medicaid |
$23.64
|
|
|
PR DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 53660
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$927.17 |
| Rate for Payer: Aetna Commercial |
$52.61
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$927.17
|
| Rate for Payer: BCN Commercial |
$110.45
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$56.53
|
| Rate for Payer: Cofinity Commercial |
$52.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Mclaren Medicaid |
$26.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Nomi Health Commercial |
$47.11
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO |
$66.05
|
| Rate for Payer: Priority Health Medicare |
$39.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.26
|
| Rate for Payer: UHC Exchange |
$39.26
|
| Rate for Payer: UHC Medicare Advantage |
$39.26
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
|
|
PR DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 53661
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$2,149.12 |
| Rate for Payer: Aetna Commercial |
$51.07
|
| Rate for Payer: Aetna Medicare |
$39.63
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$38.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,149.12
|
| Rate for Payer: BCN Commercial |
$108.48
|
| Rate for Payer: BCN Medicare Advantage |
$38.11
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$54.88
|
| Rate for Payer: Cofinity Commercial |
$51.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.11
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.02
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Nomi Health Commercial |
$45.73
|
| Rate for Payer: PACE SWMI |
$38.11
|
| Rate for Payer: PHP Medicare Advantage |
$38.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health HMO/PPO |
$63.92
|
| Rate for Payer: Priority Health Medicare |
$38.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.11
|
| Rate for Payer: UHC Exchange |
$38.11
|
| Rate for Payer: UHC Medicare Advantage |
$38.11
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
|
|
PR DILATION CERVICAL CANAL INSTRUMENTAL SPX
|
Professional
|
Both
|
$205.00
|
|
|
Service Code
|
HCPCS 57800
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$1,422.71 |
| Rate for Payer: Aetna Commercial |
$61.71
|
| Rate for Payer: Aetna Medicare |
$47.89
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$46.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.71
|
| Rate for Payer: BCN Commercial |
$114.35
|
| Rate for Payer: BCN Medicare Advantage |
$46.05
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cofinity Commercial |
$66.31
|
| Rate for Payer: Cofinity Commercial |
$61.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.05
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.35
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Nomi Health Commercial |
$55.26
|
| Rate for Payer: PACE SWMI |
$46.05
|
| Rate for Payer: PHP Medicare Advantage |
$46.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.25
|
| Rate for Payer: Priority Health HMO/PPO |
$71.93
|
| Rate for Payer: Priority Health Medicare |
$46.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.05
|
| Rate for Payer: UHC Exchange |
$46.05
|
| Rate for Payer: UHC Medicare Advantage |
$46.05
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR DILATION & CURETTAGE CERVICAL STUMP
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 57558
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$1,924.60 |
| Rate for Payer: Aetna Commercial |
$162.62
|
| Rate for Payer: Aetna Medicare |
$126.21
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$121.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.60
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$121.36
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$174.76
|
| Rate for Payer: Cofinity Commercial |
$162.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$82.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.43
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Nomi Health Commercial |
$145.63
|
| Rate for Payer: PACE SWMI |
$121.36
|
| Rate for Payer: PHP Medicare Advantage |
$121.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO |
$193.95
|
| Rate for Payer: Priority Health Medicare |
$122.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.36
|
| Rate for Payer: UHC Exchange |
$121.36
|
| Rate for Payer: UHC Medicare Advantage |
$121.36
|
| Rate for Payer: UHCCP Medicaid |
$82.43
|
|
|
PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC
|
Facility
|
OP
|
$862.00
|
|
|
Service Code
|
CPT 58120
|
| Hospital Charge Code |
58120
|
| Min. Negotiated Rate |
$204.72 |
| Max. Negotiated Rate |
$2,365.09 |
| Rate for Payer: Aetna Commercial |
$732.70
|
| Rate for Payer: Aetna Medicare |
$224.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.38
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$215.50
|
| Rate for Payer: BCBS Trust/PPO |
$708.65
|
| Rate for Payer: BCN Commercial |
$670.20
|
| Rate for Payer: BCN Medicare Advantage |
$215.50
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$741.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.50
|
| Rate for Payer: Healthscope Commercial |
$775.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.50
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.28
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.70
|
| Rate for Payer: Nomi Health Commercial |
$706.84
|
| Rate for Payer: PACE Senior Care Partners |
$204.72
|
| Rate for Payer: PACE SWMI |
$215.50
|
| Rate for Payer: PHP Commercial |
$732.70
|
| Rate for Payer: PHP Medicare Advantage |
$215.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.30
|
| Rate for Payer: Priority Health HMO/PPO |
$749.94
|
| Rate for Payer: Priority Health Medicare |
$217.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$577.54
|
| Rate for Payer: Railroad Medicare Medicare |
$215.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.56
|
| Rate for Payer: UHC Core |
$719.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.50
|
| Rate for Payer: UHC Exchange |
$215.50
|
| Rate for Payer: UHC Medicare Advantage |
$215.50
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$215.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.50
|
|
|
PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 58120
|
| Min. Negotiated Rate |
$150.17 |
| Max. Negotiated Rate |
$1,908.75 |
| Rate for Payer: Aetna Commercial |
$299.05
|
| Rate for Payer: Aetna Medicare |
$232.10
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS MAPPO |
$223.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,908.75
|
| Rate for Payer: BCN Commercial |
$438.83
|
| Rate for Payer: BCN Medicare Advantage |
$223.17
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$321.36
|
| Rate for Payer: Cofinity Commercial |
$299.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.17
|
| Rate for Payer: Mclaren Medicaid |
$150.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.33
|
| Rate for Payer: Meridian Medicaid |
$157.68
|
| Rate for Payer: Nomi Health Commercial |
$267.80
|
| Rate for Payer: PACE SWMI |
$223.17
|
| Rate for Payer: PHP Medicare Advantage |
$223.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.30
|
| Rate for Payer: Priority Health HMO/PPO |
$350.21
|
| Rate for Payer: Priority Health Medicare |
$225.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.17
|
| Rate for Payer: UHC Exchange |
$223.17
|
| Rate for Payer: UHC Medicare Advantage |
$223.17
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
|
|
PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC
|
Facility
|
IP
|
$862.00
|
|
|
Service Code
|
CPT 58120
|
| Hospital Charge Code |
58120
|
| Min. Negotiated Rate |
$560.30 |
| Max. Negotiated Rate |
$775.80 |
| Rate for Payer: Aetna Commercial |
$732.70
|
| Rate for Payer: BCBS Trust/PPO |
$703.65
|
| Rate for Payer: BCN Commercial |
$666.15
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$741.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.60
|
| Rate for Payer: Healthscope Commercial |
$775.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$732.70
|
| Rate for Payer: Nomi Health Commercial |
$706.84
|
| Rate for Payer: PHP Commercial |
$732.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.30
|
| Rate for Payer: Priority Health HMO/PPO |
$749.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$577.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.56
|
| Rate for Payer: UHC Core |
$719.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.50
|
|
|
PR DILATION & CURETTAGE DX&/THER NONOBSTETRIC
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 58120
|
| Hospital Charge Code |
58120
|
| Min. Negotiated Rate |
$150.17 |
| Max. Negotiated Rate |
$1,908.75 |
| Rate for Payer: Aetna Commercial |
$299.05
|
| Rate for Payer: Aetna Medicare |
$232.10
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS MAPPO |
$223.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,908.75
|
| Rate for Payer: BCN Commercial |
$438.83
|
| Rate for Payer: BCN Medicare Advantage |
$223.17
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$321.36
|
| Rate for Payer: Cofinity Commercial |
$299.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.17
|
| Rate for Payer: Mclaren Medicaid |
$150.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.33
|
| Rate for Payer: Meridian Medicaid |
$157.68
|
| Rate for Payer: Nomi Health Commercial |
$267.80
|
| Rate for Payer: PACE SWMI |
$223.17
|
| Rate for Payer: PHP Medicare Advantage |
$223.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.30
|
| Rate for Payer: Priority Health HMO/PPO |
$350.21
|
| Rate for Payer: Priority Health Medicare |
$225.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.17
|
| Rate for Payer: UHC Exchange |
$223.17
|
| Rate for Payer: UHC Medicare Advantage |
$223.17
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
|
|
PR DILATION ESOPHAGUS GUIDE WIRE
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 43453
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$1,187.00 |
| Rate for Payer: Aetna Commercial |
$109.76
|
| Rate for Payer: Aetna Medicare |
$85.19
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS MAPPO |
$81.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.34
|
| Rate for Payer: BCN Commercial |
$1,187.00
|
| Rate for Payer: BCN Medicare Advantage |
$81.91
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$117.95
|
| Rate for Payer: Cofinity Commercial |
$109.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.91
|
| Rate for Payer: Mclaren Medicaid |
$55.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.01
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Nomi Health Commercial |
$98.29
|
| Rate for Payer: PACE SWMI |
$81.91
|
| Rate for Payer: PHP Medicare Advantage |
$81.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.05
|
| Rate for Payer: Priority Health HMO/PPO |
$153.92
|
| Rate for Payer: Priority Health Medicare |
$82.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.91
|
| Rate for Payer: UHC Exchange |
$81.91
|
| Rate for Payer: UHC Medicare Advantage |
$81.91
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
|
|
PR DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS
|
Facility
|
IP
|
$328.00
|
|
|
Service Code
|
CPT 43450
|
| Hospital Charge Code |
43450
|
| Min. Negotiated Rate |
$213.20 |
| Max. Negotiated Rate |
$295.20 |
| Rate for Payer: Aetna Commercial |
$278.80
|
| Rate for Payer: BCBS Trust/PPO |
$267.75
|
| Rate for Payer: BCN Commercial |
$253.48
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$282.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.40
|
| Rate for Payer: Healthscope Commercial |
$295.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.80
|
| Rate for Payer: Nomi Health Commercial |
$268.96
|
| Rate for Payer: PHP Commercial |
$278.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO |
$285.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.64
|
| Rate for Payer: UHC Core |
$273.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.00
|
|
|
PR DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 43450
|
| Hospital Charge Code |
43450
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$1,202.94 |
| Rate for Payer: Aetna Commercial |
$100.73
|
| Rate for Payer: Aetna Medicare |
$78.18
|
| Rate for Payer: BCBS Complete |
$53.22
|
| Rate for Payer: BCBS MAPPO |
$75.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.94
|
| Rate for Payer: BCN Commercial |
$275.61
|
| Rate for Payer: BCN Medicare Advantage |
$75.17
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$108.24
|
| Rate for Payer: Cofinity Commercial |
$100.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.17
|
| Rate for Payer: Mclaren Medicaid |
$50.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.93
|
| Rate for Payer: Meridian Medicaid |
$53.22
|
| Rate for Payer: Nomi Health Commercial |
$90.20
|
| Rate for Payer: PACE SWMI |
$75.17
|
| Rate for Payer: PHP Medicare Advantage |
$75.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO |
$141.39
|
| Rate for Payer: Priority Health Medicare |
$75.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.17
|
| Rate for Payer: UHC Exchange |
$75.17
|
| Rate for Payer: UHC Medicare Advantage |
$75.17
|
| Rate for Payer: UHCCP Medicaid |
$50.69
|
|
