|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 92620
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$295.85 |
| Rate for Payer: Aetna Commercial |
$99.83
|
| Rate for Payer: Aetna Medicare |
$77.48
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$74.50
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$129.01
|
| Rate for Payer: BCN Medicare Advantage |
$74.50
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$107.28
|
| Rate for Payer: Cofinity Commercial |
$99.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.22
|
| Rate for Payer: Nomi Health Commercial |
$89.40
|
| Rate for Payer: PACE SWMI |
$74.50
|
| Rate for Payer: PHP Medicare Advantage |
$74.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO |
$105.84
|
| Rate for Payer: Priority Health Medicare |
$75.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.50
|
| Rate for Payer: UHC Exchange |
$74.50
|
| Rate for Payer: UHC Medicare Advantage |
$74.50
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 92621
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$281.58 |
| Rate for Payer: Aetna Commercial |
$23.57
|
| Rate for Payer: Aetna Medicare |
$18.29
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$17.59
|
| Rate for Payer: BCBS Trust/PPO |
$281.58
|
| Rate for Payer: BCN Commercial |
$31.76
|
| Rate for Payer: BCN Medicare Advantage |
$17.59
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$25.33
|
| Rate for Payer: Cofinity Commercial |
$23.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.47
|
| Rate for Payer: Nomi Health Commercial |
$21.11
|
| Rate for Payer: PACE SWMI |
$17.59
|
| Rate for Payer: PHP Medicare Advantage |
$17.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health HMO/PPO |
$24.88
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.59
|
| Rate for Payer: UHC Exchange |
$17.59
|
| Rate for Payer: UHC Medicare Advantage |
$17.59
|
|
|
PR EVAL OF ORTHOTIC/PROSTH USE, EA 15 MIN
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 97762
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
|
|
PR EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 92523
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$1,440.15 |
| Rate for Payer: Aetna Commercial |
$288.80
|
| Rate for Payer: Aetna Medicare |
$224.14
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS MAPPO |
$215.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,440.15
|
| Rate for Payer: BCN Commercial |
$331.82
|
| Rate for Payer: BCN Medicare Advantage |
$215.52
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$310.35
|
| Rate for Payer: Cofinity Commercial |
$288.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.30
|
| Rate for Payer: Nomi Health Commercial |
$258.62
|
| Rate for Payer: PACE SWMI |
$215.52
|
| Rate for Payer: PHP Medicare Advantage |
$215.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO |
$309.39
|
| Rate for Payer: Priority Health Medicare |
$217.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$309.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.52
|
| Rate for Payer: UHC Exchange |
$215.52
|
| Rate for Payer: UHC Medicare Advantage |
$215.52
|
|
|
PR EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 92521
|
| Min. Negotiated Rate |
$84.40 |
| Max. Negotiated Rate |
$1,170.71 |
| Rate for Payer: Aetna Commercial |
$168.73
|
| Rate for Payer: Aetna Medicare |
$130.96
|
| Rate for Payer: BCBS Complete |
$84.40
|
| Rate for Payer: BCBS MAPPO |
$125.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.71
|
| Rate for Payer: BCN Commercial |
$193.52
|
| Rate for Payer: BCN Medicare Advantage |
$125.92
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$181.32
|
| Rate for Payer: Cofinity Commercial |
$168.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.22
|
| Rate for Payer: Nomi Health Commercial |
$151.10
|
| Rate for Payer: PACE SWMI |
$125.92
|
| Rate for Payer: PHP Medicare Advantage |
$125.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.15
|
| Rate for Payer: Priority Health HMO/PPO |
$180.48
|
| Rate for Payer: Priority Health Medicare |
$127.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.92
|
| Rate for Payer: UHC Exchange |
$125.92
|
| Rate for Payer: UHC Medicare Advantage |
$125.92
|
|
|
PR EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 92522
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$1,580.15 |
| Rate for Payer: Aetna Commercial |
$140.77
|
| Rate for Payer: Aetna Medicare |
$109.25
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS MAPPO |
$105.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.15
|
| Rate for Payer: BCN Commercial |
$161.75
|
| Rate for Payer: BCN Medicare Advantage |
$105.05
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$151.27
|
| Rate for Payer: Cofinity Commercial |
$140.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.30
|
| Rate for Payer: Nomi Health Commercial |
$126.06
|
| Rate for Payer: PACE SWMI |
$105.05
|
| Rate for Payer: PHP Medicare Advantage |
$105.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health HMO/PPO |
$151.07
|
| Rate for Payer: Priority Health Medicare |
$106.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.05
|
| Rate for Payer: UHC Exchange |
$105.05
|
| Rate for Payer: UHC Medicare Advantage |
$105.05
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST
|
Professional
|
Both
|
$1,105.00
|
|
|
Service Code
|
HCPCS 61650
|
| Min. Negotiated Rate |
$318.04 |
| Max. Negotiated Rate |
$990.71 |
| Rate for Payer: Aetna Commercial |
$770.85
|
| Rate for Payer: Aetna Medicare |
$598.27
|
| Rate for Payer: BCBS Complete |
$393.84
|
| Rate for Payer: BCBS MAPPO |
$575.26
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$832.21
|
| Rate for Payer: BCN Medicare Advantage |
$575.26
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$828.37
|
| Rate for Payer: Cofinity Commercial |
$770.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.26
|
| Rate for Payer: Mclaren Medicaid |
$375.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.02
|
| Rate for Payer: Meridian Medicaid |
$393.84
|
| Rate for Payer: Nomi Health Commercial |
$690.31
|
| Rate for Payer: PACE SWMI |
$575.26
|
| Rate for Payer: PHP Medicare Advantage |
$575.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.25
|
| Rate for Payer: Priority Health HMO/PPO |
$990.71
|
| Rate for Payer: Priority Health Medicare |
$581.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$990.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.26
|
| Rate for Payer: UHC Exchange |
$575.26
|
| Rate for Payer: UHC Medicare Advantage |
$575.26
|
| Rate for Payer: UHCCP Medicaid |
$375.09
|
|
|
PR EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 61651
|
| Min. Negotiated Rate |
$160.18 |
| Max. Negotiated Rate |
$423.13 |
| Rate for Payer: Aetna Commercial |
$329.12
|
| Rate for Payer: Aetna Medicare |
$255.43
|
| Rate for Payer: BCBS Complete |
$168.19
|
| Rate for Payer: BCBS MAPPO |
$245.61
|
| Rate for Payer: BCBS Trust/PPO |
$301.13
|
| Rate for Payer: BCN Commercial |
$358.20
|
| Rate for Payer: BCN Medicare Advantage |
$245.61
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$353.68
|
| Rate for Payer: Cofinity Commercial |
$329.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.61
|
| Rate for Payer: Mclaren Medicaid |
$160.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.89
|
| Rate for Payer: Meridian Medicaid |
$168.19
|
| Rate for Payer: Nomi Health Commercial |
$294.73
|
| Rate for Payer: PACE SWMI |
$245.61
|
| Rate for Payer: PHP Medicare Advantage |
$245.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO |
$423.13
|
| Rate for Payer: Priority Health Medicare |
$248.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.61
|
| Rate for Payer: UHC Exchange |
$245.61
|
| Rate for Payer: UHC Medicare Advantage |
$245.61
|
| Rate for Payer: UHCCP Medicaid |
$160.18
|
|
|
PR EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 34808
|
| Min. Negotiated Rate |
$125.88 |
| Max. Negotiated Rate |
$314.31 |
| Rate for Payer: Aetna Commercial |
$260.72
|
| Rate for Payer: Aetna Medicare |
$202.35
|
| Rate for Payer: BCBS Complete |
$132.17
|
| Rate for Payer: BCBS MAPPO |
$194.57
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$194.57
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$280.18
|
| Rate for Payer: Cofinity Commercial |
$260.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.57
|
| Rate for Payer: Mclaren Medicaid |
$125.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.30
|
| Rate for Payer: Meridian Medicaid |
$132.17
|
| Rate for Payer: Nomi Health Commercial |
$233.48
|
| Rate for Payer: PACE SWMI |
$194.57
|
| Rate for Payer: PHP Medicare Advantage |
$194.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health HMO/PPO |
$314.31
|
| Rate for Payer: Priority Health Medicare |
$196.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.57
|
| Rate for Payer: UHC Exchange |
$194.57
|
| Rate for Payer: UHC Medicare Advantage |
$194.57
|
| Rate for Payer: UHCCP Medicaid |
$125.88
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT
|
Professional
|
Both
|
$2,588.00
|
|
|
Service Code
|
HCPCS 34701
|
| Min. Negotiated Rate |
$772.13 |
| Max. Negotiated Rate |
$1,920.42 |
| Rate for Payer: Aetna Commercial |
$1,587.82
|
| Rate for Payer: Aetna Medicare |
$1,232.34
|
| Rate for Payer: BCBS Complete |
$810.74
|
| Rate for Payer: BCBS MAPPO |
$1,184.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.71
|
| Rate for Payer: BCN Commercial |
$1,763.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.94
|
| Rate for Payer: Cash Price |
$2,070.40
|
| Rate for Payer: Cash Price |
$2,070.40
|
| Rate for Payer: Cofinity Commercial |
$1,706.31
|
| Rate for Payer: Cofinity Commercial |
$1,587.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.94
|
| Rate for Payer: Mclaren Medicaid |
$772.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,244.19
|
| Rate for Payer: Meridian Medicaid |
$810.74
|
| Rate for Payer: Nomi Health Commercial |
$1,421.93
|
| Rate for Payer: PACE SWMI |
$1,184.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,682.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,920.42
|
| Rate for Payer: Priority Health Medicare |
$1,196.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,920.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,184.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.94
|
| Rate for Payer: UHC Exchange |
$1,184.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.94
|
| Rate for Payer: UHCCP Medicaid |
$772.13
|
|
|
PR EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT
|
Professional
|
Both
|
$3,913.00
|
|
|
Service Code
|
HCPCS 34702
|
| Min. Negotiated Rate |
$1,119.53 |
| Max. Negotiated Rate |
$2,868.12 |
| Rate for Payer: Aetna Commercial |
$2,315.02
|
| Rate for Payer: Aetna Medicare |
$1,796.74
|
| Rate for Payer: BCBS Complete |
$1,175.51
|
| Rate for Payer: BCBS MAPPO |
$1,727.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,005.96
|
| Rate for Payer: BCN Commercial |
$2,630.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,727.63
|
| Rate for Payer: Cash Price |
$3,130.40
|
| Rate for Payer: Cash Price |
$3,130.40
|
| Rate for Payer: Cofinity Commercial |
$2,487.79
|
| Rate for Payer: Cofinity Commercial |
$2,315.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,727.63
|
| Rate for Payer: Mclaren Medicaid |
$1,119.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,814.01
|
| Rate for Payer: Meridian Medicaid |
$1,175.51
|
| Rate for Payer: Nomi Health Commercial |
$2,073.16
|
| Rate for Payer: PACE SWMI |
$1,727.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,727.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,119.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,543.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,868.12
|
| Rate for Payer: Priority Health Medicare |
$1,744.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,868.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,727.63
|
| Rate for Payer: UHC Exchange |
$1,727.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,727.63
|
| Rate for Payer: UHCCP Medicaid |
$1,119.53
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT
|
Professional
|
Both
|
$3,166.00
|
|
|
Service Code
|
HCPCS 34705
|
| Min. Negotiated Rate |
$950.83 |
| Max. Negotiated Rate |
$2,747.37 |
| Rate for Payer: Aetna Commercial |
$1,957.42
|
| Rate for Payer: Aetna Medicare |
$1,519.19
|
| Rate for Payer: BCBS Complete |
$998.37
|
| Rate for Payer: BCBS MAPPO |
$1,460.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,747.37
|
| Rate for Payer: BCN Commercial |
$2,174.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,460.76
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cash Price |
$2,532.80
|
| Rate for Payer: Cofinity Commercial |
$2,103.49
|
| Rate for Payer: Cofinity Commercial |
$1,957.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,460.76
|
| Rate for Payer: Mclaren Medicaid |
$950.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,533.80
|
| Rate for Payer: Meridian Medicaid |
$998.37
|
| Rate for Payer: Nomi Health Commercial |
$1,752.91
|
| Rate for Payer: PACE SWMI |
$1,460.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,460.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$950.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,057.90
|
| Rate for Payer: Priority Health HMO/PPO |
$2,371.93
|
| Rate for Payer: Priority Health Medicare |
$1,475.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,371.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,460.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,460.76
|
| Rate for Payer: UHC Exchange |
$1,460.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,460.76
|
| Rate for Payer: UHCCP Medicaid |
$950.83
|
|
|
PR EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT
|
Professional
|
Both
|
$4,840.00
|
|
|
Service Code
|
HCPCS 34706
|
| Min. Negotiated Rate |
$1,419.65 |
| Max. Negotiated Rate |
$3,535.04 |
| Rate for Payer: Aetna Commercial |
$2,928.93
|
| Rate for Payer: Aetna Medicare |
$2,273.20
|
| Rate for Payer: BCBS Complete |
$1,490.63
|
| Rate for Payer: BCBS MAPPO |
$2,185.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,686.93
|
| Rate for Payer: BCN Commercial |
$3,239.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,185.77
|
| Rate for Payer: Cash Price |
$3,872.00
|
| Rate for Payer: Cash Price |
$3,872.00
|
| Rate for Payer: Cofinity Commercial |
$3,147.51
|
| Rate for Payer: Cofinity Commercial |
$2,928.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,185.77
|
| Rate for Payer: Mclaren Medicaid |
$1,419.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,295.06
|
| Rate for Payer: Meridian Medicaid |
$1,490.63
|
| Rate for Payer: Nomi Health Commercial |
$2,622.92
|
| Rate for Payer: PACE SWMI |
$2,185.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,185.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,419.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,146.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,535.04
|
| Rate for Payer: Priority Health Medicare |
$2,207.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,535.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,185.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,185.77
|
| Rate for Payer: UHC Exchange |
$2,185.77
|
| Rate for Payer: UHC Medicare Advantage |
$2,185.77
|
| Rate for Payer: UHCCP Medicaid |
$1,419.65
|
|
|
PR EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT
|
Professional
|
Both
|
$2,917.00
|
|
|
Service Code
|
HCPCS 34703
|
| Min. Negotiated Rate |
$855.62 |
| Max. Negotiated Rate |
$2,308.14 |
| Rate for Payer: Aetna Commercial |
$1,761.51
|
| Rate for Payer: Aetna Medicare |
$1,367.14
|
| Rate for Payer: BCBS Complete |
$898.40
|
| Rate for Payer: BCBS MAPPO |
$1,314.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,308.14
|
| Rate for Payer: BCN Commercial |
$1,960.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,314.56
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cash Price |
$2,333.60
|
| Rate for Payer: Cofinity Commercial |
$1,892.97
|
| Rate for Payer: Cofinity Commercial |
$1,761.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,314.56
|
| Rate for Payer: Mclaren Medicaid |
$855.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,380.29
|
| Rate for Payer: Meridian Medicaid |
$898.40
|
| Rate for Payer: Nomi Health Commercial |
$1,577.47
|
| Rate for Payer: PACE SWMI |
$1,314.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,314.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,896.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,133.15
|
| Rate for Payer: Priority Health Medicare |
$1,327.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,133.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,314.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,314.56
|
| Rate for Payer: UHC Exchange |
$1,314.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,314.56
|
| Rate for Payer: UHCCP Medicaid |
$855.62
|
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT
|
Professional
|
Both
|
$2,414.00
|
|
|
Service Code
|
HCPCS 34707
|
| Min. Negotiated Rate |
$725.48 |
| Max. Negotiated Rate |
$2,209.35 |
| Rate for Payer: Aetna Commercial |
$1,491.27
|
| Rate for Payer: Aetna Medicare |
$1,157.41
|
| Rate for Payer: BCBS Complete |
$761.75
|
| Rate for Payer: BCBS MAPPO |
$1,112.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,209.35
|
| Rate for Payer: BCN Commercial |
$1,662.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.89
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cash Price |
$1,931.20
|
| Rate for Payer: Cofinity Commercial |
$1,602.56
|
| Rate for Payer: Cofinity Commercial |
$1,491.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.89
|
| Rate for Payer: Mclaren Medicaid |
$725.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,168.53
|
| Rate for Payer: Meridian Medicaid |
$761.75
|
| Rate for Payer: Nomi Health Commercial |
$1,335.47
|
| Rate for Payer: PACE SWMI |
$1,112.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,803.95
|
| Rate for Payer: Priority Health Medicare |
$1,124.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,803.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,112.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,112.89
|
| Rate for Payer: UHC Exchange |
$1,112.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,112.89
|
| Rate for Payer: UHCCP Medicaid |
$725.48
|
|
|
PR EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT
|
Professional
|
Both
|
$3,899.00
|
|
|
Service Code
|
HCPCS 34708
|
| Min. Negotiated Rate |
$1,134.44 |
| Max. Negotiated Rate |
$2,827.72 |
| Rate for Payer: Aetna Commercial |
$2,345.95
|
| Rate for Payer: Aetna Medicare |
$1,820.74
|
| Rate for Payer: BCBS Complete |
$1,191.16
|
| Rate for Payer: BCBS MAPPO |
$1,750.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.88
|
| Rate for Payer: BCN Commercial |
$2,587.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,750.71
|
| Rate for Payer: Cash Price |
$3,119.20
|
| Rate for Payer: Cash Price |
$3,119.20
|
| Rate for Payer: Cofinity Commercial |
$2,521.02
|
| Rate for Payer: Cofinity Commercial |
$2,345.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,750.71
|
| Rate for Payer: Mclaren Medicaid |
$1,134.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,838.25
|
| Rate for Payer: Meridian Medicaid |
$1,191.16
|
| Rate for Payer: Nomi Health Commercial |
$2,100.85
|
| Rate for Payer: PACE SWMI |
$1,750.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,750.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,134.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,827.72
|
| Rate for Payer: Priority Health Medicare |
$1,768.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,827.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,750.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,750.71
|
| Rate for Payer: UHC Exchange |
$1,750.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,750.71
|
| Rate for Payer: UHCCP Medicaid |
$1,134.44
|
|
|
PR EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH
|
Professional
|
Both
|
$8,245.00
|
|
|
Service Code
|
HCPCS 33880
|
| Min. Negotiated Rate |
$649.81 |
| Max. Negotiated Rate |
$5,359.25 |
| Rate for Payer: Aetna Commercial |
$2,291.68
|
| Rate for Payer: Aetna Medicare |
$1,778.62
|
| Rate for Payer: BCBS Complete |
$1,169.24
|
| Rate for Payer: BCBS MAPPO |
$1,710.21
|
| Rate for Payer: BCBS Trust/PPO |
$649.81
|
| Rate for Payer: BCN Commercial |
$2,552.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,710.21
|
| Rate for Payer: Cash Price |
$6,596.00
|
| Rate for Payer: Cash Price |
$6,596.00
|
| Rate for Payer: Cofinity Commercial |
$2,462.70
|
| Rate for Payer: Cofinity Commercial |
$2,291.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,710.21
|
| Rate for Payer: Mclaren Medicaid |
$1,113.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,795.72
|
| Rate for Payer: Meridian Medicaid |
$1,169.24
|
| Rate for Payer: Nomi Health Commercial |
$2,052.25
|
| Rate for Payer: PACE SWMI |
$1,710.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,710.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,113.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,359.25
|
| Rate for Payer: Priority Health HMO/PPO |
$2,779.31
|
| Rate for Payer: Priority Health Medicare |
$1,727.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,779.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,710.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,710.21
|
| Rate for Payer: UHC Exchange |
$1,710.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.21
|
| Rate for Payer: UHCCP Medicaid |
$1,113.56
|
|
|
PR EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN
|
Professional
|
Both
|
$5,504.00
|
|
|
Service Code
|
HCPCS 33881
|
| Min. Negotiated Rate |
$924.53 |
| Max. Negotiated Rate |
$3,577.60 |
| Rate for Payer: Aetna Commercial |
$1,967.96
|
| Rate for Payer: Aetna Medicare |
$1,527.38
|
| Rate for Payer: BCBS Complete |
$1,004.41
|
| Rate for Payer: BCBS MAPPO |
$1,468.63
|
| Rate for Payer: BCBS Trust/PPO |
$924.53
|
| Rate for Payer: BCN Commercial |
$2,187.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,468.63
|
| Rate for Payer: Cash Price |
$4,403.20
|
| Rate for Payer: Cash Price |
$4,403.20
|
| Rate for Payer: Cofinity Commercial |
$2,114.83
|
| Rate for Payer: Cofinity Commercial |
$1,967.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,468.63
|
| Rate for Payer: Mclaren Medicaid |
$956.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,542.06
|
| Rate for Payer: Meridian Medicaid |
$1,004.41
|
| Rate for Payer: Nomi Health Commercial |
$1,762.36
|
| Rate for Payer: PACE SWMI |
$1,468.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,468.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,577.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,387.37
|
| Rate for Payer: Priority Health Medicare |
$1,483.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,387.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,468.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,468.63
|
| Rate for Payer: UHC Exchange |
$1,468.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,468.63
|
| Rate for Payer: UHCCP Medicaid |
$956.58
|
|
|
PR EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI
|
Professional
|
Both
|
$959.00
|
|
|
Service Code
|
HCPCS 0254T
|
| Min. Negotiated Rate |
$383.60 |
| Max. Negotiated Rate |
$623.35 |
| Rate for Payer: Aetna Medicare |
$479.50
|
| Rate for Payer: BCBS Complete |
$383.60
|
| Rate for Payer: Cash Price |
$767.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.35
|
|
|
PR EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$2,162.00
|
|
|
Service Code
|
HCPCS 34718
|
| Min. Negotiated Rate |
$770.63 |
| Max. Negotiated Rate |
$1,924.14 |
| Rate for Payer: Aetna Commercial |
$1,587.52
|
| Rate for Payer: Aetna Medicare |
$1,232.11
|
| Rate for Payer: BCBS Complete |
$809.16
|
| Rate for Payer: BCBS MAPPO |
$1,184.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,579.62
|
| Rate for Payer: BCN Commercial |
$1,758.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.72
|
| Rate for Payer: Cash Price |
$1,729.60
|
| Rate for Payer: Cash Price |
$1,729.60
|
| Rate for Payer: Cofinity Commercial |
$1,706.00
|
| Rate for Payer: Cofinity Commercial |
$1,587.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.72
|
| Rate for Payer: Mclaren Medicaid |
$770.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.96
|
| Rate for Payer: Meridian Medicaid |
$809.16
|
| Rate for Payer: Nomi Health Commercial |
$1,421.66
|
| Rate for Payer: PACE SWMI |
$1,184.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,405.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,924.14
|
| Rate for Payer: Priority Health Medicare |
$1,196.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,924.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,184.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.72
|
| Rate for Payer: UHC Exchange |
$1,184.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.72
|
| Rate for Payer: UHCCP Medicaid |
$770.63
|
|
|
PR EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 34717
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,145.35 |
| Rate for Payer: Aetna Commercial |
$568.63
|
| Rate for Payer: Aetna Medicare |
$441.32
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$424.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,145.35
|
| Rate for Payer: BCN Commercial |
$629.42
|
| Rate for Payer: BCN Medicare Advantage |
$424.35
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$611.06
|
| Rate for Payer: Cofinity Commercial |
$568.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.35
|
| Rate for Payer: Mclaren Medicaid |
$274.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$445.57
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Nomi Health Commercial |
$509.22
|
| Rate for Payer: PACE SWMI |
$424.35
|
| Rate for Payer: PHP Medicare Advantage |
$424.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO |
$686.58
|
| Rate for Payer: Priority Health Medicare |
$428.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$424.35
|
| Rate for Payer: UHC Exchange |
$424.35
|
| Rate for Payer: UHC Medicare Advantage |
$424.35
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK
|
Professional
|
Both
|
$3,336.00
|
|
|
Service Code
|
HCPCS 61623
|
| Min. Negotiated Rate |
$124.15 |
| Max. Negotiated Rate |
$2,168.40 |
| Rate for Payer: Aetna Commercial |
$756.03
|
| Rate for Payer: Aetna Medicare |
$586.77
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$564.20
|
| Rate for Payer: BCBS Trust/PPO |
$124.15
|
| Rate for Payer: BCN Commercial |
$838.57
|
| Rate for Payer: BCN Medicare Advantage |
$564.20
|
| Rate for Payer: Cash Price |
$2,668.80
|
| Rate for Payer: Cash Price |
$2,668.80
|
| Rate for Payer: Cofinity Commercial |
$812.45
|
| Rate for Payer: Cofinity Commercial |
$756.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.20
|
| Rate for Payer: Mclaren Medicaid |
$368.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.41
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Nomi Health Commercial |
$677.04
|
| Rate for Payer: PACE SWMI |
$564.20
|
| Rate for Payer: PHP Medicare Advantage |
$564.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,168.40
|
| Rate for Payer: Priority Health HMO/PPO |
$980.47
|
| Rate for Payer: Priority Health Medicare |
$569.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$980.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.20
|
| Rate for Payer: UHC Exchange |
$564.20
|
| Rate for Payer: UHC Medicare Advantage |
$564.20
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EWHO RIGID W/O JNTS CF
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS L3763
|
| Min. Negotiated Rate |
$279.60 |
| Max. Negotiated Rate |
$646.68 |
| Rate for Payer: BCBS Complete |
$279.60
|
| Rate for Payer: BCN Commercial |
$646.68
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.35
|
|
|
PR EWHO W/JOINT(S) CF
|
Professional
|
Both
|
$731.00
|
|
|
Service Code
|
HCPCS L3764
|
| Min. Negotiated Rate |
$292.40 |
| Max. Negotiated Rate |
$676.76 |
| Rate for Payer: BCBS Complete |
$292.40
|
| Rate for Payer: BCN Commercial |
$676.76
|
| Rate for Payer: Cash Price |
$584.80
|
| Rate for Payer: Cash Price |
$584.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.15
|
|
|
PR EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM
|
Professional
|
Both
|
$2,379.00
|
|
|
Service Code
|
HCPCS 44110
|
| Min. Negotiated Rate |
$545.71 |
| Max. Negotiated Rate |
$1,643.01 |
| Rate for Payer: Aetna Commercial |
$1,100.45
|
| Rate for Payer: Aetna Medicare |
$854.08
|
| Rate for Payer: BCBS Complete |
$573.00
|
| Rate for Payer: BCBS MAPPO |
$821.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.01
|
| Rate for Payer: BCN Commercial |
$1,234.88
|
| Rate for Payer: BCN Medicare Advantage |
$821.23
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.57
|
| Rate for Payer: Cofinity Commercial |
$1,100.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.23
|
| Rate for Payer: Mclaren Medicaid |
$545.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.29
|
| Rate for Payer: Meridian Medicaid |
$573.00
|
| Rate for Payer: Nomi Health Commercial |
$985.48
|
| Rate for Payer: PACE SWMI |
$821.23
|
| Rate for Payer: PHP Medicare Advantage |
$821.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,546.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,523.10
|
| Rate for Payer: Priority Health Medicare |
$829.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,523.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.23
|
| Rate for Payer: UHC Exchange |
$821.23
|
| Rate for Payer: UHC Medicare Advantage |
$821.23
|
| Rate for Payer: UHCCP Medicaid |
$545.71
|
|
