|
PR RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS
|
Professional
|
Both
|
$5,695.00
|
|
|
Service Code
|
HCPCS 33500
|
| Min. Negotiated Rate |
$426.34 |
| Max. Negotiated Rate |
$3,986.50 |
| Rate for Payer: Aetna Commercial |
$2,052.76
|
| Rate for Payer: Aetna Medicare |
$1,593.19
|
| Rate for Payer: BCBS Complete |
$1,024.99
|
| Rate for Payer: BCBS MAPPO |
$1,531.91
|
| Rate for Payer: BCBS Trust/PPO |
$426.34
|
| Rate for Payer: BCN Commercial |
$2,235.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,531.91
|
| Rate for Payer: Cash Price |
$4,556.00
|
| Rate for Payer: Cash Price |
$4,556.00
|
| Rate for Payer: Cofinity Commercial |
$2,052.76
|
| Rate for Payer: Cofinity Commercial |
$2,205.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,531.91
|
| Rate for Payer: Mclaren Medicaid |
$976.18
|
| Rate for Payer: Meridian Medicaid |
$1,024.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,608.51
|
| Rate for Payer: PACE SWMI |
$1,531.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,531.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$976.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,986.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,433.71
|
| Rate for Payer: Priority Health Medicare |
$1,531.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,433.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,531.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,531.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,577.87
|
|
|
PR RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 36576
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$1,186.03 |
| Rate for Payer: Aetna Commercial |
$240.42
|
| Rate for Payer: Aetna Medicare |
$186.60
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$179.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.03
|
| Rate for Payer: BCN Commercial |
$507.25
|
| Rate for Payer: BCN Medicare Advantage |
$179.42
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$240.42
|
| Rate for Payer: Cofinity Commercial |
$258.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.42
|
| Rate for Payer: Mclaren Medicaid |
$115.66
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.39
|
| Rate for Payer: PACE SWMI |
$179.42
|
| Rate for Payer: PHP Medicare Advantage |
$179.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.32
|
| Rate for Payer: Priority Health Medicare |
$179.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.42
|
| Rate for Payer: UHC Medicare Advantage |
$184.80
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT
|
Professional
|
Both
|
$5,875.00
|
|
|
Service Code
|
HCPCS 39540
|
| Min. Negotiated Rate |
$552.74 |
| Max. Negotiated Rate |
$4,112.50 |
| Rate for Payer: Aetna Commercial |
$1,149.34
|
| Rate for Payer: Aetna Medicare |
$892.03
|
| Rate for Payer: BCBS Complete |
$580.38
|
| Rate for Payer: BCBS MAPPO |
$857.72
|
| Rate for Payer: BCBS Trust/PPO |
$676.75
|
| Rate for Payer: BCN Commercial |
$1,257.37
|
| Rate for Payer: BCN Medicare Advantage |
$857.72
|
| Rate for Payer: Cash Price |
$4,700.00
|
| Rate for Payer: Cash Price |
$4,700.00
|
| Rate for Payer: Cofinity Commercial |
$1,235.12
|
| Rate for Payer: Cofinity Commercial |
$1,149.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$857.72
|
| Rate for Payer: Mclaren Medicaid |
$552.74
|
| Rate for Payer: Meridian Medicaid |
$580.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$900.61
|
| Rate for Payer: PACE SWMI |
$857.72
|
| Rate for Payer: PHP Medicare Advantage |
$857.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,112.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,368.73
|
| Rate for Payer: Priority Health Medicare |
$857.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,368.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$857.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$857.72
|
| Rate for Payer: UHC Medicare Advantage |
$883.45
|
|
|
PR RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 39541
|
| Min. Negotiated Rate |
$509.28 |
| Max. Negotiated Rate |
$1,476.72 |
| Rate for Payer: Aetna Commercial |
$1,240.26
|
| Rate for Payer: Aetna Medicare |
$962.59
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS MAPPO |
$925.57
|
| Rate for Payer: BCBS Trust/PPO |
$509.28
|
| Rate for Payer: BCN Commercial |
$1,356.57
|
| Rate for Payer: BCN Medicare Advantage |
$925.57
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$1,240.26
|
| Rate for Payer: Cofinity Commercial |
$1,332.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.57
|
| Rate for Payer: Mclaren Medicaid |
$593.84
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$971.85
|
| Rate for Payer: PACE SWMI |
$925.57
|
| Rate for Payer: PHP Medicare Advantage |
$925.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,476.72
|
| Rate for Payer: Priority Health Medicare |
$925.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,476.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.57
|
| Rate for Payer: UHC Medicare Advantage |
$953.34
|
|
|
PR RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY
|
Professional
|
Both
|
$1,275.00
|
|
|
Service Code
|
HCPCS 27675
|
| Min. Negotiated Rate |
$221.89 |
| Max. Negotiated Rate |
$892.50 |
| Rate for Payer: Aetna Commercial |
$655.38
|
| Rate for Payer: Aetna Medicare |
$508.65
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$489.09
|
| Rate for Payer: BCBS Trust/PPO |
$221.89
|
| Rate for Payer: BCN Commercial |
$730.08
|
| Rate for Payer: BCN Medicare Advantage |
$489.09
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$704.29
|
| Rate for Payer: Cofinity Commercial |
$655.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.09
|
| Rate for Payer: Mclaren Medicaid |
$320.57
|
| Rate for Payer: Meridian Medicaid |
$336.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.54
|
| Rate for Payer: PACE SWMI |
$489.09
|
| Rate for Payer: PHP Medicare Advantage |
$489.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$320.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.90
|
| Rate for Payer: Priority Health Medicare |
$489.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$762.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$489.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.09
|
| Rate for Payer: UHC Medicare Advantage |
$503.76
|
|
|
PR RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM
|
Professional
|
Both
|
$1,890.04
|
|
|
Service Code
|
HCPCS 63707
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$1,608.08 |
| Rate for Payer: Aetna Commercial |
$1,257.66
|
| Rate for Payer: Aetna Medicare |
$976.09
|
| Rate for Payer: BCBS Complete |
$639.42
|
| Rate for Payer: BCBS MAPPO |
$938.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.28
|
| Rate for Payer: BCN Commercial |
$1,528.13
|
| Rate for Payer: BCN Medicare Advantage |
$938.55
|
| Rate for Payer: Cash Price |
$1,512.03
|
| Rate for Payer: Cash Price |
$1,512.03
|
| Rate for Payer: Cofinity Commercial |
$1,351.51
|
| Rate for Payer: Cofinity Commercial |
$1,257.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.55
|
| Rate for Payer: Mclaren Medicaid |
$608.97
|
| Rate for Payer: Meridian Medicaid |
$639.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$985.48
|
| Rate for Payer: PACE SWMI |
$938.55
|
| Rate for Payer: PHP Medicare Advantage |
$938.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,608.08
|
| Rate for Payer: Priority Health Medicare |
$938.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,608.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$938.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.55
|
| Rate for Payer: UHC Medicare Advantage |
$966.71
|
|
|
PR RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM
|
Professional
|
Both
|
$5,910.00
|
|
|
Service Code
|
HCPCS 63709
|
| Min. Negotiated Rate |
$722.07 |
| Max. Negotiated Rate |
$4,137.00 |
| Rate for Payer: Aetna Commercial |
$1,491.74
|
| Rate for Payer: Aetna Medicare |
$1,157.77
|
| Rate for Payer: BCBS Complete |
$758.17
|
| Rate for Payer: BCBS MAPPO |
$1,113.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.00
|
| Rate for Payer: BCN Commercial |
$1,809.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,113.24
|
| Rate for Payer: Cash Price |
$4,728.00
|
| Rate for Payer: Cash Price |
$4,728.00
|
| Rate for Payer: Cofinity Commercial |
$1,603.07
|
| Rate for Payer: Cofinity Commercial |
$1,491.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,113.24
|
| Rate for Payer: Mclaren Medicaid |
$722.07
|
| Rate for Payer: Meridian Medicaid |
$758.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,168.90
|
| Rate for Payer: PACE SWMI |
$1,113.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,113.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,904.22
|
| Rate for Payer: Priority Health Medicare |
$1,113.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,113.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,113.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,146.64
|
|
|
PR RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY
|
Professional
|
Both
|
$5,729.00
|
|
|
Service Code
|
HCPCS 62120
|
| Min. Negotiated Rate |
$1,110.49 |
| Max. Negotiated Rate |
$4,010.30 |
| Rate for Payer: Aetna Commercial |
$2,774.70
|
| Rate for Payer: Aetna Medicare |
$2,153.50
|
| Rate for Payer: BCBS Complete |
$1,413.69
|
| Rate for Payer: BCBS MAPPO |
$2,070.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.49
|
| Rate for Payer: BCN Commercial |
$3,072.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,070.67
|
| Rate for Payer: Cash Price |
$4,583.20
|
| Rate for Payer: Cash Price |
$4,583.20
|
| Rate for Payer: Cofinity Commercial |
$2,774.70
|
| Rate for Payer: Cofinity Commercial |
$2,981.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,070.67
|
| Rate for Payer: Mclaren Medicaid |
$1,346.37
|
| Rate for Payer: Meridian Medicaid |
$1,413.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,174.20
|
| Rate for Payer: PACE SWMI |
$2,070.67
|
| Rate for Payer: PHP Medicare Advantage |
$2,070.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,346.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,010.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,559.85
|
| Rate for Payer: Priority Health Medicare |
$2,070.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,559.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,070.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,070.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.79
|
|
|
PR RPR EPIGASTRIC HERNIA INCARCERATED
|
Professional
|
Both
|
$1,459.00
|
|
|
Service Code
|
HCPCS 49572
|
| Min. Negotiated Rate |
$583.60 |
| Max. Negotiated Rate |
$1,021.30 |
| Rate for Payer: BCBS Complete |
$583.60
|
| Rate for Payer: Cash Price |
$1,167.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.30
|
|
|
PR RPR EPIGASTRIC HERNIA REDUCIBLE SPX
|
Professional
|
Both
|
$1,148.00
|
|
|
Service Code
|
HCPCS 49570
|
| Min. Negotiated Rate |
$459.20 |
| Max. Negotiated Rate |
$803.60 |
| Rate for Payer: BCBS Complete |
$459.20
|
| Rate for Payer: Cash Price |
$918.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$803.60
|
|
|
PR RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 27664
|
| Min. Negotiated Rate |
$235.15 |
| Max. Negotiated Rate |
$1,815.77 |
| Rate for Payer: Aetna Commercial |
$477.71
|
| Rate for Payer: Aetna Medicare |
$370.76
|
| Rate for Payer: BCBS Complete |
$246.91
|
| Rate for Payer: BCBS MAPPO |
$356.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.77
|
| Rate for Payer: BCN Commercial |
$535.10
|
| Rate for Payer: BCN Medicare Advantage |
$356.50
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$513.36
|
| Rate for Payer: Cofinity Commercial |
$477.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.50
|
| Rate for Payer: Mclaren Medicaid |
$235.15
|
| Rate for Payer: Meridian Medicaid |
$246.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$374.32
|
| Rate for Payer: PACE SWMI |
$356.50
|
| Rate for Payer: PHP Medicare Advantage |
$356.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.15
|
| Rate for Payer: Priority Health Medicare |
$356.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$559.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.50
|
| Rate for Payer: UHC Medicare Advantage |
$367.20
|
|
|
PR RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 27665
|
| Min. Negotiated Rate |
$275.20 |
| Max. Negotiated Rate |
$1,815.77 |
| Rate for Payer: Aetna Commercial |
$553.08
|
| Rate for Payer: Aetna Medicare |
$429.26
|
| Rate for Payer: BCBS Complete |
$288.96
|
| Rate for Payer: BCBS MAPPO |
$412.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.77
|
| Rate for Payer: BCN Commercial |
$619.16
|
| Rate for Payer: BCN Medicare Advantage |
$412.75
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$594.36
|
| Rate for Payer: Cofinity Commercial |
$553.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.75
|
| Rate for Payer: Mclaren Medicaid |
$275.20
|
| Rate for Payer: Meridian Medicaid |
$288.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.39
|
| Rate for Payer: PACE SWMI |
$412.75
|
| Rate for Payer: PHP Medicare Advantage |
$412.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.99
|
| Rate for Payer: Priority Health Medicare |
$412.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$646.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$412.75
|
| Rate for Payer: UHC Medicare Advantage |
$425.13
|
|
|
PR RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 27659
|
| Min. Negotiated Rate |
$305.66 |
| Max. Negotiated Rate |
$1,861.44 |
| Rate for Payer: Aetna Commercial |
$619.28
|
| Rate for Payer: Aetna Medicare |
$480.64
|
| Rate for Payer: BCBS Complete |
$320.94
|
| Rate for Payer: BCBS MAPPO |
$462.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,861.44
|
| Rate for Payer: BCN Commercial |
$689.52
|
| Rate for Payer: BCN Medicare Advantage |
$462.15
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cofinity Commercial |
$619.28
|
| Rate for Payer: Cofinity Commercial |
$665.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.15
|
| Rate for Payer: Mclaren Medicaid |
$305.66
|
| Rate for Payer: Meridian Medicaid |
$320.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$485.26
|
| Rate for Payer: PACE SWMI |
$462.15
|
| Rate for Payer: PHP Medicare Advantage |
$462.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Medicare |
$462.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$720.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.15
|
| Rate for Payer: UHC Medicare Advantage |
$476.01
|
|
|
PR RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$5,448.00
|
|
|
Service Code
|
HCPCS 46740
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$3,813.60 |
| Rate for Payer: Aetna Commercial |
$2,882.21
|
| Rate for Payer: Aetna Medicare |
$2,236.94
|
| Rate for Payer: BCBS Complete |
$1,457.98
|
| Rate for Payer: BCBS MAPPO |
$2,150.90
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$3,167.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,150.90
|
| Rate for Payer: Cash Price |
$4,358.40
|
| Rate for Payer: Cash Price |
$4,358.40
|
| Rate for Payer: Cofinity Commercial |
$3,097.30
|
| Rate for Payer: Cofinity Commercial |
$2,882.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,150.90
|
| Rate for Payer: Mclaren Medicaid |
$1,388.55
|
| Rate for Payer: Meridian Medicaid |
$1,457.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,258.44
|
| Rate for Payer: PACE SWMI |
$2,150.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,150.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,388.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,813.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,811.24
|
| Rate for Payer: Priority Health Medicare |
$2,150.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,811.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,150.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,150.90
|
| Rate for Payer: UHC Medicare Advantage |
$2,215.43
|
|
|
PR RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL
|
Professional
|
Both
|
$5,046.00
|
|
|
Service Code
|
HCPCS 46742
|
| Min. Negotiated Rate |
$477.58 |
| Max. Negotiated Rate |
$4,399.21 |
| Rate for Payer: Aetna Commercial |
$3,332.78
|
| Rate for Payer: Aetna Medicare |
$2,586.64
|
| Rate for Payer: BCBS Complete |
$1,682.52
|
| Rate for Payer: BCBS MAPPO |
$2,487.15
|
| Rate for Payer: BCBS Trust/PPO |
$477.58
|
| Rate for Payer: BCN Commercial |
$3,656.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,487.15
|
| Rate for Payer: Cash Price |
$4,036.80
|
| Rate for Payer: Cash Price |
$4,036.80
|
| Rate for Payer: Cofinity Commercial |
$3,581.50
|
| Rate for Payer: Cofinity Commercial |
$3,332.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,487.15
|
| Rate for Payer: Mclaren Medicaid |
$1,602.40
|
| Rate for Payer: Meridian Medicaid |
$1,682.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,611.51
|
| Rate for Payer: PACE SWMI |
$2,487.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,487.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,602.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,532.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,399.21
|
| Rate for Payer: Priority Health Medicare |
$2,487.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,399.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,487.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,487.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,561.76
|
|
|
PR RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR
|
Professional
|
Both
|
$3,803.00
|
|
|
Service Code
|
HCPCS 46730
|
| Min. Negotiated Rate |
$105.13 |
| Max. Negotiated Rate |
$3,495.49 |
| Rate for Payer: Aetna Commercial |
$2,640.86
|
| Rate for Payer: Aetna Medicare |
$2,049.62
|
| Rate for Payer: BCBS Complete |
$1,336.98
|
| Rate for Payer: BCBS MAPPO |
$1,970.79
|
| Rate for Payer: BCBS Trust/PPO |
$105.13
|
| Rate for Payer: BCN Commercial |
$2,905.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,970.79
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Cash Price |
$3,042.40
|
| Rate for Payer: Cofinity Commercial |
$2,837.94
|
| Rate for Payer: Cofinity Commercial |
$2,640.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,970.79
|
| Rate for Payer: Mclaren Medicaid |
$1,273.31
|
| Rate for Payer: Meridian Medicaid |
$1,336.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,069.33
|
| Rate for Payer: PACE SWMI |
$1,970.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,970.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,273.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,662.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,495.49
|
| Rate for Payer: Priority Health Medicare |
$1,970.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,495.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,970.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,970.79
|
| Rate for Payer: UHC Medicare Advantage |
$2,029.91
|
|
|
PR RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE
|
Professional
|
Both
|
$1,946.00
|
|
|
Service Code
|
HCPCS 54340
|
| Min. Negotiated Rate |
$364.02 |
| Max. Negotiated Rate |
$2,917.27 |
| Rate for Payer: Aetna Commercial |
$744.49
|
| Rate for Payer: Aetna Medicare |
$577.81
|
| Rate for Payer: BCBS Complete |
$382.22
|
| Rate for Payer: BCBS MAPPO |
$555.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,917.27
|
| Rate for Payer: BCN Commercial |
$822.94
|
| Rate for Payer: BCN Medicare Advantage |
$555.59
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cash Price |
$1,556.80
|
| Rate for Payer: Cofinity Commercial |
$800.05
|
| Rate for Payer: Cofinity Commercial |
$744.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.59
|
| Rate for Payer: Mclaren Medicaid |
$364.02
|
| Rate for Payer: Meridian Medicaid |
$382.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$583.37
|
| Rate for Payer: PACE SWMI |
$555.59
|
| Rate for Payer: PHP Medicare Advantage |
$555.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.96
|
| Rate for Payer: Priority Health Medicare |
$555.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$909.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$555.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$555.59
|
| Rate for Payer: UHC Medicare Advantage |
$572.26
|
|
|
PR RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR
|
Professional
|
Both
|
$7,400.00
|
|
|
Service Code
|
HCPCS 33660
|
| Min. Negotiated Rate |
$1,101.42 |
| Max. Negotiated Rate |
$5,180.00 |
| Rate for Payer: Aetna Commercial |
$2,315.96
|
| Rate for Payer: Aetna Medicare |
$1,797.46
|
| Rate for Payer: BCBS Complete |
$1,156.49
|
| Rate for Payer: BCBS MAPPO |
$1,728.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.09
|
| Rate for Payer: BCN Commercial |
$2,516.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,728.33
|
| Rate for Payer: Cash Price |
$5,920.00
|
| Rate for Payer: Cash Price |
$5,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,315.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,728.33
|
| Rate for Payer: Mclaren Medicaid |
$1,101.42
|
| Rate for Payer: Meridian Medicaid |
$1,156.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,814.75
|
| Rate for Payer: PACE SWMI |
$1,728.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,728.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,101.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,739.05
|
| Rate for Payer: Priority Health Medicare |
$1,728.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,739.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,728.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,728.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,780.18
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 49525
|
| Min. Negotiated Rate |
$369.34 |
| Max. Negotiated Rate |
$1,122.80 |
| Rate for Payer: Aetna Commercial |
$765.68
|
| Rate for Payer: Aetna Medicare |
$594.26
|
| Rate for Payer: BCBS Complete |
$387.81
|
| Rate for Payer: BCBS MAPPO |
$571.40
|
| Rate for Payer: BCBS Trust/PPO |
$515.62
|
| Rate for Payer: BCN Commercial |
$842.48
|
| Rate for Payer: BCN Medicare Advantage |
$571.40
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$822.82
|
| Rate for Payer: Cofinity Commercial |
$765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.40
|
| Rate for Payer: Mclaren Medicaid |
$369.34
|
| Rate for Payer: Meridian Medicaid |
$387.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$599.97
|
| Rate for Payer: PACE SWMI |
$571.40
|
| Rate for Payer: PHP Medicare Advantage |
$571.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,122.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.67
|
| Rate for Payer: Priority Health Medicare |
$571.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,013.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.40
|
| Rate for Payer: UHC Medicare Advantage |
$588.54
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
IP
|
$1,604.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$978.28 |
| Max. Negotiated Rate |
$1,443.60 |
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.57
|
| Rate for Payer: BCN Commercial |
$1,239.57
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,203.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,363.40
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,122.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,395.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$978.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,411.52
|
| Rate for Payer: UHC Core |
$1,339.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,203.00
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
OP
|
$1,604.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$380.95 |
| Max. Negotiated Rate |
$2,382.99 |
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: Aetna Medicare |
$417.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$501.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$501.25
|
| Rate for Payer: BCBS Complete |
$2,382.99
|
| Rate for Payer: BCBS MAPPO |
$401.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.11
|
| Rate for Payer: BCN Commercial |
$1,247.11
|
| Rate for Payer: BCN Medicare Advantage |
$401.00
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.00
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,203.00
|
| Rate for Payer: Mclaren Medicaid |
$2,269.51
|
| Rate for Payer: Meridian Medicaid |
$2,382.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,363.40
|
| Rate for Payer: PACE Senior Care Partners |
$380.95
|
| Rate for Payer: PACE SWMI |
$401.00
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| Rate for Payer: PHP Medicare Advantage |
$401.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,269.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,122.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,395.48
|
| Rate for Payer: Priority Health Medicare |
$401.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$978.28
|
| Rate for Payer: Railroad Medicare Medicare |
$401.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,411.52
|
| Rate for Payer: UHC Core |
$1,339.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.00
|
| Rate for Payer: UHC Medicare Advantage |
$413.03
|
| Rate for Payer: VA VA |
$401.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,203.00
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 49525
|
| Hospital Charge Code |
49525
|
| Min. Negotiated Rate |
$369.34 |
| Max. Negotiated Rate |
$1,122.80 |
| Rate for Payer: Aetna Commercial |
$765.68
|
| Rate for Payer: Aetna Medicare |
$594.26
|
| Rate for Payer: BCBS Complete |
$387.81
|
| Rate for Payer: BCBS MAPPO |
$571.40
|
| Rate for Payer: BCBS Trust/PPO |
$515.62
|
| Rate for Payer: BCN Commercial |
$842.48
|
| Rate for Payer: BCN Medicare Advantage |
$571.40
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$822.82
|
| Rate for Payer: Cofinity Commercial |
$765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.40
|
| Rate for Payer: Mclaren Medicaid |
$369.34
|
| Rate for Payer: Meridian Medicaid |
$387.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$599.97
|
| Rate for Payer: PACE SWMI |
$571.40
|
| Rate for Payer: PHP Medicare Advantage |
$571.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,122.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,013.67
|
| Rate for Payer: Priority Health Medicare |
$571.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,013.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.40
|
| Rate for Payer: UHC Medicare Advantage |
$588.54
|
|
|
PR RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 12046
|
| Min. Negotiated Rate |
$204.05 |
| Max. Negotiated Rate |
$1,305.00 |
| Rate for Payer: Aetna Commercial |
$418.05
|
| Rate for Payer: Aetna Medicare |
$324.46
|
| Rate for Payer: BCBS Complete |
$214.25
|
| Rate for Payer: BCBS MAPPO |
$311.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.00
|
| Rate for Payer: BCN Commercial |
$734.48
|
| Rate for Payer: BCN Medicare Advantage |
$311.98
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cofinity Commercial |
$418.05
|
| Rate for Payer: Cofinity Commercial |
$449.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.98
|
| Rate for Payer: Mclaren Medicaid |
$204.05
|
| Rate for Payer: Meridian Medicaid |
$214.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$327.58
|
| Rate for Payer: PACE SWMI |
$311.98
|
| Rate for Payer: PHP Medicare Advantage |
$311.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.08
|
| Rate for Payer: Priority Health Medicare |
$311.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.98
|
| Rate for Payer: UHC Medicare Advantage |
$321.34
|
|
|
PR RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 41250
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$1,744.97 |
| Rate for Payer: Aetna Commercial |
$201.40
|
| Rate for Payer: Aetna Medicare |
$156.31
|
| Rate for Payer: BCBS Complete |
$103.77
|
| Rate for Payer: BCBS MAPPO |
$150.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.97
|
| Rate for Payer: BCN Commercial |
$420.26
|
| Rate for Payer: BCN Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$216.43
|
| Rate for Payer: Cofinity Commercial |
$201.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.30
|
| Rate for Payer: Mclaren Medicaid |
$98.83
|
| Rate for Payer: Meridian Medicaid |
$103.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.82
|
| Rate for Payer: PACE SWMI |
$150.30
|
| Rate for Payer: PHP Medicare Advantage |
$150.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.06
|
| Rate for Payer: Priority Health Medicare |
$150.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.30
|
| Rate for Payer: UHC Medicare Advantage |
$154.81
|
|
|
PR RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 41252
|
| Min. Negotiated Rate |
$133.98 |
| Max. Negotiated Rate |
$744.10 |
| Rate for Payer: Aetna Commercial |
$275.66
|
| Rate for Payer: Aetna Medicare |
$213.95
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$205.72
|
| Rate for Payer: BCBS Trust/PPO |
$370.34
|
| Rate for Payer: BCN Commercial |
$484.76
|
| Rate for Payer: BCN Medicare Advantage |
$205.72
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cofinity Commercial |
$296.24
|
| Rate for Payer: Cofinity Commercial |
$275.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.72
|
| Rate for Payer: Mclaren Medicaid |
$133.98
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.01
|
| Rate for Payer: PACE SWMI |
$205.72
|
| Rate for Payer: PHP Medicare Advantage |
$205.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.24
|
| Rate for Payer: Priority Health Medicare |
$205.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$369.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.72
|
| Rate for Payer: UHC Medicare Advantage |
$211.89
|
|
