|
PR HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 99234
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$1,631.92 |
| Rate for Payer: Aetna Commercial |
$124.04
|
| Rate for Payer: Aetna Medicare |
$96.27
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$92.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.92
|
| Rate for Payer: BCN Commercial |
$142.69
|
| Rate for Payer: BCN Medicare Advantage |
$92.57
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$133.30
|
| Rate for Payer: Cofinity Commercial |
$124.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.57
|
| Rate for Payer: Mclaren Medicaid |
$61.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.20
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Nomi Health Commercial |
$111.08
|
| Rate for Payer: PACE SWMI |
$92.57
|
| Rate for Payer: PHP Medicare Advantage |
$92.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO |
$130.13
|
| Rate for Payer: Priority Health Medicare |
$93.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.57
|
| Rate for Payer: UHC Exchange |
$92.57
|
| Rate for Payer: UHC Medicare Advantage |
$92.57
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 99239
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$1,216.15 |
| Rate for Payer: Aetna Commercial |
$145.15
|
| Rate for Payer: Aetna Medicare |
$112.65
|
| Rate for Payer: BCBS Complete |
$76.49
|
| Rate for Payer: BCBS MAPPO |
$108.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,216.15
|
| Rate for Payer: BCN Commercial |
$165.66
|
| Rate for Payer: BCN Medicare Advantage |
$108.32
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$155.98
|
| Rate for Payer: Cofinity Commercial |
$145.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.32
|
| Rate for Payer: Mclaren Medicaid |
$72.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.74
|
| Rate for Payer: Meridian Medicaid |
$76.49
|
| Rate for Payer: Nomi Health Commercial |
$129.98
|
| Rate for Payer: PACE SWMI |
$108.32
|
| Rate for Payer: PHP Medicare Advantage |
$108.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$152.57
|
| Rate for Payer: Priority Health Medicare |
$109.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.32
|
| Rate for Payer: UHC Exchange |
$108.32
|
| Rate for Payer: UHC Medicare Advantage |
$108.32
|
| Rate for Payer: UHCCP Medicaid |
$72.85
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 99238
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$255.17 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare |
$79.72
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$76.65
|
| Rate for Payer: BCBS Trust/PPO |
$255.17
|
| Rate for Payer: BCN Commercial |
$116.79
|
| Rate for Payer: BCN Medicare Advantage |
$76.65
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$110.38
|
| Rate for Payer: Cofinity Commercial |
$102.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.65
|
| Rate for Payer: Mclaren Medicaid |
$51.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.48
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Nomi Health Commercial |
$91.98
|
| Rate for Payer: PACE SWMI |
$76.65
|
| Rate for Payer: PHP Medicare Advantage |
$76.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$108.14
|
| Rate for Payer: Priority Health Medicare |
$77.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.65
|
| Rate for Payer: UHC Exchange |
$76.65
|
| Rate for Payer: UHC Medicare Advantage |
$76.65
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
|
|
PR HO W/O JOINTS CF
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS L3919
|
| Min. Negotiated Rate |
$101.20 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: BCBS Complete |
$101.20
|
| Rate for Payer: BCN Commercial |
$234.03
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.45
|
|
|
PR HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 46258
|
| Min. Negotiated Rate |
$313.96 |
| Max. Negotiated Rate |
$1,432.75 |
| Rate for Payer: Aetna Commercial |
$625.39
|
| Rate for Payer: Aetna Medicare |
$485.38
|
| Rate for Payer: BCBS Complete |
$329.66
|
| Rate for Payer: BCBS MAPPO |
$466.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,432.75
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$466.71
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$672.06
|
| Rate for Payer: Cofinity Commercial |
$625.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.71
|
| Rate for Payer: Mclaren Medicaid |
$313.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.05
|
| Rate for Payer: Meridian Medicaid |
$329.66
|
| Rate for Payer: Nomi Health Commercial |
$560.05
|
| Rate for Payer: PACE SWMI |
$466.71
|
| Rate for Payer: PHP Medicare Advantage |
$466.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO |
$872.82
|
| Rate for Payer: Priority Health Medicare |
$471.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.71
|
| Rate for Payer: UHC Exchange |
$466.71
|
| Rate for Payer: UHC Medicare Advantage |
$466.71
|
| Rate for Payer: UHCCP Medicaid |
$313.96
|
|
|
PR HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 46262
|
| Min. Negotiated Rate |
$236.15 |
| Max. Negotiated Rate |
$1,153.75 |
| Rate for Payer: Aetna Commercial |
$761.05
|
| Rate for Payer: Aetna Medicare |
$590.67
|
| Rate for Payer: BCBS Complete |
$400.78
|
| Rate for Payer: BCBS MAPPO |
$567.95
|
| Rate for Payer: BCBS Trust/PPO |
$236.15
|
| Rate for Payer: BCN Commercial |
$862.52
|
| Rate for Payer: BCN Medicare Advantage |
$567.95
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cofinity Commercial |
$817.85
|
| Rate for Payer: Cofinity Commercial |
$761.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.95
|
| Rate for Payer: Mclaren Medicaid |
$381.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$596.35
|
| Rate for Payer: Meridian Medicaid |
$400.78
|
| Rate for Payer: Nomi Health Commercial |
$681.54
|
| Rate for Payer: PACE SWMI |
$567.95
|
| Rate for Payer: PHP Medicare Advantage |
$567.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,057.77
|
| Rate for Payer: Priority Health Medicare |
$573.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,057.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$567.95
|
| Rate for Payer: UHC Exchange |
$567.95
|
| Rate for Payer: UHC Medicare Advantage |
$567.95
|
| Rate for Payer: UHCCP Medicaid |
$381.70
|
|
|
PR HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU
|
Professional
|
Both
|
$1,732.00
|
|
|
Service Code
|
HCPCS 46261
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$1,125.80 |
| Rate for Payer: Aetna Commercial |
$686.08
|
| Rate for Payer: Aetna Medicare |
$532.48
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS MAPPO |
$512.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$512.00
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cofinity Commercial |
$737.28
|
| Rate for Payer: Cofinity Commercial |
$686.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.00
|
| Rate for Payer: Mclaren Medicaid |
$345.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.60
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Nomi Health Commercial |
$614.40
|
| Rate for Payer: PACE SWMI |
$512.00
|
| Rate for Payer: PHP Medicare Advantage |
$512.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.80
|
| Rate for Payer: Priority Health HMO/PPO |
$961.11
|
| Rate for Payer: Priority Health Medicare |
$517.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$961.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.00
|
| Rate for Payer: UHC Exchange |
$512.00
|
| Rate for Payer: UHC Medicare Advantage |
$512.00
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
|
|
PR HYALGAN SUPARTZ VISCO-3 DOSE
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS J7321
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$196.95 |
| Rate for Payer: Aetna Commercial |
$98.34
|
| Rate for Payer: Aetna Medicare |
$76.32
|
| Rate for Payer: BCBS Complete |
$121.20
|
| Rate for Payer: BCBS MAPPO |
$73.39
|
| Rate for Payer: BCBS Trust/PPO |
$64.00
|
| Rate for Payer: BCN Commercial |
$76.58
|
| Rate for Payer: BCN Medicare Advantage |
$73.39
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$98.34
|
| Rate for Payer: Cofinity Commercial |
$105.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.06
|
| Rate for Payer: Nomi Health Commercial |
$88.06
|
| Rate for Payer: PACE SWMI |
$73.39
|
| Rate for Payer: PHP Medicare Advantage |
$73.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health Medicare |
$74.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.39
|
| Rate for Payer: UHC Exchange |
$73.39
|
| Rate for Payer: UHC Medicare Advantage |
$73.39
|
|
|
PR HYDROCORTISONE SODIUM SUCC I
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1720
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$30.53 |
| Rate for Payer: Aetna Commercial |
$28.41
|
| Rate for Payer: Aetna Medicare |
$22.05
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.18
|
| Rate for Payer: BCN Commercial |
$16.11
|
| Rate for Payer: BCN Medicare Advantage |
$21.20
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$30.53
|
| Rate for Payer: Cofinity Commercial |
$28.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.26
|
| Rate for Payer: Nomi Health Commercial |
$25.44
|
| Rate for Payer: PACE SWMI |
$21.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$21.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.20
|
| Rate for Payer: UHC Exchange |
$21.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.20
|
|
|
PR HYDROMORPHONE INJECTION
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J1170
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna Commercial |
$4.73
|
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.40
|
| Rate for Payer: BCN Commercial |
$0.24
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR HYDROXYPROGESTERONE CAPROATE
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS J1725
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
|
|
PR HYDROXYZINE HCL INJECTION
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS J3410
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$24.38 |
| Rate for Payer: Aetna Commercial |
$22.68
|
| Rate for Payer: Aetna Medicare |
$17.61
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$16.93
|
| Rate for Payer: BCBS Trust/PPO |
$5.95
|
| Rate for Payer: BCN Commercial |
$7.98
|
| Rate for Payer: BCN Medicare Advantage |
$16.93
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$24.38
|
| Rate for Payer: Cofinity Commercial |
$22.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.77
|
| Rate for Payer: Nomi Health Commercial |
$20.31
|
| Rate for Payer: PACE SWMI |
$16.93
|
| Rate for Payer: PHP Medicare Advantage |
$16.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$17.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.93
|
| Rate for Payer: UHC Exchange |
$16.93
|
| Rate for Payer: UHC Medicare Advantage |
$16.93
|
|
|
PR HYMENOTOMY SIMPLE INCISION
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 56442
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$2,246.86 |
| Rate for Payer: Aetna Commercial |
$61.36
|
| Rate for Payer: Aetna Medicare |
$47.62
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$45.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,246.86
|
| Rate for Payer: BCN Commercial |
$69.39
|
| Rate for Payer: BCN Medicare Advantage |
$45.79
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$65.94
|
| Rate for Payer: Cofinity Commercial |
$61.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.79
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.08
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Nomi Health Commercial |
$54.95
|
| Rate for Payer: PACE SWMI |
$45.79
|
| Rate for Payer: PHP Medicare Advantage |
$45.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
| Rate for Payer: Priority Health HMO/PPO |
$70.93
|
| Rate for Payer: Priority Health Medicare |
$46.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.79
|
| Rate for Payer: UHC Exchange |
$45.79
|
| Rate for Payer: UHC Medicare Advantage |
$45.79
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
|
|
PR HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL
|
Professional
|
Both
|
$8,489.00
|
|
|
Service Code
|
HCPCS 61548
|
| Min. Negotiated Rate |
$712.15 |
| Max. Negotiated Rate |
$5,517.85 |
| Rate for Payer: Aetna Commercial |
$2,068.64
|
| Rate for Payer: Aetna Medicare |
$1,605.51
|
| Rate for Payer: BCBS Complete |
$1,068.83
|
| Rate for Payer: BCBS MAPPO |
$1,543.76
|
| Rate for Payer: BCBS Trust/PPO |
$712.15
|
| Rate for Payer: BCN Commercial |
$3,198.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,543.76
|
| Rate for Payer: Cash Price |
$6,791.20
|
| Rate for Payer: Cash Price |
$6,791.20
|
| Rate for Payer: Cofinity Commercial |
$2,223.01
|
| Rate for Payer: Cofinity Commercial |
$2,068.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,543.76
|
| Rate for Payer: Mclaren Medicaid |
$1,017.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,620.95
|
| Rate for Payer: Meridian Medicaid |
$1,068.83
|
| Rate for Payer: Nomi Health Commercial |
$1,852.51
|
| Rate for Payer: PACE SWMI |
$1,543.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,543.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,517.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,708.79
|
| Rate for Payer: Priority Health Medicare |
$1,559.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,708.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,543.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,543.76
|
| Rate for Payer: UHC Exchange |
$1,543.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,543.76
|
| Rate for Payer: UHCCP Medicaid |
$1,017.93
|
|
|
PR HYSTERORRHAPHY RUPTURED UTERUS
|
Professional
|
Both
|
$1,312.00
|
|
|
Service Code
|
HCPCS 59350
|
| Min. Negotiated Rate |
$177.64 |
| Max. Negotiated Rate |
$852.80 |
| Rate for Payer: Aetna Commercial |
$365.40
|
| Rate for Payer: Aetna Medicare |
$283.60
|
| Rate for Payer: BCBS Complete |
$186.52
|
| Rate for Payer: BCBS MAPPO |
$272.69
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$407.56
|
| Rate for Payer: BCN Medicare Advantage |
$272.69
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cash Price |
$1,049.60
|
| Rate for Payer: Cofinity Commercial |
$392.67
|
| Rate for Payer: Cofinity Commercial |
$365.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.69
|
| Rate for Payer: Mclaren Medicaid |
$177.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.32
|
| Rate for Payer: Meridian Medicaid |
$186.52
|
| Rate for Payer: Nomi Health Commercial |
$327.23
|
| Rate for Payer: PACE SWMI |
$272.69
|
| Rate for Payer: PHP Medicare Advantage |
$272.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.80
|
| Rate for Payer: Priority Health HMO/PPO |
$389.37
|
| Rate for Payer: Priority Health Medicare |
$275.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.69
|
| Rate for Payer: UHC Exchange |
$272.69
|
| Rate for Payer: UHC Medicare Advantage |
$272.69
|
| Rate for Payer: UHCCP Medicaid |
$177.64
|
|
|
PR HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS
|
Professional
|
Both
|
$3,366.00
|
|
|
Service Code
|
HCPCS 58565
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$2,480.04 |
| Rate for Payer: Aetna Commercial |
$584.60
|
| Rate for Payer: Aetna Medicare |
$453.72
|
| Rate for Payer: BCBS Complete |
$1,346.40
|
| Rate for Payer: BCBS MAPPO |
$436.27
|
| Rate for Payer: BCBS Trust/PPO |
$3.00
|
| Rate for Payer: BCN Commercial |
$2,480.04
|
| Rate for Payer: BCN Medicare Advantage |
$436.27
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cash Price |
$2,692.80
|
| Rate for Payer: Cofinity Commercial |
$628.23
|
| Rate for Payer: Cofinity Commercial |
$584.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.08
|
| Rate for Payer: Nomi Health Commercial |
$523.52
|
| Rate for Payer: PACE SWMI |
$436.27
|
| Rate for Payer: PHP Medicare Advantage |
$436.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,187.90
|
| Rate for Payer: Priority Health HMO/PPO |
$686.53
|
| Rate for Payer: Priority Health Medicare |
$440.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.27
|
| Rate for Payer: UHC Exchange |
$436.27
|
| Rate for Payer: UHC Medicare Advantage |
$436.27
|
|
|
PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C
|
Facility
|
IP
|
$1,371.00
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
58558
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$891.15 |
| Max. Negotiated Rate |
$1,233.90 |
| Rate for Payer: Aetna Commercial |
$1,165.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,119.15
|
| Rate for Payer: BCN Commercial |
$1,059.51
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,179.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Healthscope Commercial |
$1,233.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,028.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: Nomi Health Commercial |
$1,124.22
|
| Rate for Payer: PHP Commercial |
$1,165.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,192.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$918.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,206.48
|
| Rate for Payer: UHC Core |
$1,144.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,028.25
|
|
|
PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 58558
|
| Min. Negotiated Rate |
$147.82 |
| Max. Negotiated Rate |
$1,979.15 |
| Rate for Payer: Aetna Commercial |
$298.19
|
| Rate for Payer: Aetna Medicare |
$231.43
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCBS MAPPO |
$222.53
|
| Rate for Payer: BCBS Trust/PPO |
$650.87
|
| Rate for Payer: BCN Commercial |
$1,979.15
|
| Rate for Payer: BCN Medicare Advantage |
$222.53
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$298.19
|
| Rate for Payer: Cofinity Commercial |
$320.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.53
|
| Rate for Payer: Mclaren Medicaid |
$147.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.66
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Nomi Health Commercial |
$267.04
|
| Rate for Payer: PACE SWMI |
$222.53
|
| Rate for Payer: PHP Medicare Advantage |
$222.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health HMO/PPO |
$343.27
|
| Rate for Payer: Priority Health Medicare |
$224.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.53
|
| Rate for Payer: UHC Exchange |
$222.53
|
| Rate for Payer: UHC Medicare Advantage |
$222.53
|
| Rate for Payer: UHCCP Medicaid |
$147.82
|
|
|
PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C
|
Facility
|
OP
|
$1,371.00
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
58558
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$325.61 |
| Max. Negotiated Rate |
$2,365.09 |
| Rate for Payer: Aetna Commercial |
$1,165.35
|
| Rate for Payer: Aetna Medicare |
$356.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$428.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$428.44
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$342.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.10
|
| Rate for Payer: BCN Commercial |
$1,065.95
|
| Rate for Payer: BCN Medicare Advantage |
$342.75
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,179.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.75
|
| Rate for Payer: Healthscope Commercial |
$1,233.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,028.25
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.89
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$394.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: Nomi Health Commercial |
$1,124.22
|
| Rate for Payer: PACE Senior Care Partners |
$325.61
|
| Rate for Payer: PACE SWMI |
$342.75
|
| Rate for Payer: PHP Commercial |
$1,165.35
|
| Rate for Payer: PHP Medicare Advantage |
$342.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,192.77
|
| Rate for Payer: Priority Health Medicare |
$346.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$918.57
|
| Rate for Payer: Railroad Medicare Medicare |
$342.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,206.48
|
| Rate for Payer: UHC Core |
$1,144.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.75
|
| Rate for Payer: UHC Exchange |
$342.75
|
| Rate for Payer: UHC Medicare Advantage |
$342.75
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$342.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,028.25
|
|
|
PR HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 58558
|
| Hospital Charge Code |
58558
|
| Min. Negotiated Rate |
$147.82 |
| Max. Negotiated Rate |
$1,979.15 |
| Rate for Payer: Aetna Commercial |
$298.19
|
| Rate for Payer: Aetna Medicare |
$231.43
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCBS MAPPO |
$222.53
|
| Rate for Payer: BCBS Trust/PPO |
$650.87
|
| Rate for Payer: BCN Commercial |
$1,979.15
|
| Rate for Payer: BCN Medicare Advantage |
$222.53
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$320.44
|
| Rate for Payer: Cofinity Commercial |
$298.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.53
|
| Rate for Payer: Mclaren Medicaid |
$147.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.66
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Nomi Health Commercial |
$267.04
|
| Rate for Payer: PACE SWMI |
$222.53
|
| Rate for Payer: PHP Medicare Advantage |
$222.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health HMO/PPO |
$343.27
|
| Rate for Payer: Priority Health Medicare |
$224.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.53
|
| Rate for Payer: UHC Exchange |
$222.53
|
| Rate for Payer: UHC Medicare Advantage |
$222.53
|
| Rate for Payer: UHCCP Medicaid |
$147.82
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 58555
|
| Hospital Charge Code |
58555
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$1,037.58 |
| Rate for Payer: Aetna Commercial |
$196.02
|
| Rate for Payer: Aetna Medicare |
$152.13
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$146.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.58
|
| Rate for Payer: BCN Commercial |
$536.08
|
| Rate for Payer: BCN Medicare Advantage |
$146.28
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$210.64
|
| Rate for Payer: Cofinity Commercial |
$196.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.28
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.59
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Nomi Health Commercial |
$175.54
|
| Rate for Payer: PACE SWMI |
$146.28
|
| Rate for Payer: PHP Medicare Advantage |
$146.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO |
$224.71
|
| Rate for Payer: Priority Health Medicare |
$147.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.28
|
| Rate for Payer: UHC Exchange |
$146.28
|
| Rate for Payer: UHC Medicare Advantage |
$146.28
|
| Rate for Payer: UHCCP Medicaid |
$97.34
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Facility
|
IP
|
$813.00
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
58555
|
| Min. Negotiated Rate |
$528.45 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: BCBS Trust/PPO |
$663.65
|
| Rate for Payer: BCN Commercial |
$628.29
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.40
|
| Rate for Payer: Healthscope Commercial |
$731.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$609.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.05
|
| Rate for Payer: Nomi Health Commercial |
$666.66
|
| Rate for Payer: PHP Commercial |
$691.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO |
$707.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$544.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.44
|
| Rate for Payer: UHC Core |
$678.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$609.75
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 58555
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$1,037.58 |
| Rate for Payer: Aetna Commercial |
$196.02
|
| Rate for Payer: Aetna Medicare |
$152.13
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$146.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.58
|
| Rate for Payer: BCN Commercial |
$536.08
|
| Rate for Payer: BCN Medicare Advantage |
$146.28
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$210.64
|
| Rate for Payer: Cofinity Commercial |
$196.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.28
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.59
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Nomi Health Commercial |
$175.54
|
| Rate for Payer: PACE SWMI |
$146.28
|
| Rate for Payer: PHP Medicare Advantage |
$146.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO |
$224.71
|
| Rate for Payer: Priority Health Medicare |
$147.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.28
|
| Rate for Payer: UHC Exchange |
$146.28
|
| Rate for Payer: UHC Medicare Advantage |
$146.28
|
| Rate for Payer: UHCCP Medicaid |
$97.34
|
|
|
PR HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE
|
Facility
|
OP
|
$813.00
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
58555
|
| Min. Negotiated Rate |
$193.09 |
| Max. Negotiated Rate |
$2,365.09 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: Aetna Medicare |
$211.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254.06
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$203.25
|
| Rate for Payer: BCBS Trust/PPO |
$668.37
|
| Rate for Payer: BCN Commercial |
$632.11
|
| Rate for Payer: BCN Medicare Advantage |
$203.25
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.25
|
| Rate for Payer: Healthscope Commercial |
$731.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$609.75
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.41
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.05
|
| Rate for Payer: Nomi Health Commercial |
$666.66
|
| Rate for Payer: PACE Senior Care Partners |
$193.09
|
| Rate for Payer: PACE SWMI |
$203.25
|
| Rate for Payer: PHP Commercial |
$691.05
|
| Rate for Payer: PHP Medicare Advantage |
$203.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$528.45
|
| Rate for Payer: Priority Health HMO/PPO |
$707.31
|
| Rate for Payer: Priority Health Medicare |
$205.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$544.71
|
| Rate for Payer: Railroad Medicare Medicare |
$203.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.44
|
| Rate for Payer: UHC Core |
$678.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.25
|
| Rate for Payer: UHC Exchange |
$203.25
|
| Rate for Payer: UHC Medicare Advantage |
$203.25
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$203.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$609.75
|
|
|
PR HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 58560
|
| Min. Negotiated Rate |
$29.58 |
| Max. Negotiated Rate |
$1,087.45 |
| Rate for Payer: Aetna Commercial |
$402.40
|
| Rate for Payer: Aetna Medicare |
$312.31
|
| Rate for Payer: BCBS Complete |
$209.12
|
| Rate for Payer: BCBS MAPPO |
$300.30
|
| Rate for Payer: BCBS Trust/PPO |
$29.58
|
| Rate for Payer: BCN Commercial |
$454.47
|
| Rate for Payer: BCN Medicare Advantage |
$300.30
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cofinity Commercial |
$432.43
|
| Rate for Payer: Cofinity Commercial |
$402.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.30
|
| Rate for Payer: Mclaren Medicaid |
$199.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.32
|
| Rate for Payer: Meridian Medicaid |
$209.12
|
| Rate for Payer: Nomi Health Commercial |
$360.36
|
| Rate for Payer: PACE SWMI |
$300.30
|
| Rate for Payer: PHP Medicare Advantage |
$300.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health HMO/PPO |
$463.81
|
| Rate for Payer: Priority Health Medicare |
$303.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.30
|
| Rate for Payer: UHC Exchange |
$300.30
|
| Rate for Payer: UHC Medicare Advantage |
$300.30
|
| Rate for Payer: UHCCP Medicaid |
$199.16
|
|
