|
PR SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 99050
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$608.60 |
| Rate for Payer: Aetna Commercial |
$23.50
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$608.60
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.25
|
|
|
PR SESAMOIDECTOMY FIRST TOE SPX
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 28315
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$1,893.96 |
| Rate for Payer: Aetna Commercial |
$427.37
|
| Rate for Payer: Aetna Medicare |
$331.69
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$318.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.96
|
| Rate for Payer: BCN Commercial |
$697.34
|
| Rate for Payer: BCN Medicare Advantage |
$318.93
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$427.37
|
| Rate for Payer: Cofinity Commercial |
$459.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.93
|
| Rate for Payer: Mclaren Medicaid |
$210.23
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.88
|
| Rate for Payer: PACE SWMI |
$318.93
|
| Rate for Payer: PHP Medicare Advantage |
$318.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.88
|
| Rate for Payer: Priority Health Medicare |
$318.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$497.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.93
|
| Rate for Payer: UHC Medicare Advantage |
$328.50
|
|
|
PR SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 26185
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$1,152.90 |
| Rate for Payer: Aetna Commercial |
$735.27
|
| Rate for Payer: Aetna Medicare |
$570.66
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS MAPPO |
$548.71
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$825.87
|
| Rate for Payer: BCN Medicare Advantage |
$548.71
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cofinity Commercial |
$735.27
|
| Rate for Payer: Cofinity Commercial |
$790.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.71
|
| Rate for Payer: Mclaren Medicaid |
$364.87
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$576.15
|
| Rate for Payer: PACE SWMI |
$548.71
|
| Rate for Payer: PHP Medicare Advantage |
$548.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,152.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.99
|
| Rate for Payer: Priority Health Medicare |
$548.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.71
|
| Rate for Payer: UHC Medicare Advantage |
$565.17
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$637.00
|
|
|
Service Code
|
HCPCS 45335
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$445.90 |
| Rate for Payer: Aetna Commercial |
$86.75
|
| Rate for Payer: Aetna Medicare |
$67.33
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$64.74
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$430.03
|
| Rate for Payer: BCN Medicare Advantage |
$64.74
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$93.23
|
| Rate for Payer: Cofinity Commercial |
$86.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.74
|
| Rate for Payer: Mclaren Medicaid |
$42.39
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.98
|
| Rate for Payer: PACE SWMI |
$64.74
|
| Rate for Payer: PHP Medicare Advantage |
$64.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.83
|
| Rate for Payer: Priority Health Medicare |
$64.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.74
|
| Rate for Payer: UHC Medicare Advantage |
$66.68
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
IP
|
$637.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$388.51 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Aetna Commercial |
$541.45
|
| Rate for Payer: BCBS Trust/PPO |
$492.27
|
| Rate for Payer: BCN Commercial |
$492.27
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$547.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.60
|
| Rate for Payer: Healthscope Commercial |
$573.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.45
|
| Rate for Payer: PHP Commercial |
$541.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.56
|
| Rate for Payer: UHC Core |
$531.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.75
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Professional
|
Both
|
$637.00
|
|
|
Service Code
|
HCPCS 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$445.90 |
| Rate for Payer: Aetna Commercial |
$86.75
|
| Rate for Payer: Aetna Medicare |
$67.33
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$64.74
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$430.03
|
| Rate for Payer: BCN Medicare Advantage |
$64.74
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$86.75
|
| Rate for Payer: Cofinity Commercial |
$93.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.74
|
| Rate for Payer: Mclaren Medicaid |
$42.39
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.98
|
| Rate for Payer: PACE SWMI |
$64.74
|
| Rate for Payer: PHP Medicare Advantage |
$64.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.83
|
| Rate for Payer: Priority Health Medicare |
$64.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.74
|
| Rate for Payer: UHC Medicare Advantage |
$66.68
|
|
|
PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST
|
Facility
|
OP
|
$637.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
45335
|
| Min. Negotiated Rate |
$151.29 |
| Max. Negotiated Rate |
$629.53 |
| Rate for Payer: Aetna Commercial |
$541.45
|
| Rate for Payer: Aetna Medicare |
$165.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$199.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$199.06
|
| Rate for Payer: BCBS Complete |
$629.53
|
| Rate for Payer: BCBS MAPPO |
$159.25
|
| Rate for Payer: BCBS Trust/PPO |
$495.27
|
| Rate for Payer: BCN Commercial |
$495.27
|
| Rate for Payer: BCN Medicare Advantage |
$159.25
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$547.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.25
|
| Rate for Payer: Healthscope Commercial |
$573.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.75
|
| Rate for Payer: Mclaren Medicaid |
$599.55
|
| Rate for Payer: Meridian Medicaid |
$629.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.45
|
| Rate for Payer: PACE Senior Care Partners |
$151.29
|
| Rate for Payer: PACE SWMI |
$159.25
|
| Rate for Payer: PHP Commercial |
$541.45
|
| Rate for Payer: PHP Medicare Advantage |
$159.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.19
|
| Rate for Payer: Priority Health Medicare |
$159.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.51
|
| Rate for Payer: Railroad Medicare Medicare |
$159.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.56
|
| Rate for Payer: UHC Core |
$531.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.25
|
| Rate for Payer: UHC Medicare Advantage |
$164.03
|
| Rate for Payer: VA VA |
$159.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.75
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$515.20 |
| Rate for Payer: Aetna Commercial |
$156.26
|
| Rate for Payer: Aetna Medicare |
$121.27
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$116.61
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$116.61
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$167.92
|
| Rate for Payer: Cofinity Commercial |
$156.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.61
|
| Rate for Payer: Mclaren Medicaid |
$75.83
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.44
|
| Rate for Payer: PACE SWMI |
$116.61
|
| Rate for Payer: PHP Medicare Advantage |
$116.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.55
|
| Rate for Payer: Priority Health Medicare |
$116.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.61
|
| Rate for Payer: UHC Medicare Advantage |
$120.11
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 45338
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$515.20 |
| Rate for Payer: Aetna Commercial |
$156.26
|
| Rate for Payer: Aetna Medicare |
$121.27
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$116.61
|
| Rate for Payer: BCBS Trust/PPO |
$76.08
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$116.61
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$167.92
|
| Rate for Payer: Cofinity Commercial |
$156.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.61
|
| Rate for Payer: Mclaren Medicaid |
$75.83
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.44
|
| Rate for Payer: PACE SWMI |
$116.61
|
| Rate for Payer: PHP Medicare Advantage |
$116.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.55
|
| Rate for Payer: Priority Health Medicare |
$116.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.61
|
| Rate for Payer: UHC Medicare Advantage |
$120.11
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$448.89 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: BCBS Trust/PPO |
$568.78
|
| Rate for Payer: BCN Commercial |
$568.78
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.60
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.68
|
| Rate for Payer: UHC Core |
$614.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.00
|
|
|
PR SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
45338
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$812.82 |
| Rate for Payer: Aetna Commercial |
$625.60
|
| Rate for Payer: Aetna Medicare |
$191.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.00
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$184.00
|
| Rate for Payer: BCBS Trust/PPO |
$572.24
|
| Rate for Payer: BCN Commercial |
$572.24
|
| Rate for Payer: BCN Medicare Advantage |
$184.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$632.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.00
|
| Rate for Payer: Healthscope Commercial |
$662.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.00
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$193.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.60
|
| Rate for Payer: PACE Senior Care Partners |
$174.80
|
| Rate for Payer: PACE SWMI |
$184.00
|
| Rate for Payer: PHP Commercial |
$625.60
|
| Rate for Payer: PHP Medicare Advantage |
$184.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.32
|
| Rate for Payer: Priority Health Medicare |
$184.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.89
|
| Rate for Payer: Railroad Medicare Medicare |
$184.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.68
|
| Rate for Payer: UHC Core |
$614.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.00
|
| Rate for Payer: UHC Medicare Advantage |
$189.52
|
| Rate for Payer: VA VA |
$184.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.00
|
|
|
PR SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE
|
Professional
|
Both
|
$594.00
|
|
|
Service Code
|
HCPCS 45337
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$415.80 |
| Rate for Payer: Aetna Commercial |
$149.50
|
| Rate for Payer: Aetna Medicare |
$116.03
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS MAPPO |
$111.57
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$111.57
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cofinity Commercial |
$160.66
|
| Rate for Payer: Cofinity Commercial |
$149.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.57
|
| Rate for Payer: Mclaren Medicaid |
$71.99
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$117.15
|
| Rate for Payer: PACE SWMI |
$111.57
|
| Rate for Payer: PHP Medicare Advantage |
$111.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.56
|
| Rate for Payer: Priority Health Medicare |
$111.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.57
|
| Rate for Payer: UHC Medicare Advantage |
$114.92
|
|
|
PR SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 45349
|
| Min. Negotiated Rate |
$124.39 |
| Max. Negotiated Rate |
$380.90 |
| Rate for Payer: Aetna Commercial |
$258.14
|
| Rate for Payer: Aetna Medicare |
$200.35
|
| Rate for Payer: BCBS Complete |
$130.61
|
| Rate for Payer: BCBS MAPPO |
$192.64
|
| Rate for Payer: BCBS Trust/PPO |
$380.90
|
| Rate for Payer: BCN Commercial |
$284.41
|
| Rate for Payer: BCN Medicare Advantage |
$192.64
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$277.40
|
| Rate for Payer: Cofinity Commercial |
$258.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.64
|
| Rate for Payer: Mclaren Medicaid |
$124.39
|
| Rate for Payer: Meridian Medicaid |
$130.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.27
|
| Rate for Payer: PACE SWMI |
$192.64
|
| Rate for Payer: PHP Medicare Advantage |
$192.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$342.19
|
| Rate for Payer: Priority Health Medicare |
$192.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.64
|
| Rate for Payer: UHC Medicare Advantage |
$198.42
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 11310
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$137.83 |
| Rate for Payer: Aetna Commercial |
$60.25
|
| Rate for Payer: Aetna Medicare |
$46.76
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.96
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$137.83
|
| Rate for Payer: BCN Medicare Advantage |
$44.96
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$64.74
|
| Rate for Payer: Cofinity Commercial |
$60.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.96
|
| Rate for Payer: Mclaren Medicaid |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.21
|
| Rate for Payer: PACE SWMI |
$44.96
|
| Rate for Payer: PHP Medicare Advantage |
$44.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
| Rate for Payer: Priority Health Medicare |
$44.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.96
|
| Rate for Payer: UHC Medicare Advantage |
$46.31
|
|
|
PR SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 11313
|
| Min. Negotiated Rate |
$60.71 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$125.28
|
| Rate for Payer: Aetna Medicare |
$97.23
|
| Rate for Payer: BCBS Complete |
$63.75
|
| Rate for Payer: BCBS MAPPO |
$93.49
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$214.00
|
| Rate for Payer: BCN Medicare Advantage |
$93.49
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$125.28
|
| Rate for Payer: Cofinity Commercial |
$134.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.49
|
| Rate for Payer: Mclaren Medicaid |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$63.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.16
|
| Rate for Payer: PACE SWMI |
$93.49
|
| Rate for Payer: PHP Medicare Advantage |
$93.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.32
|
| Rate for Payer: Priority Health Medicare |
$93.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.49
|
| Rate for Payer: UHC Medicare Advantage |
$96.29
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 11305
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$49.67
|
| Rate for Payer: Aetna Medicare |
$38.55
|
| Rate for Payer: BCBS Complete |
$24.82
|
| Rate for Payer: BCBS MAPPO |
$37.07
|
| Rate for Payer: BCBS Trust/PPO |
$450.00
|
| Rate for Payer: BCN Commercial |
$124.87
|
| Rate for Payer: BCN Medicare Advantage |
$37.07
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$49.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.07
|
| Rate for Payer: Mclaren Medicaid |
$23.64
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.92
|
| Rate for Payer: PACE SWMI |
$37.07
|
| Rate for Payer: PHP Medicare Advantage |
$37.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.62
|
| Rate for Payer: Priority Health Medicare |
$37.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.07
|
| Rate for Payer: UHC Medicare Advantage |
$38.18
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 11306
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$145.29 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$50.47
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$48.53
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$145.29
|
| Rate for Payer: BCN Medicare Advantage |
$48.53
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$69.88
|
| Rate for Payer: Cofinity Commercial |
$65.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.53
|
| Rate for Payer: Mclaren Medicaid |
$30.89
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.96
|
| Rate for Payer: PACE SWMI |
$48.53
|
| Rate for Payer: PHP Medicare Advantage |
$48.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.02
|
| Rate for Payer: Priority Health Medicare |
$48.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.53
|
| Rate for Payer: UHC Medicare Advantage |
$49.99
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 11307
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$2,827.44 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna Medicare |
$64.18
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: BCBS MAPPO |
$61.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
| Rate for Payer: BCN Commercial |
$164.53
|
| Rate for Payer: BCN Medicare Advantage |
$61.71
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$88.86
|
| Rate for Payer: Cofinity Commercial |
$82.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.71
|
| Rate for Payer: Mclaren Medicaid |
$39.41
|
| Rate for Payer: Meridian Medicaid |
$41.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.80
|
| Rate for Payer: PACE SWMI |
$61.71
|
| Rate for Payer: PHP Medicare Advantage |
$61.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.45
|
| Rate for Payer: Priority Health Medicare |
$61.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.71
|
| Rate for Payer: UHC Medicare Advantage |
$63.56
|
|
|
PR SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 11308
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$92.43
|
| Rate for Payer: Aetna Medicare |
$71.74
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$68.98
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$173.16
|
| Rate for Payer: BCN Medicare Advantage |
$68.98
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$92.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.98
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.43
|
| Rate for Payer: PACE SWMI |
$68.98
|
| Rate for Payer: PHP Medicare Advantage |
$68.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.09
|
| Rate for Payer: Priority Health Medicare |
$68.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.98
|
| Rate for Payer: UHC Medicare Advantage |
$71.05
|
|
|
PR SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 11300
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$44.73
|
| Rate for Payer: Aetna Medicare |
$34.72
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$33.38
|
| Rate for Payer: BCBS Trust/PPO |
$285.00
|
| Rate for Payer: BCN Commercial |
$119.76
|
| Rate for Payer: BCN Medicare Advantage |
$33.38
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$44.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.38
|
| Rate for Payer: Mclaren Medicaid |
$21.51
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.05
|
| Rate for Payer: PACE SWMI |
$33.38
|
| Rate for Payer: PHP Medicare Advantage |
$33.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.52
|
| Rate for Payer: Priority Health Medicare |
$33.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.38
|
| Rate for Payer: UHC Medicare Advantage |
$34.38
|
|
|
PR SHOE LIFTS ELEVATION HEEL /I
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS L3334
|
| Min. Negotiated Rate |
$22.97 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCN Commercial |
$36.21
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
|
|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,184.00
|
|
|
Service Code
|
HCPCS 26477
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$974.84 |
| Rate for Payer: Aetna Commercial |
$818.47
|
| Rate for Payer: Aetna Medicare |
$635.23
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS MAPPO |
$610.80
|
| Rate for Payer: BCBS Trust/PPO |
$974.19
|
| Rate for Payer: BCN Commercial |
$932.88
|
| Rate for Payer: BCN Medicare Advantage |
$610.80
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cofinity Commercial |
$879.55
|
| Rate for Payer: Cofinity Commercial |
$818.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.80
|
| Rate for Payer: Mclaren Medicaid |
$408.32
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$641.34
|
| Rate for Payer: PACE SWMI |
$610.80
|
| Rate for Payer: PHP Medicare Advantage |
$610.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.84
|
| Rate for Payer: Priority Health Medicare |
$610.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$974.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$610.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.80
|
| Rate for Payer: UHC Medicare Advantage |
$629.12
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$124.40 |
| Max. Negotiated Rate |
$873.81 |
| Rate for Payer: Aetna Commercial |
$194.58
|
| Rate for Payer: Aetna Medicare |
$151.02
|
| Rate for Payer: BCBS Complete |
$124.40
|
| Rate for Payer: BCBS MAPPO |
$145.21
|
| Rate for Payer: BCBS Trust/PPO |
$873.81
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$145.21
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$209.10
|
| Rate for Payer: Cofinity Commercial |
$194.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.47
|
| Rate for Payer: PACE SWMI |
$145.21
|
| Rate for Payer: PHP Medicare Advantage |
$145.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.41
|
| Rate for Payer: Priority Health Medicare |
$145.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.21
|
| Rate for Payer: UHC Medicare Advantage |
$149.57
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$99.85 |
| Max. Negotiated Rate |
$242.39 |
| Rate for Payer: Aetna Commercial |
$207.82
|
| Rate for Payer: Aetna Commercial |
$207.82
|
| Rate for Payer: Aetna Medicare |
$161.29
|
| Rate for Payer: Aetna Medicare |
$161.29
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS Complete |
$112.80
|
| Rate for Payer: BCBS MAPPO |
$155.09
|
| Rate for Payer: BCBS MAPPO |
$155.09
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCN Commercial |
$242.39
|
| Rate for Payer: BCN Commercial |
$242.39
|
| Rate for Payer: BCN Medicare Advantage |
$155.09
|
| Rate for Payer: BCN Medicare Advantage |
$155.09
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$223.33
|
| Rate for Payer: Cofinity Commercial |
$223.33
|
| Rate for Payer: Cofinity Commercial |
$207.82
|
| Rate for Payer: Cofinity Commercial |
$207.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.84
|
| Rate for Payer: PACE SWMI |
$155.09
|
| Rate for Payer: PACE SWMI |
$155.09
|
| Rate for Payer: PHP Medicare Advantage |
$155.09
|
| Rate for Payer: PHP Medicare Advantage |
$155.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.77
|
| Rate for Payer: Priority Health Medicare |
$155.09
|
| Rate for Payer: Priority Health Medicare |
$155.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.09
|
| Rate for Payer: UHC Medicare Advantage |
$159.74
|
| Rate for Payer: UHC Medicare Advantage |
$159.74
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$1,239.39 |
| Rate for Payer: Aetna Commercial |
$222.86
|
| Rate for Payer: Aetna Medicare |
$172.96
|
| Rate for Payer: BCBS Complete |
$128.40
|
| Rate for Payer: BCBS MAPPO |
$166.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.39
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: BCN Medicare Advantage |
$166.31
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$239.49
|
| Rate for Payer: Cofinity Commercial |
$222.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.63
|
| Rate for Payer: PACE SWMI |
$166.31
|
| Rate for Payer: PHP Medicare Advantage |
$166.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.94
|
| Rate for Payer: Priority Health Medicare |
$166.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.31
|
| Rate for Payer: UHC Medicare Advantage |
$171.30
|
|
