|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$2,787.84 |
| Rate for Payer: Aetna Commercial |
$227.85
|
| Rate for Payer: Aetna Medicare |
$176.84
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$170.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.84
|
| Rate for Payer: BCN Commercial |
$200.65
|
| Rate for Payer: BCN Medicare Advantage |
$170.04
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Cofinity Commercial |
$227.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.04
|
| Rate for Payer: Mclaren Medicaid |
$108.63
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.54
|
| Rate for Payer: PACE SWMI |
$170.04
|
| Rate for Payer: PHP Medicare Advantage |
$170.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.94
|
| Rate for Payer: Priority Health Medicare |
$170.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.04
|
| Rate for Payer: UHC Medicare Advantage |
$175.14
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Facility
|
IP
|
$2,475.00
|
|
|
Service Code
|
CPT 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$1,509.50 |
| Max. Negotiated Rate |
$2,227.50 |
| Rate for Payer: Aetna Commercial |
$2,103.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,912.68
|
| Rate for Payer: BCN Commercial |
$1,912.68
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$2,128.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,980.00
|
| Rate for Payer: Healthscope Commercial |
$2,227.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,856.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,103.75
|
| Rate for Payer: PHP Commercial |
$2,103.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,153.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,509.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,178.00
|
| Rate for Payer: UHC Core |
$2,066.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,856.25
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Facility
|
OP
|
$2,475.00
|
|
|
Service Code
|
CPT 29826
|
| Hospital Charge Code |
29826
|
| Min. Negotiated Rate |
$587.81 |
| Max. Negotiated Rate |
$2,227.50 |
| Rate for Payer: Aetna Commercial |
$2,103.75
|
| Rate for Payer: Aetna Medicare |
$643.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$773.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$773.44
|
| Rate for Payer: BCBS Complete |
$990.00
|
| Rate for Payer: BCBS MAPPO |
$618.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.31
|
| Rate for Payer: BCN Commercial |
$1,924.31
|
| Rate for Payer: BCN Medicare Advantage |
$618.75
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$2,128.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,980.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$618.75
|
| Rate for Payer: Healthscope Commercial |
$2,227.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,856.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$649.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$711.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,103.75
|
| Rate for Payer: PACE Senior Care Partners |
$587.81
|
| Rate for Payer: PACE SWMI |
$618.75
|
| Rate for Payer: PHP Commercial |
$2,103.75
|
| Rate for Payer: PHP Medicare Advantage |
$618.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,153.25
|
| Rate for Payer: Priority Health Medicare |
$618.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,509.50
|
| Rate for Payer: Railroad Medicare Medicare |
$618.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,178.00
|
| Rate for Payer: UHC Core |
$2,066.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$618.75
|
| Rate for Payer: UHC Medicare Advantage |
$637.31
|
| Rate for Payer: VA VA |
$618.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,856.25
|
|
|
PR SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS
|
Professional
|
Both
|
$2,475.00
|
|
|
Service Code
|
HCPCS 29826
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$2,787.84 |
| Rate for Payer: Aetna Commercial |
$227.85
|
| Rate for Payer: Aetna Medicare |
$176.84
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$170.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.84
|
| Rate for Payer: BCN Commercial |
$200.65
|
| Rate for Payer: BCN Medicare Advantage |
$170.04
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cash Price |
$1,980.00
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Cofinity Commercial |
$227.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.04
|
| Rate for Payer: Mclaren Medicaid |
$108.63
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.54
|
| Rate for Payer: PACE SWMI |
$170.04
|
| Rate for Payer: PHP Medicare Advantage |
$170.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,732.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.94
|
| Rate for Payer: Priority Health Medicare |
$170.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.04
|
| Rate for Payer: UHC Medicare Advantage |
$175.14
|
|
|
PR SURGICAL TRAYS
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS A4550
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Aetna Commercial |
$15.00
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI
|
Professional
|
Both
|
$5,562.00
|
|
|
Service Code
|
HCPCS 69706
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$4,200.67 |
| Rate for Payer: Aetna Commercial |
$320.84
|
| Rate for Payer: Aetna Medicare |
$249.01
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS MAPPO |
$239.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,280.67
|
| Rate for Payer: BCN Commercial |
$4,200.67
|
| Rate for Payer: BCN Medicare Advantage |
$239.43
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cofinity Commercial |
$344.78
|
| Rate for Payer: Cofinity Commercial |
$320.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.43
|
| Rate for Payer: Mclaren Medicaid |
$154.43
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.40
|
| Rate for Payer: PACE SWMI |
$239.43
|
| Rate for Payer: PHP Medicare Advantage |
$239.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,893.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.86
|
| Rate for Payer: Priority Health Medicare |
$239.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.43
|
| Rate for Payer: UHC Medicare Advantage |
$246.61
|
|
|
PR SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI
|
Professional
|
Both
|
$5,380.54
|
|
|
Service Code
|
HCPCS 69705
|
| Min. Negotiated Rate |
$110.55 |
| Max. Negotiated Rate |
$4,063.84 |
| Rate for Payer: Aetna Commercial |
$230.04
|
| Rate for Payer: Aetna Medicare |
$178.54
|
| Rate for Payer: BCBS Complete |
$116.08
|
| Rate for Payer: BCBS MAPPO |
$171.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,634.18
|
| Rate for Payer: BCN Commercial |
$4,063.84
|
| Rate for Payer: BCN Medicare Advantage |
$171.67
|
| Rate for Payer: Cash Price |
$4,304.43
|
| Rate for Payer: Cash Price |
$4,304.43
|
| Rate for Payer: Cofinity Commercial |
$230.04
|
| Rate for Payer: Cofinity Commercial |
$247.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.67
|
| Rate for Payer: Mclaren Medicaid |
$110.55
|
| Rate for Payer: Meridian Medicaid |
$116.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$180.25
|
| Rate for Payer: PACE SWMI |
$171.67
|
| Rate for Payer: PHP Medicare Advantage |
$171.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.68
|
| Rate for Payer: Priority Health Medicare |
$171.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.67
|
| Rate for Payer: UHC Medicare Advantage |
$176.82
|
|
|
PR SURG OPENING,ESOPHAGUS,ABD APPRCH
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 43350
|
| Min. Negotiated Rate |
$1,092.80 |
| Max. Negotiated Rate |
$1,912.40 |
| Rate for Payer: BCBS Complete |
$1,092.80
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.40
|
|
|
PR SURG TX ANAL FISTULA 2ND STAGE
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 46285
|
| Min. Negotiated Rate |
$273.28 |
| Max. Negotiated Rate |
$2,300.22 |
| Rate for Payer: Aetna Commercial |
$552.84
|
| Rate for Payer: Aetna Medicare |
$429.07
|
| Rate for Payer: BCBS Complete |
$286.94
|
| Rate for Payer: BCBS MAPPO |
$412.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,300.22
|
| Rate for Payer: BCN Commercial |
$826.84
|
| Rate for Payer: BCN Medicare Advantage |
$412.57
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cofinity Commercial |
$552.84
|
| Rate for Payer: Cofinity Commercial |
$594.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.57
|
| Rate for Payer: Mclaren Medicaid |
$273.28
|
| Rate for Payer: Meridian Medicaid |
$286.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.20
|
| Rate for Payer: PACE SWMI |
$412.57
|
| Rate for Payer: PHP Medicare Advantage |
$412.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.96
|
| Rate for Payer: Priority Health Medicare |
$412.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$744.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$412.57
|
| Rate for Payer: UHC Medicare Advantage |
$424.95
|
|
|
PR SURG TX ANAL FISTULA INTERSPHINCTERIC
|
Professional
|
Both
|
$1,289.00
|
|
|
Service Code
|
HCPCS 46275
|
| Min. Negotiated Rate |
$272.43 |
| Max. Negotiated Rate |
$4,730.40 |
| Rate for Payer: Aetna Commercial |
$552.92
|
| Rate for Payer: Aetna Medicare |
$429.14
|
| Rate for Payer: BCBS Complete |
$286.05
|
| Rate for Payer: BCBS MAPPO |
$412.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,730.40
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$412.63
|
| Rate for Payer: Cash Price |
$1,031.20
|
| Rate for Payer: Cash Price |
$1,031.20
|
| Rate for Payer: Cofinity Commercial |
$594.19
|
| Rate for Payer: Cofinity Commercial |
$552.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.63
|
| Rate for Payer: Mclaren Medicaid |
$272.43
|
| Rate for Payer: Meridian Medicaid |
$286.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.26
|
| Rate for Payer: PACE SWMI |
$412.63
|
| Rate for Payer: PHP Medicare Advantage |
$412.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.96
|
| Rate for Payer: Priority Health Medicare |
$412.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$744.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$412.63
|
| Rate for Payer: UHC Medicare Advantage |
$425.01
|
|
|
PR SURG TX ANAL FISTULA SUBQ
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 46270
|
| Min. Negotiated Rate |
$258.80 |
| Max. Negotiated Rate |
$2,437.58 |
| Rate for Payer: Aetna Commercial |
$525.48
|
| Rate for Payer: Aetna Medicare |
$407.84
|
| Rate for Payer: BCBS Complete |
$271.74
|
| Rate for Payer: BCBS MAPPO |
$392.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,437.58
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$392.15
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$525.48
|
| Rate for Payer: Cofinity Commercial |
$564.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.15
|
| Rate for Payer: Mclaren Medicaid |
$258.80
|
| Rate for Payer: Meridian Medicaid |
$271.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.76
|
| Rate for Payer: PACE SWMI |
$392.15
|
| Rate for Payer: PHP Medicare Advantage |
$392.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$591.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.51
|
| Rate for Payer: Priority Health Medicare |
$392.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.15
|
| Rate for Payer: UHC Medicare Advantage |
$403.91
|
|
|
PR SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD
|
Professional
|
Both
|
$11,112.00
|
|
|
Service Code
|
HCPCS 33548
|
| Min. Negotiated Rate |
$624.98 |
| Max. Negotiated Rate |
$7,778.40 |
| Rate for Payer: Aetna Commercial |
$3,878.56
|
| Rate for Payer: Aetna Medicare |
$3,010.23
|
| Rate for Payer: BCBS Complete |
$1,931.44
|
| Rate for Payer: BCBS MAPPO |
$2,894.45
|
| Rate for Payer: BCBS Trust/PPO |
$624.98
|
| Rate for Payer: BCN Commercial |
$4,215.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.45
|
| Rate for Payer: Cash Price |
$8,889.60
|
| Rate for Payer: Cash Price |
$8,889.60
|
| Rate for Payer: Cofinity Commercial |
$4,168.01
|
| Rate for Payer: Cofinity Commercial |
$3,878.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.45
|
| Rate for Payer: Mclaren Medicaid |
$1,839.47
|
| Rate for Payer: Meridian Medicaid |
$1,931.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,039.17
|
| Rate for Payer: PACE SWMI |
$2,894.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,839.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,778.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,588.67
|
| Rate for Payer: Priority Health Medicare |
$2,894.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,588.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,894.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,894.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,981.28
|
|
|
PR SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 64832
|
| Min. Negotiated Rate |
$210.23 |
| Max. Negotiated Rate |
$907.90 |
| Rate for Payer: Aetna Commercial |
$437.95
|
| Rate for Payer: Aetna Medicare |
$339.90
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$326.83
|
| Rate for Payer: BCBS Trust/PPO |
$294.79
|
| Rate for Payer: BCN Commercial |
$481.35
|
| Rate for Payer: BCN Medicare Advantage |
$326.83
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$470.64
|
| Rate for Payer: Cofinity Commercial |
$437.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.83
|
| Rate for Payer: Mclaren Medicaid |
$210.23
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$343.17
|
| Rate for Payer: PACE SWMI |
$326.83
|
| Rate for Payer: PHP Medicare Advantage |
$326.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$907.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.73
|
| Rate for Payer: Priority Health Medicare |
$326.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.83
|
| Rate for Payer: UHC Medicare Advantage |
$336.63
|
|
|
PR SUTR ESOPHGL WND/INJ CRV APPR
|
Professional
|
Both
|
$2,799.00
|
|
|
Service Code
|
HCPCS 43410
|
| Min. Negotiated Rate |
$663.50 |
| Max. Negotiated Rate |
$1,959.30 |
| Rate for Payer: Aetna Commercial |
$1,365.00
|
| Rate for Payer: Aetna Medicare |
$1,059.41
|
| Rate for Payer: BCBS Complete |
$696.68
|
| Rate for Payer: BCBS MAPPO |
$1,018.66
|
| Rate for Payer: BCBS Trust/PPO |
$949.92
|
| Rate for Payer: BCN Commercial |
$1,513.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,018.66
|
| Rate for Payer: Cash Price |
$2,239.20
|
| Rate for Payer: Cash Price |
$2,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,466.87
|
| Rate for Payer: Cofinity Commercial |
$1,365.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,018.66
|
| Rate for Payer: Mclaren Medicaid |
$663.50
|
| Rate for Payer: Meridian Medicaid |
$696.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,069.59
|
| Rate for Payer: PACE SWMI |
$1,018.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,018.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$663.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,959.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,820.96
|
| Rate for Payer: Priority Health Medicare |
$1,018.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,018.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,018.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,049.22
|
|
|
PR SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR
|
Professional
|
Both
|
$3,996.00
|
|
|
Service Code
|
HCPCS 43415
|
| Min. Negotiated Rate |
$1,207.03 |
| Max. Negotiated Rate |
$4,470.35 |
| Rate for Payer: Aetna Commercial |
$3,407.08
|
| Rate for Payer: Aetna Medicare |
$2,644.30
|
| Rate for Payer: BCBS Complete |
$1,711.82
|
| Rate for Payer: BCBS MAPPO |
$2,542.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,207.03
|
| Rate for Payer: BCN Commercial |
$3,715.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,542.60
|
| Rate for Payer: Cash Price |
$3,196.80
|
| Rate for Payer: Cash Price |
$3,196.80
|
| Rate for Payer: Cofinity Commercial |
$3,407.08
|
| Rate for Payer: Cofinity Commercial |
$3,661.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,542.60
|
| Rate for Payer: Mclaren Medicaid |
$1,630.30
|
| Rate for Payer: Meridian Medicaid |
$1,711.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,669.73
|
| Rate for Payer: PACE SWMI |
$2,542.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,542.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,630.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,470.35
|
| Rate for Payer: Priority Health Medicare |
$2,542.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,470.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,542.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,542.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,618.88
|
|
|
PR SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 27381
|
| Min. Negotiated Rate |
$530.58 |
| Max. Negotiated Rate |
$3,176.14 |
| Rate for Payer: Aetna Commercial |
$1,083.48
|
| Rate for Payer: Aetna Medicare |
$840.91
|
| Rate for Payer: BCBS Complete |
$557.11
|
| Rate for Payer: BCBS MAPPO |
$808.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,176.14
|
| Rate for Payer: BCN Commercial |
$1,209.96
|
| Rate for Payer: BCN Medicare Advantage |
$808.57
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$1,164.34
|
| Rate for Payer: Cofinity Commercial |
$1,083.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.57
|
| Rate for Payer: Mclaren Medicaid |
$530.58
|
| Rate for Payer: Meridian Medicaid |
$557.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.00
|
| Rate for Payer: PACE SWMI |
$808.57
|
| Rate for Payer: PHP Medicare Advantage |
$808.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,264.37
|
| Rate for Payer: Priority Health Medicare |
$808.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,264.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$808.57
|
| Rate for Payer: UHC Medicare Advantage |
$832.83
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY
|
Professional
|
Both
|
$2,880.00
|
|
|
Service Code
|
HCPCS 44605
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$2,268.40 |
| Rate for Payer: Aetna Commercial |
$1,722.28
|
| Rate for Payer: Aetna Medicare |
$1,336.69
|
| Rate for Payer: BCBS Complete |
$860.38
|
| Rate for Payer: BCBS MAPPO |
$1,285.28
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$1,885.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,285.28
|
| Rate for Payer: Cash Price |
$2,304.00
|
| Rate for Payer: Cash Price |
$2,304.00
|
| Rate for Payer: Cofinity Commercial |
$1,850.80
|
| Rate for Payer: Cofinity Commercial |
$1,722.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,285.28
|
| Rate for Payer: Mclaren Medicaid |
$819.41
|
| Rate for Payer: Meridian Medicaid |
$860.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,349.54
|
| Rate for Payer: PACE SWMI |
$1,285.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,285.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$819.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,016.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,268.40
|
| Rate for Payer: Priority Health Medicare |
$1,285.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,268.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,285.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,323.84
|
|
|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY
|
Professional
|
Both
|
$3,021.00
|
|
|
Service Code
|
HCPCS 44604
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$2,114.70 |
| Rate for Payer: Aetna Commercial |
$1,403.69
|
| Rate for Payer: Aetna Medicare |
$1,089.43
|
| Rate for Payer: BCBS Complete |
$705.17
|
| Rate for Payer: BCBS MAPPO |
$1,047.53
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$1,534.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,047.53
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cofinity Commercial |
$1,508.44
|
| Rate for Payer: Cofinity Commercial |
$1,403.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.53
|
| Rate for Payer: Mclaren Medicaid |
$671.59
|
| Rate for Payer: Meridian Medicaid |
$705.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,099.91
|
| Rate for Payer: PACE SWMI |
$1,047.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,047.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$671.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,114.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,846.83
|
| Rate for Payer: Priority Health Medicare |
$1,047.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,846.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,047.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,047.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,078.96
|
|
|
PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH
|
Professional
|
Both
|
$5,811.00
|
|
|
Service Code
|
HCPCS 38381
|
| Min. Negotiated Rate |
$510.77 |
| Max. Negotiated Rate |
$4,067.70 |
| Rate for Payer: Aetna Commercial |
$1,062.37
|
| Rate for Payer: Aetna Medicare |
$824.52
|
| Rate for Payer: BCBS Complete |
$536.31
|
| Rate for Payer: BCBS MAPPO |
$792.81
|
| Rate for Payer: BCBS Trust/PPO |
$540.98
|
| Rate for Payer: BCN Commercial |
$1,163.05
|
| Rate for Payer: BCN Medicare Advantage |
$792.81
|
| Rate for Payer: Cash Price |
$4,648.80
|
| Rate for Payer: Cash Price |
$4,648.80
|
| Rate for Payer: Cofinity Commercial |
$1,141.65
|
| Rate for Payer: Cofinity Commercial |
$1,062.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.81
|
| Rate for Payer: Mclaren Medicaid |
$510.77
|
| Rate for Payer: Meridian Medicaid |
$536.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$832.45
|
| Rate for Payer: PACE SWMI |
$792.81
|
| Rate for Payer: PHP Medicare Advantage |
$792.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,067.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.94
|
| Rate for Payer: Priority Health Medicare |
$792.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,723.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$792.81
|
| Rate for Payer: UHC Medicare Advantage |
$816.59
|
|
|
PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 69740
|
| Min. Negotiated Rate |
$744.22 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$1,530.17
|
| Rate for Payer: Aetna Medicare |
$1,187.60
|
| Rate for Payer: BCBS Complete |
$781.43
|
| Rate for Payer: BCBS MAPPO |
$1,141.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$1,709.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.92
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,530.17
|
| Rate for Payer: Cofinity Commercial |
$1,644.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.92
|
| Rate for Payer: Mclaren Medicaid |
$744.22
|
| Rate for Payer: Meridian Medicaid |
$781.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,199.02
|
| Rate for Payer: PACE SWMI |
$1,141.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$744.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,410.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,649.16
|
| Rate for Payer: Priority Health Medicare |
$1,141.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,649.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,141.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,176.18
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS
|
Professional
|
Both
|
$3,113.00
|
|
|
Service Code
|
HCPCS 64857
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$2,179.10 |
| Rate for Payer: Aetna Commercial |
$1,389.98
|
| Rate for Payer: Aetna Medicare |
$1,078.79
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$1,037.30
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,539.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.30
|
| Rate for Payer: Cash Price |
$2,490.40
|
| Rate for Payer: Cash Price |
$2,490.40
|
| Rate for Payer: Cofinity Commercial |
$1,493.71
|
| Rate for Payer: Cofinity Commercial |
$1,389.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.30
|
| Rate for Payer: Mclaren Medicaid |
$674.57
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,089.16
|
| Rate for Payer: PACE SWMI |
$1,037.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,179.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,784.18
|
| Rate for Payer: Priority Health Medicare |
$1,037.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,784.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,068.42
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS
|
Professional
|
Both
|
$3,875.00
|
|
|
Service Code
|
HCPCS 64856
|
| Min. Negotiated Rate |
$183.32 |
| Max. Negotiated Rate |
$2,712.50 |
| Rate for Payer: Aetna Commercial |
$1,337.68
|
| Rate for Payer: Aetna Medicare |
$1,038.20
|
| Rate for Payer: BCBS Complete |
$677.66
|
| Rate for Payer: BCBS MAPPO |
$998.27
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$1,480.20
|
| Rate for Payer: BCN Medicare Advantage |
$998.27
|
| Rate for Payer: Cash Price |
$3,100.00
|
| Rate for Payer: Cash Price |
$3,100.00
|
| Rate for Payer: Cofinity Commercial |
$1,337.68
|
| Rate for Payer: Cofinity Commercial |
$1,437.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.27
|
| Rate for Payer: Mclaren Medicaid |
$645.39
|
| Rate for Payer: Meridian Medicaid |
$677.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,048.18
|
| Rate for Payer: PACE SWMI |
$998.27
|
| Rate for Payer: PHP Medicare Advantage |
$998.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,712.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,715.09
|
| Rate for Payer: Priority Health Medicare |
$998.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,715.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$998.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,028.22
|
|
|
PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,296.00
|
|
|
Service Code
|
HCPCS 27386
|
| Min. Negotiated Rate |
$553.80 |
| Max. Negotiated Rate |
$1,607.20 |
| Rate for Payer: Aetna Commercial |
$1,128.86
|
| Rate for Payer: Aetna Medicare |
$876.13
|
| Rate for Payer: BCBS Complete |
$581.49
|
| Rate for Payer: BCBS MAPPO |
$842.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.54
|
| Rate for Payer: BCN Commercial |
$1,261.27
|
| Rate for Payer: BCN Medicare Advantage |
$842.43
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cash Price |
$1,836.80
|
| Rate for Payer: Cofinity Commercial |
$1,213.10
|
| Rate for Payer: Cofinity Commercial |
$1,128.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.43
|
| Rate for Payer: Mclaren Medicaid |
$553.80
|
| Rate for Payer: Meridian Medicaid |
$581.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$884.55
|
| Rate for Payer: PACE SWMI |
$842.43
|
| Rate for Payer: PHP Medicare Advantage |
$842.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,607.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,317.99
|
| Rate for Payer: Priority Health Medicare |
$842.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$842.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$842.43
|
| Rate for Payer: UHC Medicare Advantage |
$867.70
|
|
|
PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP
|
Professional
|
Both
|
$2,160.00
|
|
|
Service Code
|
HCPCS 33320
|
| Min. Negotiated Rate |
$375.26 |
| Max. Negotiated Rate |
$1,675.14 |
| Rate for Payer: Aetna Commercial |
$1,411.07
|
| Rate for Payer: Aetna Medicare |
$1,095.16
|
| Rate for Payer: BCBS Complete |
$707.41
|
| Rate for Payer: BCBS MAPPO |
$1,053.04
|
| Rate for Payer: BCBS Trust/PPO |
$375.26
|
| Rate for Payer: BCN Commercial |
$1,538.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.04
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,728.00
|
| Rate for Payer: Cofinity Commercial |
$1,516.38
|
| Rate for Payer: Cofinity Commercial |
$1,411.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.04
|
| Rate for Payer: Mclaren Medicaid |
$673.72
|
| Rate for Payer: Meridian Medicaid |
$707.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,105.69
|
| Rate for Payer: PACE SWMI |
$1,053.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,512.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,675.14
|
| Rate for Payer: Priority Health Medicare |
$1,053.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,675.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,053.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,084.63
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,128.00
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$276.90 |
| Max. Negotiated Rate |
$2,017.58 |
| Rate for Payer: Aetna Commercial |
$563.95
|
| Rate for Payer: Aetna Medicare |
$437.69
|
| Rate for Payer: BCBS Complete |
$290.74
|
| Rate for Payer: BCBS MAPPO |
$420.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.58
|
| Rate for Payer: BCN Commercial |
$870.33
|
| Rate for Payer: BCN Medicare Advantage |
$420.86
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cash Price |
$902.40
|
| Rate for Payer: Cofinity Commercial |
$563.95
|
| Rate for Payer: Cofinity Commercial |
$606.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.86
|
| Rate for Payer: Mclaren Medicaid |
$276.90
|
| Rate for Payer: Meridian Medicaid |
$290.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$441.90
|
| Rate for Payer: PACE SWMI |
$420.86
|
| Rate for Payer: PHP Medicare Advantage |
$420.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$789.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.77
|
| Rate for Payer: Priority Health Medicare |
$420.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$755.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.86
|
| Rate for Payer: UHC Medicare Advantage |
$433.49
|
|
