|
PR TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE
|
Professional
|
Both
|
$1,778.00
|
|
|
Service Code
|
HCPCS 37218
|
| Min. Negotiated Rate |
$517.59 |
| Max. Negotiated Rate |
$1,283.62 |
| Rate for Payer: Aetna Commercial |
$1,083.58
|
| Rate for Payer: Aetna Medicare |
$840.99
|
| Rate for Payer: BCBS Complete |
$543.47
|
| Rate for Payer: BCBS MAPPO |
$808.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.92
|
| Rate for Payer: BCN Commercial |
$1,179.18
|
| Rate for Payer: BCN Medicare Advantage |
$808.64
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cofinity Commercial |
$1,164.44
|
| Rate for Payer: Cofinity Commercial |
$1,083.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.64
|
| Rate for Payer: Mclaren Medicaid |
$517.59
|
| Rate for Payer: Meridian Medicaid |
$543.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$849.07
|
| Rate for Payer: PACE SWMI |
$808.64
|
| Rate for Payer: PHP Medicare Advantage |
$808.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$517.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,244.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,283.62
|
| Rate for Payer: Priority Health Medicare |
$808.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$808.64
|
| Rate for Payer: UHC Medicare Advantage |
$832.90
|
|
|
PR TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE
|
Professional
|
Both
|
$1,721.00
|
|
|
Service Code
|
HCPCS 37217
|
| Min. Negotiated Rate |
$672.65 |
| Max. Negotiated Rate |
$1,682.04 |
| Rate for Payer: Aetna Commercial |
$1,427.49
|
| Rate for Payer: Aetna Medicare |
$1,107.90
|
| Rate for Payer: BCBS Complete |
$706.28
|
| Rate for Payer: BCBS MAPPO |
$1,065.29
|
| Rate for Payer: BCBS Trust/PPO |
$721.66
|
| Rate for Payer: BCN Commercial |
$1,545.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,065.29
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,427.49
|
| Rate for Payer: Cofinity Commercial |
$1,534.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,065.29
|
| Rate for Payer: Mclaren Medicaid |
$672.65
|
| Rate for Payer: Meridian Medicaid |
$706.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,118.55
|
| Rate for Payer: PACE SWMI |
$1,065.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,065.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,682.04
|
| Rate for Payer: Priority Health Medicare |
$1,065.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,682.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,065.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,097.25
|
|
|
PR TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR
|
Professional
|
Both
|
$674.00
|
|
|
Service Code
|
HCPCS 33289
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$1,657.81 |
| Rate for Payer: Aetna Commercial |
$437.89
|
| Rate for Payer: Aetna Medicare |
$339.85
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS MAPPO |
$326.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,657.81
|
| Rate for Payer: BCN Commercial |
$476.95
|
| Rate for Payer: BCN Medicare Advantage |
$326.78
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cash Price |
$539.20
|
| Rate for Payer: Cofinity Commercial |
$437.89
|
| Rate for Payer: Cofinity Commercial |
$470.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.78
|
| Rate for Payer: Mclaren Medicaid |
$208.53
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$343.12
|
| Rate for Payer: PACE SWMI |
$326.78
|
| Rate for Payer: PHP Medicare Advantage |
$326.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.19
|
| Rate for Payer: Priority Health Medicare |
$326.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.78
|
| Rate for Payer: UHC Medicare Advantage |
$336.58
|
|
|
PR TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
HCPCS 33274
|
| Min. Negotiated Rate |
$299.90 |
| Max. Negotiated Rate |
$1,157.51 |
| Rate for Payer: Aetna Commercial |
$631.07
|
| Rate for Payer: Aetna Medicare |
$489.79
|
| Rate for Payer: BCBS Complete |
$314.90
|
| Rate for Payer: BCBS MAPPO |
$470.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.51
|
| Rate for Payer: BCN Commercial |
$692.95
|
| Rate for Payer: BCN Medicare Advantage |
$470.95
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$678.17
|
| Rate for Payer: Cofinity Commercial |
$631.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.95
|
| Rate for Payer: Mclaren Medicaid |
$299.90
|
| Rate for Payer: Meridian Medicaid |
$314.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$494.50
|
| Rate for Payer: PACE SWMI |
$470.95
|
| Rate for Payer: PHP Medicare Advantage |
$470.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.32
|
| Rate for Payer: Priority Health Medicare |
$470.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$470.95
|
| Rate for Payer: UHC Medicare Advantage |
$485.08
|
|
|
PR TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ
|
Professional
|
Both
|
$2,068.90
|
|
|
Service Code
|
HCPCS 37215
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$1,543.21 |
| Rate for Payer: Aetna Commercial |
$1,305.00
|
| Rate for Payer: Aetna Medicare |
$1,012.84
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS MAPPO |
$973.88
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$1,417.66
|
| Rate for Payer: BCN Medicare Advantage |
$973.88
|
| Rate for Payer: Cash Price |
$1,655.12
|
| Rate for Payer: Cash Price |
$1,655.12
|
| Rate for Payer: Cofinity Commercial |
$1,402.39
|
| Rate for Payer: Cofinity Commercial |
$1,305.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.88
|
| Rate for Payer: Mclaren Medicaid |
$618.55
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,022.57
|
| Rate for Payer: PACE SWMI |
$973.88
|
| Rate for Payer: PHP Medicare Advantage |
$973.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.21
|
| Rate for Payer: Priority Health Medicare |
$973.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,543.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$973.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,003.10
|
|
|
PR TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ
|
Professional
|
Both
|
$4,102.00
|
|
|
Service Code
|
HCPCS 37216
|
| Min. Negotiated Rate |
$471.24 |
| Max. Negotiated Rate |
$2,871.40 |
| Rate for Payer: Aetna Commercial |
$1,302.62
|
| Rate for Payer: BCBS Complete |
$1,640.80
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCN Commercial |
$1,417.16
|
| Rate for Payer: Cash Price |
$3,281.60
|
| Rate for Payer: Cash Price |
$3,281.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,871.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.68
|
|
|
PR TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS
|
Professional
|
Both
|
$3,685.00
|
|
|
Service Code
|
HCPCS 33418
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$2,794.37 |
| Rate for Payer: Aetna Commercial |
$2,357.17
|
| Rate for Payer: Aetna Medicare |
$1,829.44
|
| Rate for Payer: BCBS Complete |
$1,181.76
|
| Rate for Payer: BCBS MAPPO |
$1,759.08
|
| Rate for Payer: BCBS Trust/PPO |
$308.00
|
| Rate for Payer: BCN Commercial |
$2,567.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,759.08
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cash Price |
$2,948.00
|
| Rate for Payer: Cofinity Commercial |
$2,533.08
|
| Rate for Payer: Cofinity Commercial |
$2,357.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,759.08
|
| Rate for Payer: Mclaren Medicaid |
$1,125.49
|
| Rate for Payer: Meridian Medicaid |
$1,181.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,847.03
|
| Rate for Payer: PACE SWMI |
$1,759.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,759.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,125.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,579.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,794.37
|
| Rate for Payer: Priority Health Medicare |
$1,759.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,794.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,759.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,811.85
|
|
|
PR TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS
|
Professional
|
Both
|
$4,533.00
|
|
|
Service Code
|
HCPCS 61624
|
| Min. Negotiated Rate |
$113.06 |
| Max. Negotiated Rate |
$3,173.10 |
| Rate for Payer: Aetna Commercial |
$1,555.97
|
| Rate for Payer: Aetna Medicare |
$1,207.62
|
| Rate for Payer: BCBS Complete |
$777.63
|
| Rate for Payer: BCBS MAPPO |
$1,161.17
|
| Rate for Payer: BCBS Trust/PPO |
$113.06
|
| Rate for Payer: BCN Commercial |
$2,342.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,161.17
|
| Rate for Payer: Cash Price |
$3,626.40
|
| Rate for Payer: Cash Price |
$3,626.40
|
| Rate for Payer: Cofinity Commercial |
$1,555.97
|
| Rate for Payer: Cofinity Commercial |
$1,672.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,161.17
|
| Rate for Payer: Mclaren Medicaid |
$740.60
|
| Rate for Payer: Meridian Medicaid |
$777.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,219.23
|
| Rate for Payer: PACE SWMI |
$1,161.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,161.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,173.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,956.30
|
| Rate for Payer: Priority Health Medicare |
$1,161.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,956.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,161.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,161.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,196.01
|
|
|
PR TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS
|
Professional
|
Both
|
$1,812.30
|
|
|
Service Code
|
HCPCS 61626
|
| Min. Negotiated Rate |
$73.96 |
| Max. Negotiated Rate |
$1,507.86 |
| Rate for Payer: Aetna Commercial |
$1,197.02
|
| Rate for Payer: Aetna Medicare |
$929.03
|
| Rate for Payer: BCBS Complete |
$602.74
|
| Rate for Payer: BCBS MAPPO |
$893.30
|
| Rate for Payer: BCBS Trust/PPO |
$73.96
|
| Rate for Payer: BCN Commercial |
$1,301.35
|
| Rate for Payer: BCN Medicare Advantage |
$893.30
|
| Rate for Payer: Cash Price |
$1,449.84
|
| Rate for Payer: Cash Price |
$1,449.84
|
| Rate for Payer: Cofinity Commercial |
$1,197.02
|
| Rate for Payer: Cofinity Commercial |
$1,286.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.30
|
| Rate for Payer: Mclaren Medicaid |
$574.04
|
| Rate for Payer: Meridian Medicaid |
$602.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$937.96
|
| Rate for Payer: PACE SWMI |
$893.30
|
| Rate for Payer: PHP Medicare Advantage |
$893.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,268.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,507.86
|
| Rate for Payer: Priority Health Medicare |
$893.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,507.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$893.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.30
|
| Rate for Payer: UHC Medicare Advantage |
$920.10
|
|
|
PR TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD
|
Professional
|
Both
|
$6,660.00
|
|
|
Service Code
|
HCPCS 61635
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$4,662.00 |
| Rate for Payer: Aetna Commercial |
$1,974.21
|
| Rate for Payer: Aetna Medicare |
$1,532.22
|
| Rate for Payer: BCBS Complete |
$2,664.00
|
| Rate for Payer: BCBS MAPPO |
$1,473.29
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: BCN Commercial |
$2,155.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,473.29
|
| Rate for Payer: Cash Price |
$5,328.00
|
| Rate for Payer: Cash Price |
$5,328.00
|
| Rate for Payer: Cofinity Commercial |
$2,121.54
|
| Rate for Payer: Cofinity Commercial |
$1,974.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,473.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,546.95
|
| Rate for Payer: PACE SWMI |
$1,473.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,473.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,662.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,497.05
|
| Rate for Payer: Priority Health Medicare |
$1,473.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,497.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,473.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,473.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,517.49
|
|
|
PR TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL
|
Professional
|
Both
|
$9,679.00
|
|
|
Service Code
|
HCPCS 0075T
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$6,775.30 |
| Rate for Payer: Aetna Commercial |
$1,381.29
|
| Rate for Payer: BCBS Complete |
$3,871.60
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$6,440.29
|
| Rate for Payer: Cash Price |
$7,743.20
|
| Rate for Payer: Cash Price |
$7,743.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,775.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,900.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,900.00
|
|
|
PR TDAP VACCINE 7 YRS/> IM
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 90715
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$55.79 |
| Rate for Payer: Aetna Commercial |
$51.92
|
| Rate for Payer: Aetna Medicare |
$40.29
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$38.74
|
| Rate for Payer: BCBS Trust/PPO |
$40.48
|
| Rate for Payer: BCN Commercial |
$42.12
|
| Rate for Payer: BCN Medicare Advantage |
$38.74
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$55.79
|
| Rate for Payer: Cofinity Commercial |
$51.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.68
|
| Rate for Payer: PACE SWMI |
$38.74
|
| Rate for Payer: PHP Medicare Advantage |
$38.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health Medicare |
$38.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.74
|
| Rate for Payer: UHC Medicare Advantage |
$39.91
|
|
|
PR TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN
|
Professional
|
Both
|
$2,581.00
|
|
|
Service Code
|
HCPCS 25310
|
| Min. Negotiated Rate |
$404.49 |
| Max. Negotiated Rate |
$1,806.70 |
| Rate for Payer: Aetna Commercial |
$822.01
|
| Rate for Payer: Aetna Medicare |
$637.98
|
| Rate for Payer: BCBS Complete |
$424.71
|
| Rate for Payer: BCBS MAPPO |
$613.44
|
| Rate for Payer: BCBS Trust/PPO |
$791.39
|
| Rate for Payer: BCN Commercial |
$919.20
|
| Rate for Payer: BCN Medicare Advantage |
$613.44
|
| Rate for Payer: Cash Price |
$2,064.80
|
| Rate for Payer: Cash Price |
$2,064.80
|
| Rate for Payer: Cofinity Commercial |
$883.35
|
| Rate for Payer: Cofinity Commercial |
$822.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.44
|
| Rate for Payer: Mclaren Medicaid |
$404.49
|
| Rate for Payer: Meridian Medicaid |
$424.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$644.11
|
| Rate for Payer: PACE SWMI |
$613.44
|
| Rate for Payer: PHP Medicare Advantage |
$613.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,806.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.54
|
| Rate for Payer: Priority Health Medicare |
$613.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$960.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$613.44
|
| Rate for Payer: UHC Medicare Advantage |
$631.84
|
|
|
PR TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR
|
Professional
|
Both
|
$1,552.00
|
|
|
Service Code
|
HCPCS 25312
|
| Min. Negotiated Rate |
$226.11 |
| Max. Negotiated Rate |
$1,106.59 |
| Rate for Payer: Aetna Commercial |
$949.98
|
| Rate for Payer: Aetna Medicare |
$737.30
|
| Rate for Payer: BCBS Complete |
$488.45
|
| Rate for Payer: BCBS MAPPO |
$708.94
|
| Rate for Payer: BCBS Trust/PPO |
$226.11
|
| Rate for Payer: BCN Commercial |
$1,058.97
|
| Rate for Payer: BCN Medicare Advantage |
$708.94
|
| Rate for Payer: Cash Price |
$1,241.60
|
| Rate for Payer: Cash Price |
$1,241.60
|
| Rate for Payer: Cofinity Commercial |
$949.98
|
| Rate for Payer: Cofinity Commercial |
$1,020.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.94
|
| Rate for Payer: Mclaren Medicaid |
$465.19
|
| Rate for Payer: Meridian Medicaid |
$488.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$744.39
|
| Rate for Payer: PACE SWMI |
$708.94
|
| Rate for Payer: PHP Medicare Advantage |
$708.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,106.59
|
| Rate for Payer: Priority Health Medicare |
$708.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,106.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$708.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.94
|
| Rate for Payer: UHC Medicare Advantage |
$730.21
|
|
|
PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 90714
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$44.70 |
| Rate for Payer: Aetna Commercial |
$41.60
|
| Rate for Payer: Aetna Medicare |
$32.29
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCBS Trust/PPO |
$35.19
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.60
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health Medicare |
$31.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.04
|
| Rate for Payer: UHC Medicare Advantage |
$31.98
|
|
|
PR TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 35306
|
| Min. Negotiated Rate |
$276.26 |
| Max. Negotiated Rate |
$991.62 |
| Rate for Payer: Aetna Commercial |
$590.85
|
| Rate for Payer: Aetna Medicare |
$458.57
|
| Rate for Payer: BCBS Complete |
$290.07
|
| Rate for Payer: BCBS MAPPO |
$440.93
|
| Rate for Payer: BCBS Trust/PPO |
$991.62
|
| Rate for Payer: BCN Commercial |
$633.82
|
| Rate for Payer: BCN Medicare Advantage |
$440.93
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$590.85
|
| Rate for Payer: Cofinity Commercial |
$634.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.93
|
| Rate for Payer: Mclaren Medicaid |
$276.26
|
| Rate for Payer: Meridian Medicaid |
$290.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.98
|
| Rate for Payer: PACE SWMI |
$440.93
|
| Rate for Payer: PHP Medicare Advantage |
$440.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.95
|
| Rate for Payer: Priority Health Medicare |
$440.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$689.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.93
|
| Rate for Payer: UHC Medicare Advantage |
$454.16
|
|
|
PR TEAEC W/GRAFT POPLITEAL ARTERY
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 35303
|
| Min. Negotiated Rate |
$764.24 |
| Max. Negotiated Rate |
$1,921.44 |
| Rate for Payer: Aetna Commercial |
$1,632.43
|
| Rate for Payer: Aetna Medicare |
$1,266.96
|
| Rate for Payer: BCBS Complete |
$802.45
|
| Rate for Payer: BCBS MAPPO |
$1,218.23
|
| Rate for Payer: BCBS Trust/PPO |
$903.39
|
| Rate for Payer: BCN Commercial |
$1,765.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.23
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$1,754.25
|
| Rate for Payer: Cofinity Commercial |
$1,632.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.23
|
| Rate for Payer: Mclaren Medicaid |
$764.24
|
| Rate for Payer: Meridian Medicaid |
$802.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,279.14
|
| Rate for Payer: PACE SWMI |
$1,218.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$764.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,921.44
|
| Rate for Payer: Priority Health Medicare |
$1,218.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,921.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,254.78
|
|
|
PR TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY
|
Professional
|
Both
|
$2,149.00
|
|
|
Service Code
|
HCPCS 35302
|
| Min. Negotiated Rate |
$655.62 |
| Max. Negotiated Rate |
$1,738.43 |
| Rate for Payer: Aetna Commercial |
$1,476.76
|
| Rate for Payer: Aetna Medicare |
$1,146.14
|
| Rate for Payer: BCBS Complete |
$732.01
|
| Rate for Payer: BCBS MAPPO |
$1,102.06
|
| Rate for Payer: BCBS Trust/PPO |
$655.62
|
| Rate for Payer: BCN Commercial |
$1,596.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,102.06
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cash Price |
$1,719.20
|
| Rate for Payer: Cofinity Commercial |
$1,586.97
|
| Rate for Payer: Cofinity Commercial |
$1,476.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,102.06
|
| Rate for Payer: Mclaren Medicaid |
$697.15
|
| Rate for Payer: Meridian Medicaid |
$732.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,157.16
|
| Rate for Payer: PACE SWMI |
$1,102.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,102.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$697.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,738.43
|
| Rate for Payer: Priority Health Medicare |
$1,102.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,738.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,102.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,102.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.12
|
|
|
PR TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL
|
Professional
|
Both
|
$2,364.00
|
|
|
Service Code
|
HCPCS 35305
|
| Min. Negotiated Rate |
$501.36 |
| Max. Negotiated Rate |
$1,899.08 |
| Rate for Payer: Aetna Commercial |
$1,614.82
|
| Rate for Payer: Aetna Medicare |
$1,253.29
|
| Rate for Payer: BCBS Complete |
$803.58
|
| Rate for Payer: BCBS MAPPO |
$1,205.09
|
| Rate for Payer: BCBS Trust/PPO |
$501.36
|
| Rate for Payer: BCN Commercial |
$1,744.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,205.09
|
| Rate for Payer: Cash Price |
$1,891.20
|
| Rate for Payer: Cash Price |
$1,891.20
|
| Rate for Payer: Cofinity Commercial |
$1,614.82
|
| Rate for Payer: Cofinity Commercial |
$1,735.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,205.09
|
| Rate for Payer: Mclaren Medicaid |
$765.31
|
| Rate for Payer: Meridian Medicaid |
$803.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,265.34
|
| Rate for Payer: PACE SWMI |
$1,205.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,205.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,899.08
|
| Rate for Payer: Priority Health Medicare |
$1,205.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,899.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,205.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,205.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,241.24
|
|
|
PR TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY
|
Professional
|
Both
|
$2,460.00
|
|
|
Service Code
|
HCPCS 35304
|
| Min. Negotiated Rate |
$795.56 |
| Max. Negotiated Rate |
$1,973.57 |
| Rate for Payer: Aetna Commercial |
$1,678.81
|
| Rate for Payer: Aetna Medicare |
$1,302.95
|
| Rate for Payer: BCBS Complete |
$835.34
|
| Rate for Payer: BCBS MAPPO |
$1,252.84
|
| Rate for Payer: BCBS Trust/PPO |
$836.83
|
| Rate for Payer: BCN Commercial |
$1,812.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,252.84
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cash Price |
$1,968.00
|
| Rate for Payer: Cofinity Commercial |
$1,678.81
|
| Rate for Payer: Cofinity Commercial |
$1,804.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,252.84
|
| Rate for Payer: Mclaren Medicaid |
$795.56
|
| Rate for Payer: Meridian Medicaid |
$835.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,315.48
|
| Rate for Payer: PACE SWMI |
$1,252.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,252.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,973.57
|
| Rate for Payer: Priority Health Medicare |
$1,252.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,973.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,252.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,252.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,290.43
|
|
|
PR TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC
|
Professional
|
Both
|
$3,625.00
|
|
|
Service Code
|
HCPCS 35301
|
| Min. Negotiated Rate |
$276.83 |
| Max. Negotiated Rate |
$2,537.50 |
| Rate for Payer: Aetna Commercial |
$1,490.09
|
| Rate for Payer: Aetna Medicare |
$1,156.49
|
| Rate for Payer: BCBS Complete |
$740.28
|
| Rate for Payer: BCBS MAPPO |
$1,112.01
|
| Rate for Payer: BCBS Trust/PPO |
$276.83
|
| Rate for Payer: BCN Commercial |
$1,613.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,112.01
|
| Rate for Payer: Cash Price |
$2,900.00
|
| Rate for Payer: Cash Price |
$2,900.00
|
| Rate for Payer: Cofinity Commercial |
$1,601.29
|
| Rate for Payer: Cofinity Commercial |
$1,490.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,112.01
|
| Rate for Payer: Mclaren Medicaid |
$705.03
|
| Rate for Payer: Meridian Medicaid |
$740.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,167.61
|
| Rate for Payer: PACE SWMI |
$1,112.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,112.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,537.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,756.00
|
| Rate for Payer: Priority Health Medicare |
$1,112.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,756.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,112.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,112.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,145.37
|
|
|
PR TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
|
Professional
|
Both
|
$4,641.00
|
|
|
Service Code
|
HCPCS 35331
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$3,248.70 |
| Rate for Payer: Aetna Commercial |
$1,926.96
|
| Rate for Payer: Aetna Medicare |
$1,495.55
|
| Rate for Payer: BCBS Complete |
$952.75
|
| Rate for Payer: BCBS MAPPO |
$1,438.03
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,084.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,438.03
|
| Rate for Payer: Cash Price |
$3,712.80
|
| Rate for Payer: Cash Price |
$3,712.80
|
| Rate for Payer: Cofinity Commercial |
$1,926.96
|
| Rate for Payer: Cofinity Commercial |
$2,070.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,438.03
|
| Rate for Payer: Mclaren Medicaid |
$907.38
|
| Rate for Payer: Meridian Medicaid |
$952.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,509.93
|
| Rate for Payer: PACE SWMI |
$1,438.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,438.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$907.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,248.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,269.33
|
| Rate for Payer: Priority Health Medicare |
$1,438.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,269.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,438.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,438.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,481.17
|
|
|
PR TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL
|
Professional
|
Both
|
$3,275.00
|
|
|
Service Code
|
HCPCS 35363
|
| Min. Negotiated Rate |
$1,012.60 |
| Max. Negotiated Rate |
$2,517.22 |
| Rate for Payer: Aetna Commercial |
$2,146.91
|
| Rate for Payer: Aetna Medicare |
$1,666.26
|
| Rate for Payer: BCBS Complete |
$1,063.23
|
| Rate for Payer: BCBS MAPPO |
$1,602.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.79
|
| Rate for Payer: BCN Commercial |
$2,312.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.17
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Cofinity Commercial |
$2,307.12
|
| Rate for Payer: Cofinity Commercial |
$2,146.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.17
|
| Rate for Payer: Mclaren Medicaid |
$1,012.60
|
| Rate for Payer: Meridian Medicaid |
$1,063.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,682.28
|
| Rate for Payer: PACE SWMI |
$1,602.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,012.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,517.22
|
| Rate for Payer: Priority Health Medicare |
$1,602.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,517.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,602.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,602.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,650.24
|
|
|
PR TEAEC W/WO PATCH GRAFT COMMON FEMORAL
|
Professional
|
Both
|
$1,717.00
|
|
|
Service Code
|
HCPCS 35371
|
| Min. Negotiated Rate |
$508.43 |
| Max. Negotiated Rate |
$1,266.58 |
| Rate for Payer: Aetna Commercial |
$1,074.56
|
| Rate for Payer: Aetna Medicare |
$833.99
|
| Rate for Payer: BCBS Complete |
$533.85
|
| Rate for Payer: BCBS MAPPO |
$801.91
|
| Rate for Payer: BCBS Trust/PPO |
$666.19
|
| Rate for Payer: BCN Commercial |
$1,163.54
|
| Rate for Payer: BCN Medicare Advantage |
$801.91
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cash Price |
$1,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,154.75
|
| Rate for Payer: Cofinity Commercial |
$1,074.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.91
|
| Rate for Payer: Mclaren Medicaid |
$508.43
|
| Rate for Payer: Meridian Medicaid |
$533.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$842.01
|
| Rate for Payer: PACE SWMI |
$801.91
|
| Rate for Payer: PHP Medicare Advantage |
$801.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,201.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,266.58
|
| Rate for Payer: Priority Health Medicare |
$801.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,266.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$801.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$801.91
|
| Rate for Payer: UHC Medicare Advantage |
$825.97
|
|
|
PR TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL
|
Professional
|
Both
|
$3,699.00
|
|
|
Service Code
|
HCPCS 35372
|
| Min. Negotiated Rate |
$609.18 |
| Max. Negotiated Rate |
$2,589.30 |
| Rate for Payer: Aetna Commercial |
$1,287.36
|
| Rate for Payer: Aetna Medicare |
$999.15
|
| Rate for Payer: BCBS Complete |
$639.64
|
| Rate for Payer: BCBS MAPPO |
$960.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.49
|
| Rate for Payer: BCN Commercial |
$1,392.25
|
| Rate for Payer: BCN Medicare Advantage |
$960.72
|
| Rate for Payer: Cash Price |
$2,959.20
|
| Rate for Payer: Cash Price |
$2,959.20
|
| Rate for Payer: Cofinity Commercial |
$1,383.44
|
| Rate for Payer: Cofinity Commercial |
$1,287.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.72
|
| Rate for Payer: Mclaren Medicaid |
$609.18
|
| Rate for Payer: Meridian Medicaid |
$639.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,008.76
|
| Rate for Payer: PACE SWMI |
$960.72
|
| Rate for Payer: PHP Medicare Advantage |
$960.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$609.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,589.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,515.55
|
| Rate for Payer: Priority Health Medicare |
$960.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,515.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$960.72
|
| Rate for Payer: UHC Medicare Advantage |
$989.54
|
|
