|
PR PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 11105
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$118.30 |
| Rate for Payer: Aetna Commercial |
$32.43
|
| Rate for Payer: Aetna Medicare |
$25.17
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$24.20
|
| Rate for Payer: BCBS Trust/PPO |
$23.50
|
| Rate for Payer: BCN Commercial |
$69.89
|
| Rate for Payer: BCN Medicare Advantage |
$24.20
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$32.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.20
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.41
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$29.04
|
| Rate for Payer: PACE SWMI |
$24.20
|
| Rate for Payer: PHP Medicare Advantage |
$24.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO |
$34.32
|
| Rate for Payer: Priority Health Medicare |
$24.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.20
|
| Rate for Payer: UHC Exchange |
$24.20
|
| Rate for Payer: UHC Medicare Advantage |
$24.20
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
|
|
PR PUNCH BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 11104
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$158.60 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare |
$46.27
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$148.43
|
| Rate for Payer: BCN Medicare Advantage |
$44.49
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Cofinity Commercial |
$59.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.49
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.71
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$53.39
|
| Rate for Payer: PACE SWMI |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$44.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.60
|
| Rate for Payer: Priority Health HMO/PPO |
$62.76
|
| Rate for Payer: Priority Health Medicare |
$44.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.49
|
| Rate for Payer: UHC Exchange |
$44.49
|
| Rate for Payer: UHC Medicare Advantage |
$44.49
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$51.06 |
| Max. Negotiated Rate |
$297.19 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$55.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.19
|
| Rate for Payer: BCBS Complete |
$297.19
|
| Rate for Payer: BCBS MAPPO |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$176.75
|
| Rate for Payer: BCN Commercial |
$167.16
|
| Rate for Payer: BCN Medicare Advantage |
$53.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Mclaren Medicaid |
$283.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.44
|
| Rate for Payer: Meridian Medicaid |
$297.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$176.30
|
| Rate for Payer: PACE Senior Care Partners |
$51.06
|
| Rate for Payer: PACE SWMI |
$53.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$53.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$187.05
|
| Rate for Payer: Priority Health Medicare |
$54.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.05
|
| Rate for Payer: Railroad Medicare Medicare |
$53.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.20
|
| Rate for Payer: UHC Core |
$179.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.75
|
| Rate for Payer: UHC Exchange |
$53.75
|
| Rate for Payer: UHC Medicare Advantage |
$53.75
|
| Rate for Payer: UHCCP Medicaid |
$283.02
|
| Rate for Payer: VA VA |
$53.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: BCBS Complete |
$65.53
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$91.29
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$131.46
|
| Rate for Payer: Cofinity Commercial |
$122.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.29
|
| Rate for Payer: Mclaren Medicaid |
$62.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$65.53
|
| Rate for Payer: Nomi Health Commercial |
$109.55
|
| Rate for Payer: PACE SWMI |
$91.29
|
| Rate for Payer: PHP Medicare Advantage |
$91.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$131.40
|
| Rate for Payer: Priority Health Medicare |
$92.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Exchange |
$91.29
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$62.41
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: BCBS Complete |
$65.53
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$91.29
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$131.46
|
| Rate for Payer: Cofinity Commercial |
$122.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.29
|
| Rate for Payer: Mclaren Medicaid |
$62.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$65.53
|
| Rate for Payer: Nomi Health Commercial |
$109.55
|
| Rate for Payer: PACE SWMI |
$91.29
|
| Rate for Payer: PHP Medicare Advantage |
$91.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$131.40
|
| Rate for Payer: Priority Health Medicare |
$92.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Exchange |
$91.29
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$62.41
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$139.75 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: BCBS Trust/PPO |
$175.50
|
| Rate for Payer: BCN Commercial |
$166.15
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$176.30
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO |
$187.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.20
|
| Rate for Payer: UHC Core |
$179.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
PR PUNCTURE ASPIRATION CYST BREAST EACH ADDL CYST
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 19001
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$20.30
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Medicare Advantage |
$19.52
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$28.11
|
| Rate for Payer: Cofinity Commercial |
$26.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.52
|
| Rate for Payer: Mclaren Medicaid |
$12.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.50
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$23.42
|
| Rate for Payer: PACE SWMI |
$19.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO |
$28.00
|
| Rate for Payer: Priority Health Medicare |
$19.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.52
|
| Rate for Payer: UHC Exchange |
$19.52
|
| Rate for Payer: UHC Medicare Advantage |
$19.52
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
|
|
PR PUNCTURE ASPIRATION CYST OF BREAST
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 19000
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$54.75
|
| Rate for Payer: Aetna Medicare |
$42.49
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$40.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$149.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.86
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$58.84
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.86
|
| Rate for Payer: Mclaren Medicaid |
$27.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.90
|
| Rate for Payer: Meridian Medicaid |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$49.03
|
| Rate for Payer: PACE SWMI |
$40.86
|
| Rate for Payer: PHP Medicare Advantage |
$40.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO |
$56.44
|
| Rate for Payer: Priority Health Medicare |
$41.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.86
|
| Rate for Payer: UHC Exchange |
$40.86
|
| Rate for Payer: UHC Medicare Advantage |
$40.86
|
| Rate for Payer: UHCCP Medicaid |
$27.05
|
|
|
PR PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 61070
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$355.02 |
| Rate for Payer: Aetna Commercial |
$71.98
|
| Rate for Payer: Aetna Medicare |
$55.87
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$53.72
|
| Rate for Payer: BCBS Trust/PPO |
$355.02
|
| Rate for Payer: BCN Commercial |
$113.90
|
| Rate for Payer: BCN Medicare Advantage |
$53.72
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$71.98
|
| Rate for Payer: Cofinity Commercial |
$77.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.72
|
| Rate for Payer: Mclaren Medicaid |
$36.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.41
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Nomi Health Commercial |
$64.46
|
| Rate for Payer: PACE SWMI |
$53.72
|
| Rate for Payer: PHP Medicare Advantage |
$53.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO |
$95.54
|
| Rate for Payer: Priority Health Medicare |
$54.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.72
|
| Rate for Payer: UHC Exchange |
$53.72
|
| Rate for Payer: UHC Medicare Advantage |
$53.72
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
|
|
PR PURE TONE AUDIOMETRY AIR & BONE
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 92553
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$1,526.79 |
| Rate for Payer: Aetna Commercial |
$57.37
|
| Rate for Payer: Aetna Medicare |
$44.52
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS MAPPO |
$42.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$42.81
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$57.37
|
| Rate for Payer: Cofinity Commercial |
$61.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.95
|
| Rate for Payer: Nomi Health Commercial |
$51.37
|
| Rate for Payer: PACE SWMI |
$42.81
|
| Rate for Payer: PHP Medicare Advantage |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health HMO/PPO |
$62.42
|
| Rate for Payer: Priority Health Medicare |
$43.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.81
|
| Rate for Payer: UHC Exchange |
$42.81
|
| Rate for Payer: UHC Medicare Advantage |
$42.81
|
|
|
PR PURE TONE AUDIOMETRY AIR ONLY
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 92552
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$1,476.07 |
| Rate for Payer: Aetna Commercial |
$47.50
|
| Rate for Payer: Aetna Medicare |
$36.87
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$35.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.07
|
| Rate for Payer: BCN Commercial |
$51.80
|
| Rate for Payer: BCN Medicare Advantage |
$35.45
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$51.05
|
| Rate for Payer: Cofinity Commercial |
$47.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.22
|
| Rate for Payer: Nomi Health Commercial |
$42.54
|
| Rate for Payer: PACE SWMI |
$35.45
|
| Rate for Payer: PHP Medicare Advantage |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO |
$51.57
|
| Rate for Payer: Priority Health Medicare |
$35.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.45
|
| Rate for Payer: UHC Exchange |
$35.45
|
| Rate for Payer: UHC Medicare Advantage |
$35.45
|
|
|
PR PVB THORACIC CONT CATHETER INFUSION W/IMG GID
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 64463
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$788.75 |
| Rate for Payer: Aetna Commercial |
$104.71
|
| Rate for Payer: Aetna Medicare |
$81.27
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$788.75
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$104.71
|
| Rate for Payer: Cofinity Commercial |
$112.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Mclaren Medicaid |
$51.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.05
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Nomi Health Commercial |
$93.77
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health HMO/PPO |
$137.06
|
| Rate for Payer: Priority Health Medicare |
$78.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.14
|
| Rate for Payer: UHC Exchange |
$78.14
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
|
|
PR PYELOPLASTY COMPLICATED
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 50405
|
| Min. Negotiated Rate |
$888.00 |
| Max. Negotiated Rate |
$2,206.56 |
| Rate for Payer: Aetna Commercial |
$1,781.38
|
| Rate for Payer: Aetna Medicare |
$1,382.57
|
| Rate for Payer: BCBS Complete |
$932.40
|
| Rate for Payer: BCBS MAPPO |
$1,329.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,085.73
|
| Rate for Payer: BCN Commercial |
$2,003.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,329.39
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,914.32
|
| Rate for Payer: Cofinity Commercial |
$1,781.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,329.39
|
| Rate for Payer: Mclaren Medicaid |
$888.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,395.86
|
| Rate for Payer: Meridian Medicaid |
$932.40
|
| Rate for Payer: Nomi Health Commercial |
$1,595.27
|
| Rate for Payer: PACE SWMI |
$1,329.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,329.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$888.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,206.56
|
| Rate for Payer: Priority Health Medicare |
$1,342.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,206.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,329.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,329.39
|
| Rate for Payer: UHC Exchange |
$1,329.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,329.39
|
| Rate for Payer: UHCCP Medicaid |
$888.00
|
|
|
PR PYELOPLASTY SIMPLE
|
Professional
|
Both
|
$1,795.00
|
|
|
Service Code
|
HCPCS 50400
|
| Min. Negotiated Rate |
$736.13 |
| Max. Negotiated Rate |
$2,368.90 |
| Rate for Payer: Aetna Commercial |
$1,475.78
|
| Rate for Payer: Aetna Medicare |
$1,145.38
|
| Rate for Payer: BCBS Complete |
$772.94
|
| Rate for Payer: BCBS MAPPO |
$1,101.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,368.90
|
| Rate for Payer: BCN Commercial |
$1,659.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.33
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cash Price |
$1,436.00
|
| Rate for Payer: Cofinity Commercial |
$1,585.92
|
| Rate for Payer: Cofinity Commercial |
$1,475.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.33
|
| Rate for Payer: Mclaren Medicaid |
$736.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,156.40
|
| Rate for Payer: Meridian Medicaid |
$772.94
|
| Rate for Payer: Nomi Health Commercial |
$1,321.60
|
| Rate for Payer: PACE SWMI |
$1,101.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,166.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,829.49
|
| Rate for Payer: Priority Health Medicare |
$1,112.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,829.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,101.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.33
|
| Rate for Payer: UHC Exchange |
$1,101.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,101.33
|
| Rate for Payer: UHCCP Medicaid |
$736.13
|
|
|
PR PYLOROMYOTOMY CUTTING PYLORIC MUSC
|
Professional
|
Both
|
$2,256.00
|
|
|
Service Code
|
HCPCS 43520
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$1,466.40 |
| Rate for Payer: Aetna Commercial |
$930.47
|
| Rate for Payer: Aetna Medicare |
$722.16
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS MAPPO |
$694.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.39
|
| Rate for Payer: BCN Commercial |
$1,007.65
|
| Rate for Payer: BCN Medicare Advantage |
$694.38
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cash Price |
$1,804.80
|
| Rate for Payer: Cofinity Commercial |
$999.91
|
| Rate for Payer: Cofinity Commercial |
$930.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.38
|
| Rate for Payer: Mclaren Medicaid |
$460.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.10
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Nomi Health Commercial |
$833.26
|
| Rate for Payer: PACE SWMI |
$694.38
|
| Rate for Payer: PHP Medicare Advantage |
$694.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,466.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,240.92
|
| Rate for Payer: Priority Health Medicare |
$701.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,240.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.38
|
| Rate for Payer: UHC Exchange |
$694.38
|
| Rate for Payer: UHC Medicare Advantage |
$694.38
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
|
|
PR PYLOROPLASTY
|
Professional
|
Both
|
$2,557.00
|
|
|
Service Code
|
HCPCS 43800
|
| Min. Negotiated Rate |
$598.32 |
| Max. Negotiated Rate |
$1,667.49 |
| Rate for Payer: Aetna Commercial |
$1,212.20
|
| Rate for Payer: Aetna Medicare |
$940.82
|
| Rate for Payer: BCBS Complete |
$628.24
|
| Rate for Payer: BCBS MAPPO |
$904.63
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$1,357.06
|
| Rate for Payer: BCN Medicare Advantage |
$904.63
|
| Rate for Payer: Cash Price |
$2,045.60
|
| Rate for Payer: Cash Price |
$2,045.60
|
| Rate for Payer: Cofinity Commercial |
$1,302.67
|
| Rate for Payer: Cofinity Commercial |
$1,212.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.63
|
| Rate for Payer: Mclaren Medicaid |
$598.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.86
|
| Rate for Payer: Meridian Medicaid |
$628.24
|
| Rate for Payer: Nomi Health Commercial |
$1,085.56
|
| Rate for Payer: PACE SWMI |
$904.63
|
| Rate for Payer: PHP Medicare Advantage |
$904.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,662.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,667.49
|
| Rate for Payer: Priority Health Medicare |
$913.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,667.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$904.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$904.63
|
| Rate for Payer: UHC Exchange |
$904.63
|
| Rate for Payer: UHC Medicare Advantage |
$904.63
|
| Rate for Payer: UHCCP Medicaid |
$598.32
|
|
|
PR QUADRICEPSPLASTY
|
Professional
|
Both
|
$2,049.00
|
|
|
Service Code
|
HCPCS 27430
|
| Min. Negotiated Rate |
$484.36 |
| Max. Negotiated Rate |
$1,331.85 |
| Rate for Payer: Aetna Commercial |
$960.51
|
| Rate for Payer: Aetna Medicare |
$745.47
|
| Rate for Payer: BCBS Complete |
$508.58
|
| Rate for Payer: BCBS MAPPO |
$716.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.92
|
| Rate for Payer: BCN Commercial |
$1,093.66
|
| Rate for Payer: BCN Medicare Advantage |
$716.80
|
| Rate for Payer: Cash Price |
$1,639.20
|
| Rate for Payer: Cash Price |
$1,639.20
|
| Rate for Payer: Cofinity Commercial |
$960.51
|
| Rate for Payer: Cofinity Commercial |
$1,032.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.80
|
| Rate for Payer: Mclaren Medicaid |
$484.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.64
|
| Rate for Payer: Meridian Medicaid |
$508.58
|
| Rate for Payer: Nomi Health Commercial |
$860.16
|
| Rate for Payer: PACE SWMI |
$716.80
|
| Rate for Payer: PHP Medicare Advantage |
$716.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,331.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,149.51
|
| Rate for Payer: Priority Health Medicare |
$723.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,149.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.80
|
| Rate for Payer: UHC Exchange |
$716.80
|
| Rate for Payer: UHC Medicare Advantage |
$716.80
|
| Rate for Payer: UHCCP Medicaid |
$484.36
|
|
|
PR QUAL NONMD EST PT 11-20M
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G2062
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$24.64 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO |
$24.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.64
|
|
|
PR QUAL NONMD EST PT 21>MIN
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G2063
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$38.19 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO |
$38.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.19
|
|
|
PR QUAL NONMD EST PT 5-10M
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS G2061
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO |
$13.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.96
|
|
|
PR RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 90375
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$383.67 |
| Rate for Payer: Aetna Commercial |
$357.02
|
| Rate for Payer: Aetna Medicare |
$277.09
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: BCBS MAPPO |
$266.44
|
| Rate for Payer: BCBS Trust/PPO |
$298.09
|
| Rate for Payer: BCN Commercial |
$345.60
|
| Rate for Payer: BCN Medicare Advantage |
$266.44
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Cofinity Commercial |
$383.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.76
|
| Rate for Payer: Nomi Health Commercial |
$319.72
|
| Rate for Payer: PACE SWMI |
$266.44
|
| Rate for Payer: PHP Medicare Advantage |
$266.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: Priority Health Medicare |
$269.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.44
|
| Rate for Payer: UHC Exchange |
$266.44
|
| Rate for Payer: UHC Medicare Advantage |
$266.44
|
|
|
PR RABIES VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 90675
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$449.32 |
| Rate for Payer: Aetna Commercial |
$418.12
|
| Rate for Payer: Aetna Medicare |
$324.51
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS MAPPO |
$312.03
|
| Rate for Payer: BCBS Trust/PPO |
$345.74
|
| Rate for Payer: BCN Commercial |
$364.50
|
| Rate for Payer: BCN Medicare Advantage |
$312.03
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cofinity Commercial |
$449.32
|
| Rate for Payer: Cofinity Commercial |
$418.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$374.44
|
| Rate for Payer: PACE SWMI |
$312.03
|
| Rate for Payer: PHP Medicare Advantage |
$312.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health Medicare |
$315.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.03
|
| Rate for Payer: UHC Exchange |
$312.03
|
| Rate for Payer: UHC Medicare Advantage |
$312.03
|
|
|
PR RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY
|
Professional
|
Both
|
$6,028.00
|
|
|
Service Code
|
HCPCS 58210
|
| Min. Negotiated Rate |
$166.94 |
| Max. Negotiated Rate |
$3,918.20 |
| Rate for Payer: Aetna Commercial |
$2,344.97
|
| Rate for Payer: Aetna Medicare |
$1,819.98
|
| Rate for Payer: BCBS Complete |
$1,227.39
|
| Rate for Payer: BCBS MAPPO |
$1,749.98
|
| Rate for Payer: BCBS Trust/PPO |
$166.94
|
| Rate for Payer: BCN Commercial |
$2,658.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,749.98
|
| Rate for Payer: Cash Price |
$4,822.40
|
| Rate for Payer: Cash Price |
$4,822.40
|
| Rate for Payer: Cofinity Commercial |
$2,519.97
|
| Rate for Payer: Cofinity Commercial |
$2,344.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,749.98
|
| Rate for Payer: Mclaren Medicaid |
$1,168.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,837.48
|
| Rate for Payer: Meridian Medicaid |
$1,227.39
|
| Rate for Payer: Nomi Health Commercial |
$2,099.98
|
| Rate for Payer: PACE SWMI |
$1,749.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,749.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,168.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,918.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,719.82
|
| Rate for Payer: Priority Health Medicare |
$1,767.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,719.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,749.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,749.98
|
| Rate for Payer: UHC Exchange |
$1,749.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,749.98
|
| Rate for Payer: UHCCP Medicaid |
$1,168.94
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS
|
Professional
|
Both
|
$2,719.00
|
|
|
Service Code
|
HCPCS 25115
|
| Min. Negotiated Rate |
$306.41 |
| Max. Negotiated Rate |
$1,767.35 |
| Rate for Payer: Aetna Commercial |
$982.01
|
| Rate for Payer: Aetna Medicare |
$762.15
|
| Rate for Payer: BCBS Complete |
$522.00
|
| Rate for Payer: BCBS MAPPO |
$732.84
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$1,116.14
|
| Rate for Payer: BCN Medicare Advantage |
$732.84
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cash Price |
$2,175.20
|
| Rate for Payer: Cofinity Commercial |
$982.01
|
| Rate for Payer: Cofinity Commercial |
$1,055.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.84
|
| Rate for Payer: Mclaren Medicaid |
$497.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.48
|
| Rate for Payer: Meridian Medicaid |
$522.00
|
| Rate for Payer: Nomi Health Commercial |
$879.41
|
| Rate for Payer: PACE SWMI |
$732.84
|
| Rate for Payer: PHP Medicare Advantage |
$732.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,767.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,173.43
|
| Rate for Payer: Priority Health Medicare |
$740.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,173.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.84
|
| Rate for Payer: UHC Exchange |
$732.84
|
| Rate for Payer: UHC Medicare Advantage |
$732.84
|
| Rate for Payer: UHCCP Medicaid |
$497.14
|
|
|
PR RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS
|
Professional
|
Both
|
$2,330.00
|
|
|
Service Code
|
HCPCS 25116
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$1,514.50 |
| Rate for Payer: Aetna Commercial |
$783.97
|
| Rate for Payer: Aetna Medicare |
$608.45
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$585.05
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$893.30
|
| Rate for Payer: BCN Medicare Advantage |
$585.05
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cash Price |
$1,864.00
|
| Rate for Payer: Cofinity Commercial |
$842.47
|
| Rate for Payer: Cofinity Commercial |
$783.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.05
|
| Rate for Payer: Mclaren Medicaid |
$398.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$614.30
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Nomi Health Commercial |
$702.06
|
| Rate for Payer: PACE SWMI |
$585.05
|
| Rate for Payer: PHP Medicare Advantage |
$585.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,514.50
|
| Rate for Payer: Priority Health HMO/PPO |
$941.90
|
| Rate for Payer: Priority Health Medicare |
$590.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$941.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.05
|
| Rate for Payer: UHC Exchange |
$585.05
|
| Rate for Payer: UHC Medicare Advantage |
$585.05
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
