|
PR AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 27594
|
| Min. Negotiated Rate |
$444.80 |
| Max. Negotiated Rate |
$722.80 |
| Rate for Payer: Aetna Commercial |
$652.19
|
| Rate for Payer: Aetna Medicare |
$506.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.19
|
| Rate for Payer: BCBS Complete |
$444.80
|
| Rate for Payer: BCBS MAPPO |
$486.71
|
| Rate for Payer: BCN Medicare Advantage |
$486.71
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$700.86
|
| Rate for Payer: Cofinity Commercial |
$652.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.05
|
| Rate for Payer: Nomi Health Commercial |
$584.05
|
| Rate for Payer: PACE SWMI |
$486.71
|
| Rate for Payer: PHP Commercial |
$681.39
|
| Rate for Payer: PHP Medicare Advantage |
$486.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.80
|
| Rate for Payer: Priority Health Medicare |
$486.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.71
|
| Rate for Payer: UHC Medicare Advantage |
$486.71
|
| Rate for Payer: UMR Bronson Commercial |
$511.52
|
|
|
PR AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR
|
Professional
|
Both
|
$1,263.00
|
|
|
Service Code
|
HCPCS 24920
|
| Min. Negotiated Rate |
$505.20 |
| Max. Negotiated Rate |
$1,022.26 |
| Rate for Payer: Aetna Commercial |
$951.27
|
| Rate for Payer: Aetna Medicare |
$738.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$951.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,022.26
|
| Rate for Payer: BCBS Complete |
$505.20
|
| Rate for Payer: BCBS MAPPO |
$709.90
|
| Rate for Payer: BCN Medicare Advantage |
$709.90
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cash Price |
$1,010.40
|
| Rate for Payer: Cofinity Commercial |
$951.27
|
| Rate for Payer: Cofinity Commercial |
$1,022.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$745.39
|
| Rate for Payer: Nomi Health Commercial |
$851.88
|
| Rate for Payer: PACE SWMI |
$709.90
|
| Rate for Payer: PHP Commercial |
$993.86
|
| Rate for Payer: PHP Medicare Advantage |
$709.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$820.95
|
| Rate for Payer: Priority Health Medicare |
$709.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.90
|
| Rate for Payer: UHC Medicare Advantage |
$709.90
|
| Rate for Payer: UMR Bronson Commercial |
$580.98
|
|
|
PR AMPUTATION ARM THRU HUMERUS RE-AMPUTATION
|
Professional
|
Both
|
$2,374.00
|
|
|
Service Code
|
HCPCS 24930
|
| Min. Negotiated Rate |
$748.38 |
| Max. Negotiated Rate |
$1,543.10 |
| Rate for Payer: Aetna Commercial |
$1,002.83
|
| Rate for Payer: Aetna Medicare |
$778.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.83
|
| Rate for Payer: BCBS Complete |
$949.60
|
| Rate for Payer: BCBS MAPPO |
$748.38
|
| Rate for Payer: BCN Medicare Advantage |
$748.38
|
| Rate for Payer: Cash Price |
$1,899.20
|
| Rate for Payer: Cash Price |
$1,899.20
|
| Rate for Payer: Cofinity Commercial |
$1,077.67
|
| Rate for Payer: Cofinity Commercial |
$1,002.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$785.80
|
| Rate for Payer: Nomi Health Commercial |
$898.06
|
| Rate for Payer: PACE SWMI |
$748.38
|
| Rate for Payer: PHP Commercial |
$1,047.73
|
| Rate for Payer: PHP Medicare Advantage |
$748.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,543.10
|
| Rate for Payer: Priority Health Medicare |
$748.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.38
|
| Rate for Payer: UHC Medicare Advantage |
$748.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,092.04
|
|
|
PR AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 24900
|
| Min. Negotiated Rate |
$737.83 |
| Max. Negotiated Rate |
$1,503.45 |
| Rate for Payer: Aetna Commercial |
$988.69
|
| Rate for Payer: Aetna Medicare |
$767.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.48
|
| Rate for Payer: BCBS Complete |
$925.20
|
| Rate for Payer: BCBS MAPPO |
$737.83
|
| Rate for Payer: BCN Medicare Advantage |
$737.83
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$988.69
|
| Rate for Payer: Cofinity Commercial |
$1,062.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$774.72
|
| Rate for Payer: Nomi Health Commercial |
$885.40
|
| Rate for Payer: PACE SWMI |
$737.83
|
| Rate for Payer: PHP Commercial |
$1,032.96
|
| Rate for Payer: PHP Medicare Advantage |
$737.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health Medicare |
$737.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$737.83
|
| Rate for Payer: UHC Medicare Advantage |
$737.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.98
|
|
|
PR AMPUTATION FOOT MIDTARSAL
|
Professional
|
Both
|
$1,633.00
|
|
|
Service Code
|
HCPCS 28800
|
| Min. Negotiated Rate |
$504.80 |
| Max. Negotiated Rate |
$1,061.45 |
| Rate for Payer: Aetna Commercial |
$676.43
|
| Rate for Payer: Aetna Medicare |
$524.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$726.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$676.43
|
| Rate for Payer: BCBS Complete |
$653.20
|
| Rate for Payer: BCBS MAPPO |
$504.80
|
| Rate for Payer: BCN Medicare Advantage |
$504.80
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cofinity Commercial |
$726.91
|
| Rate for Payer: Cofinity Commercial |
$676.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$504.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$530.04
|
| Rate for Payer: Nomi Health Commercial |
$605.76
|
| Rate for Payer: PACE SWMI |
$504.80
|
| Rate for Payer: PHP Commercial |
$706.72
|
| Rate for Payer: PHP Medicare Advantage |
$504.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,061.45
|
| Rate for Payer: Priority Health Medicare |
$504.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$504.80
|
| Rate for Payer: UHC Medicare Advantage |
$504.80
|
| Rate for Payer: UMR Bronson Commercial |
$751.18
|
|
|
PR AMPUTATION FOOT TRANSMETARSAL
|
Professional
|
Both
|
$1,930.00
|
|
|
Service Code
|
HCPCS 28805
|
| Min. Negotiated Rate |
$676.63 |
| Max. Negotiated Rate |
$1,254.50 |
| Rate for Payer: Aetna Commercial |
$906.68
|
| Rate for Payer: Aetna Medicare |
$703.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.68
|
| Rate for Payer: BCBS Complete |
$772.00
|
| Rate for Payer: BCBS MAPPO |
$676.63
|
| Rate for Payer: BCN Medicare Advantage |
$676.63
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cash Price |
$1,544.00
|
| Rate for Payer: Cofinity Commercial |
$974.35
|
| Rate for Payer: Cofinity Commercial |
$906.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.46
|
| Rate for Payer: Nomi Health Commercial |
$811.96
|
| Rate for Payer: PACE SWMI |
$676.63
|
| Rate for Payer: PHP Commercial |
$947.28
|
| Rate for Payer: PHP Medicare Advantage |
$676.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.50
|
| Rate for Payer: Priority Health Medicare |
$676.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.63
|
| Rate for Payer: UHC Medicare Advantage |
$676.63
|
| Rate for Payer: UMR Bronson Commercial |
$887.80
|
|
|
PR AMPUTATION FOREARM THROUGH RADIUS & ULNA
|
Professional
|
Both
|
$2,381.00
|
|
|
Service Code
|
HCPCS 25900
|
| Min. Negotiated Rate |
$695.80 |
| Max. Negotiated Rate |
$1,547.65 |
| Rate for Payer: Aetna Commercial |
$932.37
|
| Rate for Payer: Aetna Medicare |
$723.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$932.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,001.95
|
| Rate for Payer: BCBS Complete |
$952.40
|
| Rate for Payer: BCBS MAPPO |
$695.80
|
| Rate for Payer: BCN Medicare Advantage |
$695.80
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cofinity Commercial |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,001.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$730.59
|
| Rate for Payer: Nomi Health Commercial |
$834.96
|
| Rate for Payer: PACE SWMI |
$695.80
|
| Rate for Payer: PHP Commercial |
$974.12
|
| Rate for Payer: PHP Medicare Advantage |
$695.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.65
|
| Rate for Payer: Priority Health Medicare |
$695.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.80
|
| Rate for Payer: UHC Medicare Advantage |
$695.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,095.26
|
|
|
PR AMPUTATION LEG THROUGH TIBIA&FIBULA
|
Professional
|
Both
|
$2,710.00
|
|
|
Service Code
|
HCPCS 27880
|
| Min. Negotiated Rate |
$867.61 |
| Max. Negotiated Rate |
$1,761.50 |
| Rate for Payer: Aetna Commercial |
$1,162.60
|
| Rate for Payer: Aetna Medicare |
$902.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,249.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,162.60
|
| Rate for Payer: BCBS Complete |
$1,084.00
|
| Rate for Payer: BCBS MAPPO |
$867.61
|
| Rate for Payer: BCN Medicare Advantage |
$867.61
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cofinity Commercial |
$1,249.36
|
| Rate for Payer: Cofinity Commercial |
$1,162.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$867.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.99
|
| Rate for Payer: Nomi Health Commercial |
$1,041.13
|
| Rate for Payer: PACE SWMI |
$867.61
|
| Rate for Payer: PHP Commercial |
$1,214.65
|
| Rate for Payer: PHP Medicare Advantage |
$867.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,761.50
|
| Rate for Payer: Priority Health Medicare |
$867.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$867.61
|
| Rate for Payer: UHC Medicare Advantage |
$867.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.60
|
|
|
PR AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR
|
Professional
|
Both
|
$2,140.00
|
|
|
Service Code
|
HCPCS 27882
|
| Min. Negotiated Rate |
$571.07 |
| Max. Negotiated Rate |
$1,391.00 |
| Rate for Payer: Aetna Commercial |
$765.23
|
| Rate for Payer: Aetna Medicare |
$593.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.23
|
| Rate for Payer: BCBS Complete |
$856.00
|
| Rate for Payer: BCBS MAPPO |
$571.07
|
| Rate for Payer: BCN Medicare Advantage |
$571.07
|
| Rate for Payer: Cash Price |
$1,712.00
|
| Rate for Payer: Cash Price |
$1,712.00
|
| Rate for Payer: Cofinity Commercial |
$822.34
|
| Rate for Payer: Cofinity Commercial |
$765.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.62
|
| Rate for Payer: Nomi Health Commercial |
$685.28
|
| Rate for Payer: PACE SWMI |
$571.07
|
| Rate for Payer: PHP Commercial |
$799.50
|
| Rate for Payer: PHP Medicare Advantage |
$571.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,391.00
|
| Rate for Payer: Priority Health Medicare |
$571.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.07
|
| Rate for Payer: UHC Medicare Advantage |
$571.07
|
| Rate for Payer: UMR Bronson Commercial |
$984.40
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 28810
|
| Hospital Charge Code |
28810
|
| Min. Negotiated Rate |
$403.68 |
| Max. Negotiated Rate |
$933.40 |
| Rate for Payer: Aetna Commercial |
$540.93
|
| Rate for Payer: Aetna Medicare |
$419.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.93
|
| Rate for Payer: BCBS Complete |
$574.40
|
| Rate for Payer: BCBS MAPPO |
$403.68
|
| Rate for Payer: BCN Medicare Advantage |
$403.68
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$540.93
|
| Rate for Payer: Cofinity Commercial |
$581.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.86
|
| Rate for Payer: Nomi Health Commercial |
$484.42
|
| Rate for Payer: PACE SWMI |
$403.68
|
| Rate for Payer: PHP Commercial |
$565.15
|
| Rate for Payer: PHP Medicare Advantage |
$403.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health Medicare |
$403.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.68
|
| Rate for Payer: UHC Medicare Advantage |
$403.68
|
| Rate for Payer: UMR Bronson Commercial |
$660.56
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Professional
|
Both
|
$1,436.00
|
|
|
Service Code
|
HCPCS 28810
|
| Min. Negotiated Rate |
$403.68 |
| Max. Negotiated Rate |
$933.40 |
| Rate for Payer: Aetna Commercial |
$540.93
|
| Rate for Payer: Aetna Medicare |
$419.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.93
|
| Rate for Payer: BCBS Complete |
$574.40
|
| Rate for Payer: BCBS MAPPO |
$403.68
|
| Rate for Payer: BCN Medicare Advantage |
$403.68
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$581.30
|
| Rate for Payer: Cofinity Commercial |
$540.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.86
|
| Rate for Payer: Nomi Health Commercial |
$484.42
|
| Rate for Payer: PACE SWMI |
$403.68
|
| Rate for Payer: PHP Commercial |
$565.15
|
| Rate for Payer: PHP Medicare Advantage |
$403.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health Medicare |
$403.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.68
|
| Rate for Payer: UHC Medicare Advantage |
$403.68
|
| Rate for Payer: UMR Bronson Commercial |
$660.56
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Facility
|
OP
|
$1,436.00
|
|
|
Service Code
|
CPT 28810
|
| Hospital Charge Code |
28810
|
| Min. Negotiated Rate |
$531.32 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$933.40
|
| Rate for Payer: Aetna Commercial |
$1,220.60
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$1,234.96
|
| Rate for Payer: Cofinity Commercial |
$1,005.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,005.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,292.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,005.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.00
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.60
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$1,220.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$904.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$531.32
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.00
|
|
|
PR AMPUTATION METATARSAL W/TOE SINGLE
|
Facility
|
IP
|
$1,436.00
|
|
|
Service Code
|
CPT 28810
|
| Hospital Charge Code |
28810
|
| Min. Negotiated Rate |
$631.84 |
| Max. Negotiated Rate |
$1,292.40 |
| Rate for Payer: Aetna American Axle |
$933.40
|
| Rate for Payer: Aetna Commercial |
$1,220.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.40
|
| Rate for Payer: Cash Price |
$1,148.80
|
| Rate for Payer: Cofinity Commercial |
$1,005.20
|
| Rate for Payer: Cofinity Commercial |
$1,234.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,005.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.80
|
| Rate for Payer: Healthscope Commercial |
$1,292.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,005.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.60
|
| Rate for Payer: PHP Commercial |
$1,220.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.40
|
| Rate for Payer: Priority Health SBD |
$904.68
|
| Rate for Payer: UMR Bronson Commercial |
$631.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.00
|
|
|
PR AMPUTATION PENIS COMPLETE
|
Professional
|
Both
|
$1,552.00
|
|
|
Service Code
|
HCPCS 54125
|
| Min. Negotiated Rate |
$620.80 |
| Max. Negotiated Rate |
$1,140.13 |
| Rate for Payer: Aetna Commercial |
$1,060.96
|
| Rate for Payer: Aetna Medicare |
$823.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,140.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,060.96
|
| Rate for Payer: BCBS Complete |
$620.80
|
| Rate for Payer: BCBS MAPPO |
$791.76
|
| Rate for Payer: BCN Medicare Advantage |
$791.76
|
| Rate for Payer: Cash Price |
$1,241.60
|
| Rate for Payer: Cash Price |
$1,241.60
|
| Rate for Payer: Cofinity Commercial |
$1,140.13
|
| Rate for Payer: Cofinity Commercial |
$1,060.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$791.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$831.35
|
| Rate for Payer: Nomi Health Commercial |
$950.11
|
| Rate for Payer: PACE SWMI |
$791.76
|
| Rate for Payer: PHP Commercial |
$1,108.46
|
| Rate for Payer: PHP Medicare Advantage |
$791.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.80
|
| Rate for Payer: Priority Health Medicare |
$791.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$791.76
|
| Rate for Payer: UHC Medicare Advantage |
$791.76
|
| Rate for Payer: UMR Bronson Commercial |
$713.92
|
|
|
PR AMPUTATION PENIS PARTIAL
|
Professional
|
Both
|
$1,202.00
|
|
|
Service Code
|
HCPCS 54120
|
| Min. Negotiated Rate |
$480.80 |
| Max. Negotiated Rate |
$872.16 |
| Rate for Payer: Aetna Commercial |
$811.60
|
| Rate for Payer: Aetna Medicare |
$629.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.60
|
| Rate for Payer: BCBS Complete |
$480.80
|
| Rate for Payer: BCBS MAPPO |
$605.67
|
| Rate for Payer: BCN Medicare Advantage |
$605.67
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cofinity Commercial |
$872.16
|
| Rate for Payer: Cofinity Commercial |
$811.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.95
|
| Rate for Payer: Nomi Health Commercial |
$726.80
|
| Rate for Payer: PACE SWMI |
$605.67
|
| Rate for Payer: PHP Commercial |
$847.94
|
| Rate for Payer: PHP Medicare Advantage |
$605.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.30
|
| Rate for Payer: Priority Health Medicare |
$605.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.67
|
| Rate for Payer: UHC Medicare Advantage |
$605.67
|
| Rate for Payer: UMR Bronson Commercial |
$552.92
|
|
|
PR AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE
|
Professional
|
Both
|
$2,482.00
|
|
|
Service Code
|
HCPCS 54130
|
| Min. Negotiated Rate |
$992.80 |
| Max. Negotiated Rate |
$1,639.32 |
| Rate for Payer: Aetna Commercial |
$1,525.48
|
| Rate for Payer: Aetna Medicare |
$1,183.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,525.48
|
| Rate for Payer: BCBS Complete |
$992.80
|
| Rate for Payer: BCBS MAPPO |
$1,138.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.42
|
| Rate for Payer: Cash Price |
$1,985.60
|
| Rate for Payer: Cash Price |
$1,985.60
|
| Rate for Payer: Cofinity Commercial |
$1,639.32
|
| Rate for Payer: Cofinity Commercial |
$1,525.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,195.34
|
| Rate for Payer: Nomi Health Commercial |
$1,366.10
|
| Rate for Payer: PACE SWMI |
$1,138.42
|
| Rate for Payer: PHP Commercial |
$1,593.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,613.30
|
| Rate for Payer: Priority Health Medicare |
$1,138.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,138.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,138.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,141.72
|
|
|
PR AMPUTATION THIGH THROUGH FEMUR ANY LEVEL
|
Professional
|
Both
|
$2,582.00
|
|
|
Service Code
|
HCPCS 27590
|
| Min. Negotiated Rate |
$756.87 |
| Max. Negotiated Rate |
$1,678.30 |
| Rate for Payer: Aetna Commercial |
$1,014.21
|
| Rate for Payer: Aetna Medicare |
$787.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.21
|
| Rate for Payer: BCBS Complete |
$1,032.80
|
| Rate for Payer: BCBS MAPPO |
$756.87
|
| Rate for Payer: BCN Medicare Advantage |
$756.87
|
| Rate for Payer: Cash Price |
$2,065.60
|
| Rate for Payer: Cash Price |
$2,065.60
|
| Rate for Payer: Cofinity Commercial |
$1,089.89
|
| Rate for Payer: Cofinity Commercial |
$1,014.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.71
|
| Rate for Payer: Nomi Health Commercial |
$908.24
|
| Rate for Payer: PACE SWMI |
$756.87
|
| Rate for Payer: PHP Commercial |
$1,059.62
|
| Rate for Payer: PHP Medicare Advantage |
$756.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,678.30
|
| Rate for Payer: Priority Health Medicare |
$756.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$756.87
|
| Rate for Payer: UHC Medicare Advantage |
$756.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,187.72
|
|
|
PR AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 27596
|
| Min. Negotiated Rate |
$685.69 |
| Max. Negotiated Rate |
$1,578.20 |
| Rate for Payer: Aetna Commercial |
$918.82
|
| Rate for Payer: Aetna Medicare |
$713.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.82
|
| Rate for Payer: BCBS Complete |
$971.20
|
| Rate for Payer: BCBS MAPPO |
$685.69
|
| Rate for Payer: BCN Medicare Advantage |
$685.69
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$987.39
|
| Rate for Payer: Cofinity Commercial |
$918.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.97
|
| Rate for Payer: Nomi Health Commercial |
$822.83
|
| Rate for Payer: PACE SWMI |
$685.69
|
| Rate for Payer: PHP Commercial |
$959.97
|
| Rate for Payer: PHP Medicare Advantage |
$685.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.20
|
| Rate for Payer: Priority Health Medicare |
$685.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.69
|
| Rate for Payer: UHC Medicare Advantage |
$685.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,116.88
|
|
|
PR AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR
|
Professional
|
Both
|
$3,097.00
|
|
|
Service Code
|
HCPCS 27592
|
| Min. Negotiated Rate |
$652.05 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$873.75
|
| Rate for Payer: Aetna Medicare |
$678.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.75
|
| Rate for Payer: BCBS Complete |
$1,238.80
|
| Rate for Payer: BCBS MAPPO |
$652.05
|
| Rate for Payer: BCN Medicare Advantage |
$652.05
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cash Price |
$2,477.60
|
| Rate for Payer: Cofinity Commercial |
$938.95
|
| Rate for Payer: Cofinity Commercial |
$873.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.65
|
| Rate for Payer: Nomi Health Commercial |
$782.46
|
| Rate for Payer: PACE SWMI |
$652.05
|
| Rate for Payer: PHP Commercial |
$912.87
|
| Rate for Payer: PHP Medicare Advantage |
$652.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.05
|
| Rate for Payer: Priority Health Medicare |
$652.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.05
|
| Rate for Payer: UHC Medicare Advantage |
$652.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.62
|
|
|
PR AMPUTATION TOE INTERPHALANGEAL JOINT
|
Professional
|
Both
|
$1,346.00
|
|
|
Service Code
|
HCPCS 28825
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$874.90 |
| Rate for Payer: Aetna Commercial |
$222.91
|
| Rate for Payer: Aetna Medicare |
$173.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.91
|
| Rate for Payer: BCBS Complete |
$538.40
|
| Rate for Payer: BCBS MAPPO |
$166.35
|
| Rate for Payer: BCN Medicare Advantage |
$166.35
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cash Price |
$1,076.80
|
| Rate for Payer: Cofinity Commercial |
$239.54
|
| Rate for Payer: Cofinity Commercial |
$222.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.67
|
| Rate for Payer: Nomi Health Commercial |
$199.62
|
| Rate for Payer: PACE SWMI |
$166.35
|
| Rate for Payer: PHP Commercial |
$232.89
|
| Rate for Payer: PHP Medicare Advantage |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.90
|
| Rate for Payer: Priority Health Medicare |
$166.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.35
|
| Rate for Payer: UHC Medicare Advantage |
$166.35
|
| Rate for Payer: UMR Bronson Commercial |
$619.16
|
|
|
PR AMPUTATION TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 28820
|
| Hospital Charge Code |
28820
|
| Min. Negotiated Rate |
$170.56 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$228.55
|
| Rate for Payer: Aetna Medicare |
$177.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.61
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$170.56
|
| Rate for Payer: BCN Medicare Advantage |
$170.56
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$245.61
|
| Rate for Payer: Cofinity Commercial |
$228.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.09
|
| Rate for Payer: Nomi Health Commercial |
$204.67
|
| Rate for Payer: PACE SWMI |
$170.56
|
| Rate for Payer: PHP Commercial |
$238.78
|
| Rate for Payer: PHP Medicare Advantage |
$170.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$170.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.56
|
| Rate for Payer: UHC Medicare Advantage |
$170.56
|
| Rate for Payer: UMR Bronson Commercial |
$716.22
|
|
|
PR AMPUTATION TOE METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 28820
|
| Min. Negotiated Rate |
$170.56 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$228.55
|
| Rate for Payer: Aetna Medicare |
$177.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.55
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$170.56
|
| Rate for Payer: BCN Medicare Advantage |
$170.56
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$245.61
|
| Rate for Payer: Cofinity Commercial |
$228.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.09
|
| Rate for Payer: Nomi Health Commercial |
$204.67
|
| Rate for Payer: PACE SWMI |
$170.56
|
| Rate for Payer: PHP Commercial |
$238.78
|
| Rate for Payer: PHP Medicare Advantage |
$170.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$170.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.56
|
| Rate for Payer: UHC Medicare Advantage |
$170.56
|
| Rate for Payer: UMR Bronson Commercial |
$716.22
|
|
|
PR AMPUTATION TOE METATARSOPHALANGEAL JOINT
|
Facility
|
OP
|
$1,557.00
|
|
|
Service Code
|
CPT 28820
|
| Hospital Charge Code |
28820
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$576.09 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$1,012.05
|
| Rate for Payer: Aetna Commercial |
$1,323.45
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,339.02
|
| Rate for Payer: Cofinity Commercial |
$1,089.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,089.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,401.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,089.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.75
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,323.45
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$1,323.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$980.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$576.09
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.75
|
|
|
PR AMPUTATION TOE METATARSOPHALANGEAL JOINT
|
Facility
|
IP
|
$1,557.00
|
|
|
Service Code
|
CPT 28820
|
| Hospital Charge Code |
28820
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$685.08 |
| Max. Negotiated Rate |
$1,401.30 |
| Rate for Payer: Aetna American Axle |
$1,012.05
|
| Rate for Payer: Aetna Commercial |
$1,323.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.05
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,089.90
|
| Rate for Payer: Cofinity Commercial |
$1,339.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,089.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Healthscope Commercial |
$1,401.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,089.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,323.45
|
| Rate for Payer: PHP Commercial |
$1,323.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health SBD |
$980.91
|
| Rate for Payer: UMR Bronson Commercial |
$685.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.75
|
|
|
PR ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 92603
|
| Min. Negotiated Rate |
$111.22 |
| Max. Negotiated Rate |
$205.40 |
| Rate for Payer: Aetna Commercial |
$149.03
|
| Rate for Payer: Aetna Medicare |
$115.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.03
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS MAPPO |
$111.22
|
| Rate for Payer: BCN Medicare Advantage |
$111.22
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$160.16
|
| Rate for Payer: Cofinity Commercial |
$149.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.78
|
| Rate for Payer: Nomi Health Commercial |
$133.46
|
| Rate for Payer: PACE SWMI |
$111.22
|
| Rate for Payer: PHP Commercial |
$155.71
|
| Rate for Payer: PHP Medicare Advantage |
$111.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$111.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.22
|
| Rate for Payer: UHC Medicare Advantage |
$111.22
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
