|
ADENOSINE (DIAGNOSTIC) 3 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$114.90
|
|
|
Service Code
|
HCPCS J0153
|
| Hospital Charge Code |
15330
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$50.56 |
| Max. Negotiated Rate |
$103.41 |
| Rate for Payer: Aetna American Axle |
$74.69
|
| Rate for Payer: Aetna American Axle |
$49.55
|
| Rate for Payer: Aetna American Axle |
$46.98
|
| Rate for Payer: Aetna Commercial |
$61.43
|
| Rate for Payer: Aetna Commercial |
$97.67
|
| Rate for Payer: Aetna Commercial |
$64.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.98
|
| Rate for Payer: Cash Price |
$57.82
|
| Rate for Payer: Cash Price |
$91.92
|
| Rate for Payer: Cash Price |
$60.98
|
| Rate for Payer: Cofinity Advantage |
$53.36
|
| Rate for Payer: Cofinity Advantage |
$80.43
|
| Rate for Payer: Cofinity Advantage |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$65.56
|
| Rate for Payer: Cofinity Commercial |
$98.81
|
| Rate for Payer: Cofinity Commercial |
$62.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$65.04
|
| Rate for Payer: Healthscope Commercial |
$68.61
|
| Rate for Payer: Healthscope Commercial |
$103.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.17
|
| Rate for Payer: PHP Commercial |
$61.43
|
| Rate for Payer: PHP Commercial |
$97.67
|
| Rate for Payer: PHP Commercial |
$64.80
|
| Rate for Payer: Priority Health SBD |
$72.39
|
| Rate for Payer: Priority Health SBD |
$45.53
|
| Rate for Payer: Priority Health SBD |
$48.02
|
| Rate for Payer: UMR Bronson Commercial |
$50.56
|
| Rate for Payer: UMR Bronson Commercial |
$33.54
|
| Rate for Payer: UMR Bronson Commercial |
$31.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.17
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; DEFECT 30.1 SQ CM TO 60.0 SQ CM
|
Facility
|
OP
|
$11,418.88
|
|
|
Service Code
|
CPT 14301
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,846.70 |
| Max. Negotiated Rate |
$11,418.88 |
| Rate for Payer: Aetna Medicare |
$3,672.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,413.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,413.73
|
| Rate for Payer: BCBS Complete |
$1,939.21
|
| Rate for Payer: BCBS MAPPO |
$3,530.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,546.78
|
| Rate for Payer: BCN Commercial |
$2,546.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,530.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,530.98
|
| Rate for Payer: Mclaren Medicaid |
$3,530.98
|
| Rate for Payer: Mclaren Medicare |
$3,530.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,707.53
|
| Rate for Payer: Meridian Medicaid |
$3,707.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,060.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,884.08
|
| Rate for Payer: Nomi Health Commercial |
$10,592.94
|
| Rate for Payer: PACE Medicare |
$3,354.43
|
| Rate for Payer: PACE SWMI |
$3,530.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,530.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,846.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,418.88
|
| Rate for Payer: Priority Health Medicare |
$3,530.98
|
| Rate for Payer: Priority Health Tiered Network |
$9,135.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,530.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,530.98
|
| Rate for Payer: UHC Medicaid |
$1,846.70
|
| Rate for Payer: UHCCP Medicaid |
$1,846.70
|
| Rate for Payer: VA VA |
$3,530.98
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; EACH ADDITIONAL 30.0 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$976.90
|
|
|
Service Code
|
CPT 14302
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$976.90 |
| Max. Negotiated Rate |
$976.90 |
| Rate for Payer: BCBS Trust/PPO |
$976.90
|
| Rate for Payer: BCN Commercial |
$976.90
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,285.08
|
| Rate for Payer: BCN Commercial |
$3,285.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 SQ CM OR LESS
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.85
|
| Rate for Payer: BCN Commercial |
$1,725.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10.1 SQ CM TO 30.0 SQ CM
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14041
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.85
|
| Rate for Payer: BCN Commercial |
$1,725.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,496.03
|
| Rate for Payer: BCN Commercial |
$2,496.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10.1 SQ CM TO 30.0 SQ CM
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14021
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.85
|
| Rate for Payer: BCN Commercial |
$1,725.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10 SQ CM OR LESS
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.85
|
| Rate for Payer: BCN Commercial |
$1,725.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM
|
Facility
|
OP
|
$6,648.46
|
|
|
Service Code
|
CPT 14001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.85
|
| Rate for Payer: BCN Commercial |
$1,725.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: VA VA |
$2,055.86
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$3,184.01
|
|
|
Service Code
|
APR-DRG 7551
|
| Min. Negotiated Rate |
$3,032.39 |
| Max. Negotiated Rate |
$3,184.01 |
| Rate for Payer: BCBS Complete |
$3,184.01
|
| Rate for Payer: Mclaren Medicaid |
$3,032.39
|
| Rate for Payer: Meridian Medicaid |
$3,184.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,032.39
|
| Rate for Payer: UHC Medicaid |
$3,032.39
|
| Rate for Payer: UHCCP Medicaid |
$3,032.39
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$6,898.89
|
|
|
Service Code
|
APR-DRG 7553
|
| Min. Negotiated Rate |
$6,570.37 |
| Max. Negotiated Rate |
$6,898.89 |
| Rate for Payer: BCBS Complete |
$6,898.89
|
| Rate for Payer: Mclaren Medicaid |
$6,570.37
|
| Rate for Payer: Meridian Medicaid |
$6,898.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,570.37
|
| Rate for Payer: UHC Medicaid |
$6,570.37
|
| Rate for Payer: UHCCP Medicaid |
$6,570.37
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$7,065.96
|
|
|
Service Code
|
APR-DRG 7554
|
| Min. Negotiated Rate |
$6,729.48 |
| Max. Negotiated Rate |
$7,065.96 |
| Rate for Payer: BCBS Complete |
$7,065.96
|
| Rate for Payer: Mclaren Medicaid |
$6,729.48
|
| Rate for Payer: Meridian Medicaid |
$7,065.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,729.48
|
| Rate for Payer: UHC Medicaid |
$6,729.48
|
| Rate for Payer: UHCCP Medicaid |
$6,729.48
|
|
|
ADJUSTMENT DISORDERS
|
Facility
|
IP
|
$3,835.94
|
|
|
Service Code
|
APR-DRG 7552
|
| Min. Negotiated Rate |
$3,653.28 |
| Max. Negotiated Rate |
$3,835.94 |
| Rate for Payer: BCBS Complete |
$3,835.94
|
| Rate for Payer: Mclaren Medicaid |
$3,653.28
|
| Rate for Payer: Meridian Medicaid |
$3,835.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,653.28
|
| Rate for Payer: UHC Medicaid |
$3,653.28
|
| Rate for Payer: UHCCP Medicaid |
$3,653.28
|
|
|
ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$18,630.00
|
|
|
Service Code
|
HCPCS J9354
|
| Hospital Charge Code |
165224
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$16,767.00 |
| Rate for Payer: Aetna American Axle |
$12,109.50
|
| Rate for Payer: Aetna Commercial |
$15,835.50
|
| Rate for Payer: Aetna Medicare |
$43.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,109.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.75
|
| Rate for Payer: BCBS Complete |
$23.18
|
| Rate for Payer: BCBS MAPPO |
$42.20
|
| Rate for Payer: BCBS Trust/PPO |
$134.27
|
| Rate for Payer: BCN Commercial |
$134.27
|
| Rate for Payer: BCN Medicare Advantage |
$42.20
|
| Rate for Payer: Cash Price |
$14,904.00
|
| Rate for Payer: Cash Price |
$14,904.00
|
| Rate for Payer: Cofinity Advantage |
$13,041.00
|
| Rate for Payer: Cofinity Commercial |
$16,021.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,904.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.20
|
| Rate for Payer: Healthscope Commercial |
$16,767.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,041.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,972.50
|
| Rate for Payer: Mclaren Medicaid |
$42.20
|
| Rate for Payer: Mclaren Medicare |
$42.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.31
|
| Rate for Payer: Meridian Medicaid |
$44.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,835.50
|
| Rate for Payer: Nomi Health Commercial |
$126.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,972.50
|
| Rate for Payer: PACE Medicare |
$40.09
|
| Rate for Payer: PACE SWMI |
$42.20
|
| Rate for Payer: PHP Commercial |
$15,835.50
|
| Rate for Payer: PHP Medicare Advantage |
$42.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.97
|
| Rate for Payer: Priority Health Medicare |
$42.20
|
| Rate for Payer: Priority Health SBD |
$11,736.90
|
| Rate for Payer: Priority Health Tiered Network |
$106.38
|
| Rate for Payer: Railroad Medicare Medicare |
$42.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.61
|
| Rate for Payer: UHC Core |
$69.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.20
|
| Rate for Payer: UHC Exchange |
$69.61
|
| Rate for Payer: UHC Medicaid |
$22.07
|
| Rate for Payer: UHCCP Medicaid |
$22.07
|
| Rate for Payer: UMR Bronson Commercial |
$6,893.10
|
| Rate for Payer: VA VA |
$42.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,972.50
|
|
|
ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$18,630.00
|
|
|
Service Code
|
HCPCS J9354
|
| Hospital Charge Code |
165224
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8,197.20 |
| Max. Negotiated Rate |
$16,767.00 |
| Rate for Payer: Aetna American Axle |
$12,109.50
|
| Rate for Payer: Aetna Commercial |
$15,835.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,109.50
|
| Rate for Payer: Cash Price |
$14,904.00
|
| Rate for Payer: Cofinity Advantage |
$13,041.00
|
| Rate for Payer: Cofinity Commercial |
$16,021.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,904.00
|
| Rate for Payer: Healthscope Commercial |
$16,767.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,041.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,972.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,835.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,972.50
|
| Rate for Payer: PHP Commercial |
$15,835.50
|
| Rate for Payer: Priority Health SBD |
$11,736.90
|
| Rate for Payer: UMR Bronson Commercial |
$8,197.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,972.50
|
|
|
ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29,807.95
|
|
|
Service Code
|
HCPCS J9354
|
| Hospital Charge Code |
165225
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$26,827.15 |
| Rate for Payer: Aetna American Axle |
$19,375.17
|
| Rate for Payer: Aetna Commercial |
$25,336.76
|
| Rate for Payer: Aetna Medicare |
$43.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,375.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.75
|
| Rate for Payer: BCBS Complete |
$23.18
|
| Rate for Payer: BCBS MAPPO |
$42.20
|
| Rate for Payer: BCBS Trust/PPO |
$134.27
|
| Rate for Payer: BCN Commercial |
$134.27
|
| Rate for Payer: BCN Medicare Advantage |
$42.20
|
| Rate for Payer: Cash Price |
$23,846.36
|
| Rate for Payer: Cash Price |
$23,846.36
|
| Rate for Payer: Cofinity Advantage |
$20,865.56
|
| Rate for Payer: Cofinity Commercial |
$25,634.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,846.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.20
|
| Rate for Payer: Healthscope Commercial |
$26,827.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,865.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,355.96
|
| Rate for Payer: Mclaren Medicaid |
$42.20
|
| Rate for Payer: Mclaren Medicare |
$42.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.31
|
| Rate for Payer: Meridian Medicaid |
$44.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,336.76
|
| Rate for Payer: Nomi Health Commercial |
$126.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,355.96
|
| Rate for Payer: PACE Medicare |
$40.09
|
| Rate for Payer: PACE SWMI |
$42.20
|
| Rate for Payer: PHP Commercial |
$25,336.76
|
| Rate for Payer: PHP Medicare Advantage |
$42.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.97
|
| Rate for Payer: Priority Health Medicare |
$42.20
|
| Rate for Payer: Priority Health SBD |
$18,779.01
|
| Rate for Payer: Priority Health Tiered Network |
$106.38
|
| Rate for Payer: Railroad Medicare Medicare |
$42.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.61
|
| Rate for Payer: UHC Core |
$69.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.20
|
| Rate for Payer: UHC Exchange |
$69.61
|
| Rate for Payer: UHC Medicaid |
$22.07
|
| Rate for Payer: UHCCP Medicaid |
$22.07
|
| Rate for Payer: UMR Bronson Commercial |
$11,028.94
|
| Rate for Payer: VA VA |
$42.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,355.96
|
|
|
ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$66,590.64
|
|
|
Service Code
|
MSDRG 614
|
| Min. Negotiated Rate |
$17,976.21 |
| Max. Negotiated Rate |
$66,590.64 |
| Rate for Payer: Aetna Medicare |
$19,679.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,652.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,652.91
|
| Rate for Payer: BCBS MAPPO |
$18,922.33
|
| Rate for Payer: BCBS Trust/PPO |
$66,590.64
|
| Rate for Payer: BCN Commercial |
$66,590.64
|
| Rate for Payer: BCN Medicare Advantage |
$18,922.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,922.33
|
| Rate for Payer: Mclaren Medicare |
$18,922.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,868.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,760.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,814.56
|
| Rate for Payer: Nomi Health Commercial |
$28,274.22
|
| Rate for Payer: PACE Medicare |
$17,976.21
|
| Rate for Payer: PACE SWMI |
$18,922.33
|
| Rate for Payer: PHP Medicare Advantage |
$18,922.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35,336.51
|
| Rate for Payer: Priority Health Medicare |
$18,922.33
|
| Rate for Payer: Priority Health Tiered Network |
$28,269.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18,922.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,726.34
|
| Rate for Payer: UHC Core |
$29,889.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,922.33
|
| Rate for Payer: UHC Exchange |
$24,410.08
|
| Rate for Payer: VA VA |
$18,922.33
|
|
|
ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,632.97
|
|
|
Service Code
|
MSDRG 615
|
| Min. Negotiated Rate |
$11,680.15 |
| Max. Negotiated Rate |
$40,632.97 |
| Rate for Payer: Aetna Medicare |
$12,786.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,368.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,368.61
|
| Rate for Payer: BCBS MAPPO |
$12,294.89
|
| Rate for Payer: BCBS Trust/PPO |
$40,632.97
|
| Rate for Payer: BCN Commercial |
$40,632.97
|
| Rate for Payer: BCN Medicare Advantage |
$12,294.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,294.89
|
| Rate for Payer: Mclaren Medicare |
$12,294.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,909.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,139.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,524.38
|
| Rate for Payer: Nomi Health Commercial |
$18,050.97
|
| Rate for Payer: PACE Medicare |
$11,680.15
|
| Rate for Payer: PACE SWMI |
$12,294.89
|
| Rate for Payer: PHP Medicare Advantage |
$12,294.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22,559.71
|
| Rate for Payer: Priority Health Medicare |
$12,294.89
|
| Rate for Payer: Priority Health Tiered Network |
$18,047.77
|
| Rate for Payer: Railroad Medicare Medicare |
$12,294.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,808.59
|
| Rate for Payer: UHC Core |
$19,082.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12,294.89
|
| Rate for Payer: UHC Exchange |
$15,584.00
|
| Rate for Payer: VA VA |
$12,294.89
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$30,844.94
|
|
|
Service Code
|
APR-DRG 4014
|
| Min. Negotiated Rate |
$29,376.13 |
| Max. Negotiated Rate |
$30,844.94 |
| Rate for Payer: BCBS Complete |
$30,844.94
|
| Rate for Payer: Mclaren Medicaid |
$29,376.13
|
| Rate for Payer: Meridian Medicaid |
$30,844.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,376.13
|
| Rate for Payer: UHC Medicaid |
$29,376.13
|
| Rate for Payer: UHCCP Medicaid |
$29,376.13
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$13,182.77
|
|
|
Service Code
|
APR-DRG 4012
|
| Min. Negotiated Rate |
$12,555.02 |
| Max. Negotiated Rate |
$13,182.77 |
| Rate for Payer: BCBS Complete |
$13,182.77
|
| Rate for Payer: Mclaren Medicaid |
$12,555.02
|
| Rate for Payer: Meridian Medicaid |
$13,182.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,555.02
|
| Rate for Payer: UHC Medicaid |
$12,555.02
|
| Rate for Payer: UHCCP Medicaid |
$12,555.02
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$18,710.60
|
|
|
Service Code
|
APR-DRG 4013
|
| Min. Negotiated Rate |
$17,819.62 |
| Max. Negotiated Rate |
$18,710.60 |
| Rate for Payer: BCBS Complete |
$18,710.60
|
| Rate for Payer: Mclaren Medicaid |
$17,819.62
|
| Rate for Payer: Meridian Medicaid |
$18,710.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$17,819.62
|
| Rate for Payer: UHC Medicaid |
$17,819.62
|
| Rate for Payer: UHCCP Medicaid |
$17,819.62
|
|
|
ADRENAL PROCEDURES
|
Facility
|
IP
|
$9,099.85
|
|
|
Service Code
|
APR-DRG 4011
|
| Min. Negotiated Rate |
$8,666.52 |
| Max. Negotiated Rate |
$9,099.85 |
| Rate for Payer: BCBS Complete |
$9,099.85
|
| Rate for Payer: Mclaren Medicaid |
$8,666.52
|
| Rate for Payer: Meridian Medicaid |
$9,099.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,666.52
|
| Rate for Payer: UHC Medicaid |
$8,666.52
|
| Rate for Payer: UHCCP Medicaid |
$8,666.52
|
|
|
AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$20,989.03
|
|
|
Service Code
|
MSDRG 560
|
| Min. Negotiated Rate |
$9,509.68 |
| Max. Negotiated Rate |
$20,989.03 |
| Rate for Payer: Aetna Medicare |
$10,410.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,512.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,512.74
|
| Rate for Payer: BCBS MAPPO |
$10,010.19
|
| Rate for Payer: BCBS Trust/PPO |
$20,989.03
|
| Rate for Payer: BCN Commercial |
$20,989.03
|
| Rate for Payer: BCN Medicare Advantage |
$10,010.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,010.19
|
| Rate for Payer: Mclaren Medicare |
$10,010.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,510.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,511.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,011.21
|
| Rate for Payer: Nomi Health Commercial |
$14,526.69
|
| Rate for Payer: PACE Medicare |
$9,509.68
|
| Rate for Payer: PACE SWMI |
$10,010.19
|
| Rate for Payer: PHP Medicare Advantage |
$10,010.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,155.14
|
| Rate for Payer: Priority Health Medicare |
$10,010.19
|
| Rate for Payer: Priority Health Tiered Network |
$14,524.11
|
| Rate for Payer: Railroad Medicare Medicare |
$10,010.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,355.43
|
| Rate for Payer: UHC Core |
$15,356.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,010.19
|
| Rate for Payer: UHC Exchange |
$12,541.38
|
| Rate for Payer: VA VA |
$10,010.19
|
|
|
AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$52,217.29
|
|
|
Service Code
|
MSDRG 559
|
| Min. Negotiated Rate |
$15,379.13 |
| Max. Negotiated Rate |
$52,217.29 |
| Rate for Payer: Aetna Medicare |
$16,836.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,235.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,235.70
|
| Rate for Payer: BCBS MAPPO |
$16,188.56
|
| Rate for Payer: BCBS Trust/PPO |
$52,217.29
|
| Rate for Payer: BCN Commercial |
$52,217.29
|
| Rate for Payer: BCN Medicare Advantage |
$16,188.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,188.56
|
| Rate for Payer: Mclaren Medicare |
$16,188.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,997.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,616.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,807.42
|
| Rate for Payer: Nomi Health Commercial |
$24,057.21
|
| Rate for Payer: PACE Medicare |
$15,379.13
|
| Rate for Payer: PACE SWMI |
$16,188.56
|
| Rate for Payer: PHP Medicare Advantage |
$16,188.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30,066.18
|
| Rate for Payer: Priority Health Medicare |
$16,188.56
|
| Rate for Payer: Priority Health Tiered Network |
$24,052.94
|
| Rate for Payer: Railroad Medicare Medicare |
$16,188.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,397.87
|
| Rate for Payer: UHC Core |
$25,431.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16,188.56
|
| Rate for Payer: UHC Exchange |
$20,769.39
|
| Rate for Payer: VA VA |
$16,188.56
|
|
