|
TEMOZOLOMIDE 140 MG CAPSULE
|
Facility
|
OP
|
$1,868.47
|
|
|
Service Code
|
HCPCS J8700
|
| Hospital Charge Code |
81461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$691.33 |
| Max. Negotiated Rate |
$1,681.62 |
| Rate for Payer: Aetna American Axle |
$1,214.51
|
| Rate for Payer: Aetna American Axle |
$404.84
|
| Rate for Payer: Aetna American Axle |
$568.33
|
| Rate for Payer: Aetna American Axle |
$80.97
|
| Rate for Payer: Aetna American Axle |
$190.48
|
| Rate for Payer: Aetna Commercial |
$105.88
|
| Rate for Payer: Aetna Commercial |
$743.20
|
| Rate for Payer: Aetna Commercial |
$249.08
|
| Rate for Payer: Aetna Commercial |
$529.41
|
| Rate for Payer: Aetna Commercial |
$1,588.20
|
| Rate for Payer: Aetna Medicare |
$311.42
|
| Rate for Payer: Aetna Medicare |
$934.24
|
| Rate for Payer: Aetna Medicare |
$437.18
|
| Rate for Payer: Aetna Medicare |
$146.52
|
| Rate for Payer: Aetna Medicare |
$62.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.84
|
| Rate for Payer: BCBS Complete |
$349.74
|
| Rate for Payer: BCBS Complete |
$49.83
|
| Rate for Payer: BCBS Complete |
$249.13
|
| Rate for Payer: BCBS Complete |
$117.22
|
| Rate for Payer: BCBS Complete |
$747.39
|
| Rate for Payer: Cash Price |
$699.48
|
| Rate for Payer: Cash Price |
$99.66
|
| Rate for Payer: Cash Price |
$1,494.78
|
| Rate for Payer: Cash Price |
$498.26
|
| Rate for Payer: Cash Price |
$234.43
|
| Rate for Payer: Cofinity Commercial |
$612.04
|
| Rate for Payer: Cofinity Commercial |
$1,606.88
|
| Rate for Payer: Cofinity Commercial |
$535.63
|
| Rate for Payer: Cofinity Commercial |
$107.13
|
| Rate for Payer: Cofinity Commercial |
$252.01
|
| Rate for Payer: Cofinity Commercial |
$205.13
|
| Rate for Payer: Cofinity Commercial |
$435.98
|
| Rate for Payer: Cofinity Commercial |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$1,307.93
|
| Rate for Payer: Cofinity Commercial |
$751.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,307.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$205.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,494.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.43
|
| Rate for Payer: Healthscope Commercial |
$112.11
|
| Rate for Payer: Healthscope Commercial |
$263.74
|
| Rate for Payer: Healthscope Commercial |
$786.91
|
| Rate for Payer: Healthscope Commercial |
$560.55
|
| Rate for Payer: Healthscope Commercial |
$1,681.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,307.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$612.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,401.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,588.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.20
|
| Rate for Payer: PHP Commercial |
$529.41
|
| Rate for Payer: PHP Commercial |
$249.08
|
| Rate for Payer: PHP Commercial |
$105.88
|
| Rate for Payer: PHP Commercial |
$1,588.20
|
| Rate for Payer: PHP Commercial |
$743.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,214.51
|
| Rate for Payer: Priority Health SBD |
$1,177.14
|
| Rate for Payer: Priority Health SBD |
$78.48
|
| Rate for Payer: Priority Health SBD |
$184.62
|
| Rate for Payer: Priority Health SBD |
$392.38
|
| Rate for Payer: Priority Health SBD |
$550.84
|
| Rate for Payer: UMR Bronson Commercial |
$323.51
|
| Rate for Payer: UMR Bronson Commercial |
$230.45
|
| Rate for Payer: UMR Bronson Commercial |
$691.33
|
| Rate for Payer: UMR Bronson Commercial |
$46.09
|
| Rate for Payer: UMR Bronson Commercial |
$108.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,401.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.78
|
|
|
TEMOZOLOMIDE 140 MG CAPSULE
|
Facility
|
IP
|
$622.83
|
|
|
Service Code
|
HCPCS J8700
|
| Hospital Charge Code |
81461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$274.05 |
| Max. Negotiated Rate |
$560.55 |
| Rate for Payer: Aetna American Axle |
$404.84
|
| Rate for Payer: Aetna American Axle |
$80.97
|
| Rate for Payer: Aetna American Axle |
$1,214.51
|
| Rate for Payer: Aetna American Axle |
$568.33
|
| Rate for Payer: Aetna American Axle |
$190.48
|
| Rate for Payer: Aetna Commercial |
$529.41
|
| Rate for Payer: Aetna Commercial |
$1,588.20
|
| Rate for Payer: Aetna Commercial |
$105.88
|
| Rate for Payer: Aetna Commercial |
$743.20
|
| Rate for Payer: Aetna Commercial |
$249.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,214.51
|
| Rate for Payer: Cash Price |
$498.26
|
| Rate for Payer: Cash Price |
$699.48
|
| Rate for Payer: Cash Price |
$1,494.78
|
| Rate for Payer: Cash Price |
$234.43
|
| Rate for Payer: Cash Price |
$99.66
|
| Rate for Payer: Cofinity Commercial |
$612.04
|
| Rate for Payer: Cofinity Commercial |
$107.13
|
| Rate for Payer: Cofinity Commercial |
$535.63
|
| Rate for Payer: Cofinity Commercial |
$435.98
|
| Rate for Payer: Cofinity Commercial |
$205.13
|
| Rate for Payer: Cofinity Commercial |
$1,307.93
|
| Rate for Payer: Cofinity Commercial |
$1,606.88
|
| Rate for Payer: Cofinity Commercial |
$252.01
|
| Rate for Payer: Cofinity Commercial |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$751.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,307.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$205.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,494.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.43
|
| Rate for Payer: Healthscope Commercial |
$1,681.62
|
| Rate for Payer: Healthscope Commercial |
$560.55
|
| Rate for Payer: Healthscope Commercial |
$263.74
|
| Rate for Payer: Healthscope Commercial |
$786.91
|
| Rate for Payer: Healthscope Commercial |
$112.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,307.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$612.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,401.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,588.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.88
|
| Rate for Payer: PHP Commercial |
$105.88
|
| Rate for Payer: PHP Commercial |
$743.20
|
| Rate for Payer: PHP Commercial |
$249.08
|
| Rate for Payer: PHP Commercial |
$529.41
|
| Rate for Payer: PHP Commercial |
$1,588.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,214.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.97
|
| Rate for Payer: Priority Health SBD |
$550.84
|
| Rate for Payer: Priority Health SBD |
$184.62
|
| Rate for Payer: Priority Health SBD |
$1,177.14
|
| Rate for Payer: Priority Health SBD |
$78.48
|
| Rate for Payer: Priority Health SBD |
$392.38
|
| Rate for Payer: UMR Bronson Commercial |
$54.81
|
| Rate for Payer: UMR Bronson Commercial |
$822.13
|
| Rate for Payer: UMR Bronson Commercial |
$274.05
|
| Rate for Payer: UMR Bronson Commercial |
$384.71
|
| Rate for Payer: UMR Bronson Commercial |
$128.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,401.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.12
|
|
|
TEMPORARY CLOSURE OF EYELIDS BY SUTURE (EG, FROST SUTURE)
|
Facility
|
OP
|
$2,658.95
|
|
|
Service Code
|
CPT 67875
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$506.31 |
| Max. Negotiated Rate |
$2,658.95 |
| Rate for Payer: Aetna Medicare |
$982.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,180.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,180.75
|
| Rate for Payer: BCBS Complete |
$531.62
|
| Rate for Payer: BCBS MAPPO |
$944.60
|
| Rate for Payer: BCN Medicare Advantage |
$944.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.60
|
| Rate for Payer: Mclaren Medicaid |
$506.31
|
| Rate for Payer: Mclaren Medicare |
$944.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.83
|
| Rate for Payer: Meridian Medicaid |
$531.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,086.29
|
| Rate for Payer: PACE Medicare |
$897.37
|
| Rate for Payer: PACE SWMI |
$944.60
|
| Rate for Payer: PHP Medicare Advantage |
$944.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$506.31
|
| Rate for Payer: Priority Health Medicare |
$944.60
|
| Rate for Payer: Railroad Medicare Medicare |
$944.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,658.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$944.60
|
| Rate for Payer: UHC Exchange |
$1,805.23
|
| Rate for Payer: UHC Medicare Advantage |
$944.60
|
| Rate for Payer: UHCCP Medicaid |
$506.31
|
| Rate for Payer: VA VA |
$944.60
|
|
|
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN
|
Facility
|
OP
|
$7,785.57
|
|
|
Service Code
|
HCPCS J9330
|
| Hospital Charge Code |
82228
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.32 |
| Max. Negotiated Rate |
$7,007.01 |
| Rate for Payer: Aetna American Axle |
$5,060.62
|
| Rate for Payer: Aetna American Axle |
$1,980.23
|
| Rate for Payer: Aetna American Axle |
$1,791.29
|
| Rate for Payer: Aetna Commercial |
$6,617.73
|
| Rate for Payer: Aetna Commercial |
$2,342.46
|
| Rate for Payer: Aetna Commercial |
$2,589.53
|
| Rate for Payer: Aetna Medicare |
$27.78
|
| Rate for Payer: Aetna Medicare |
$27.78
|
| Rate for Payer: Aetna Medicare |
$27.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,980.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,060.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.39
|
| Rate for Payer: BCBS Complete |
$15.03
|
| Rate for Payer: BCBS Complete |
$15.03
|
| Rate for Payer: BCBS Complete |
$15.03
|
| Rate for Payer: BCBS MAPPO |
$26.71
|
| Rate for Payer: BCBS MAPPO |
$26.71
|
| Rate for Payer: BCBS MAPPO |
$26.71
|
| Rate for Payer: BCN Medicare Advantage |
$26.71
|
| Rate for Payer: BCN Medicare Advantage |
$26.71
|
| Rate for Payer: BCN Medicare Advantage |
$26.71
|
| Rate for Payer: Cash Price |
$2,437.21
|
| Rate for Payer: Cash Price |
$2,437.21
|
| Rate for Payer: Cash Price |
$2,204.66
|
| Rate for Payer: Cash Price |
$2,204.66
|
| Rate for Payer: Cash Price |
$6,228.46
|
| Rate for Payer: Cash Price |
$6,228.46
|
| Rate for Payer: Cofinity Commercial |
$1,929.08
|
| Rate for Payer: Cofinity Commercial |
$6,695.59
|
| Rate for Payer: Cofinity Commercial |
$5,449.90
|
| Rate for Payer: Cofinity Commercial |
$2,132.56
|
| Rate for Payer: Cofinity Commercial |
$2,370.01
|
| Rate for Payer: Cofinity Commercial |
$2,620.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,449.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,132.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,228.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,437.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.71
|
| Rate for Payer: Healthscope Commercial |
$2,480.25
|
| Rate for Payer: Healthscope Commercial |
$7,007.01
|
| Rate for Payer: Healthscope Commercial |
$2,741.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,132.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,449.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,929.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,839.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,284.88
|
| Rate for Payer: Mclaren Medicaid |
$14.32
|
| Rate for Payer: Mclaren Medicaid |
$14.32
|
| Rate for Payer: Mclaren Medicaid |
$14.32
|
| Rate for Payer: Mclaren Medicare |
$26.71
|
| Rate for Payer: Mclaren Medicare |
$26.71
|
| Rate for Payer: Mclaren Medicare |
$26.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.05
|
| Rate for Payer: Meridian Medicaid |
$15.03
|
| Rate for Payer: Meridian Medicaid |
$15.03
|
| Rate for Payer: Meridian Medicaid |
$15.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,589.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,617.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.46
|
| Rate for Payer: PACE Medicare |
$25.37
|
| Rate for Payer: PACE Medicare |
$25.37
|
| Rate for Payer: PACE Medicare |
$25.37
|
| Rate for Payer: PACE SWMI |
$26.71
|
| Rate for Payer: PACE SWMI |
$26.71
|
| Rate for Payer: PACE SWMI |
$26.71
|
| Rate for Payer: PHP Commercial |
$6,617.73
|
| Rate for Payer: PHP Commercial |
$2,342.46
|
| Rate for Payer: PHP Commercial |
$2,589.53
|
| Rate for Payer: PHP Medicare Advantage |
$26.71
|
| Rate for Payer: PHP Medicare Advantage |
$26.71
|
| Rate for Payer: PHP Medicare Advantage |
$26.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,980.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,060.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.29
|
| Rate for Payer: Priority Health Medicare |
$26.71
|
| Rate for Payer: Priority Health Medicare |
$26.71
|
| Rate for Payer: Priority Health Medicare |
$26.71
|
| Rate for Payer: Priority Health SBD |
$1,736.17
|
| Rate for Payer: Priority Health SBD |
$1,919.30
|
| Rate for Payer: Priority Health SBD |
$4,904.91
|
| Rate for Payer: Railroad Medicare Medicare |
$26.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.71
|
| Rate for Payer: UHC Exchange |
$51.05
|
| Rate for Payer: UHC Exchange |
$51.05
|
| Rate for Payer: UHC Exchange |
$51.05
|
| Rate for Payer: UHC Medicare Advantage |
$26.71
|
| Rate for Payer: UHC Medicare Advantage |
$26.71
|
| Rate for Payer: UHC Medicare Advantage |
$26.71
|
| Rate for Payer: UHCCP Medicaid |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$14.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,127.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,880.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,019.66
|
| Rate for Payer: VA VA |
$26.71
|
| Rate for Payer: VA VA |
$26.71
|
| Rate for Payer: VA VA |
$26.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,284.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,839.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.87
|
|
|
TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST DILUTION) INTRAVENOUS SOLN
|
Facility
|
IP
|
$3,046.51
|
|
|
Service Code
|
HCPCS J9330
|
| Hospital Charge Code |
82228
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,340.46 |
| Max. Negotiated Rate |
$2,741.86 |
| Rate for Payer: Aetna American Axle |
$1,980.23
|
| Rate for Payer: Aetna American Axle |
$1,791.29
|
| Rate for Payer: Aetna American Axle |
$5,060.62
|
| Rate for Payer: Aetna Commercial |
$2,589.53
|
| Rate for Payer: Aetna Commercial |
$2,342.46
|
| Rate for Payer: Aetna Commercial |
$6,617.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,060.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,980.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.29
|
| Rate for Payer: Cash Price |
$6,228.46
|
| Rate for Payer: Cash Price |
$2,437.21
|
| Rate for Payer: Cash Price |
$2,204.66
|
| Rate for Payer: Cofinity Commercial |
$2,370.01
|
| Rate for Payer: Cofinity Commercial |
$1,929.08
|
| Rate for Payer: Cofinity Commercial |
$2,132.56
|
| Rate for Payer: Cofinity Commercial |
$2,620.00
|
| Rate for Payer: Cofinity Commercial |
$5,449.90
|
| Rate for Payer: Cofinity Commercial |
$6,695.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,449.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,132.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,437.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,228.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.66
|
| Rate for Payer: Healthscope Commercial |
$7,007.01
|
| Rate for Payer: Healthscope Commercial |
$2,480.25
|
| Rate for Payer: Healthscope Commercial |
$2,741.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,132.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,929.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,449.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,839.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,284.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,589.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,617.73
|
| Rate for Payer: PHP Commercial |
$2,342.46
|
| Rate for Payer: PHP Commercial |
$6,617.73
|
| Rate for Payer: PHP Commercial |
$2,589.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,980.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,060.62
|
| Rate for Payer: Priority Health SBD |
$1,919.30
|
| Rate for Payer: Priority Health SBD |
$1,736.17
|
| Rate for Payer: Priority Health SBD |
$4,904.91
|
| Rate for Payer: UMR Bronson Commercial |
$3,425.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,340.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,839.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,284.88
|
|
|
TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER)
|
Facility
|
OP
|
$4,393.64
|
|
|
Service Code
|
CPT 26055
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,982.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; EACH TENDON
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 25310
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; WITH TENDON GRAFT(S) (INCLUDES OBTAINING GRAFT), EACH TENDON
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 25312
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENECTEPLASE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$29,932.38
|
|
|
Service Code
|
HCPCS J3101
|
| Hospital Charge Code |
186094
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13,170.25 |
| Max. Negotiated Rate |
$26,939.14 |
| Rate for Payer: Aetna American Axle |
$19,456.05
|
| Rate for Payer: Aetna Commercial |
$25,442.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,456.05
|
| Rate for Payer: Cash Price |
$23,945.90
|
| Rate for Payer: Cofinity Commercial |
$20,952.67
|
| Rate for Payer: Cofinity Commercial |
$25,741.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,952.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,945.90
|
| Rate for Payer: Healthscope Commercial |
$26,939.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,952.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,449.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,442.52
|
| Rate for Payer: PHP Commercial |
$25,442.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,456.05
|
| Rate for Payer: Priority Health SBD |
$18,857.40
|
| Rate for Payer: UMR Bronson Commercial |
$13,170.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,449.28
|
|
|
TENECTEPLASE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$29,932.38
|
|
|
Service Code
|
HCPCS J3101
|
| Hospital Charge Code |
186094
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$92.31 |
| Max. Negotiated Rate |
$26,939.14 |
| Rate for Payer: Aetna American Axle |
$19,456.05
|
| Rate for Payer: Aetna Commercial |
$25,442.52
|
| Rate for Payer: Aetna Medicare |
$179.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,456.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.28
|
| Rate for Payer: BCBS Complete |
$96.93
|
| Rate for Payer: BCBS MAPPO |
$172.22
|
| Rate for Payer: BCN Medicare Advantage |
$172.22
|
| Rate for Payer: Cash Price |
$23,945.90
|
| Rate for Payer: Cash Price |
$23,945.90
|
| Rate for Payer: Cofinity Commercial |
$25,741.85
|
| Rate for Payer: Cofinity Commercial |
$20,952.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,952.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,945.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.22
|
| Rate for Payer: Healthscope Commercial |
$26,939.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,952.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,449.28
|
| Rate for Payer: Mclaren Medicaid |
$92.31
|
| Rate for Payer: Mclaren Medicare |
$172.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.83
|
| Rate for Payer: Meridian Medicaid |
$96.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,442.52
|
| Rate for Payer: PACE Medicare |
$163.61
|
| Rate for Payer: PACE SWMI |
$172.22
|
| Rate for Payer: PHP Commercial |
$25,442.52
|
| Rate for Payer: PHP Medicare Advantage |
$172.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,456.05
|
| Rate for Payer: Priority Health Medicare |
$172.22
|
| Rate for Payer: Priority Health SBD |
$18,857.40
|
| Rate for Payer: Railroad Medicare Medicare |
$172.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.22
|
| Rate for Payer: UHC Exchange |
$329.13
|
| Rate for Payer: UHC Medicare Advantage |
$172.22
|
| Rate for Payer: UHCCP Medicaid |
$92.31
|
| Rate for Payer: UMR Bronson Commercial |
$11,074.98
|
| Rate for Payer: VA VA |
$172.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,449.28
|
|
|
TENODESIS AT WRIST; FLEXORS OF FINGERS
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 25300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENODESIS OF LONG TENDON OF BICEPS
|
Facility
|
OP
|
$19,611.80
|
|
|
Service Code
|
CPT 23430
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,734.39 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Exchange |
$13,314.90
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,734.39
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
TENODESIS; OF PROXIMAL INTERPHALANGEAL JOINT, EACH JOINT
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 26471
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
IP
|
$4,522.03
|
|
|
Service Code
|
NDC 61958040101
|
| Hospital Charge Code |
31684
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,989.69 |
| Max. Negotiated Rate |
$4,069.83 |
| Rate for Payer: Aetna American Axle |
$2,939.32
|
| Rate for Payer: Aetna Commercial |
$3,843.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,939.32
|
| Rate for Payer: Cash Price |
$3,617.62
|
| Rate for Payer: Cofinity Commercial |
$3,165.42
|
| Rate for Payer: Cofinity Commercial |
$3,888.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,165.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,617.62
|
| Rate for Payer: Healthscope Commercial |
$4,069.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,165.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,391.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,843.73
|
| Rate for Payer: PHP Commercial |
$3,843.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,939.32
|
| Rate for Payer: Priority Health SBD |
$2,848.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,989.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,391.52
|
|
|
TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET
|
Facility
|
OP
|
$4,522.03
|
|
|
Service Code
|
NDC 61958040101
|
| Hospital Charge Code |
31684
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,673.15 |
| Max. Negotiated Rate |
$4,069.83 |
| Rate for Payer: Aetna American Axle |
$2,939.32
|
| Rate for Payer: Aetna Commercial |
$3,843.73
|
| Rate for Payer: Aetna Medicare |
$2,261.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,939.32
|
| Rate for Payer: BCBS Complete |
$1,808.81
|
| Rate for Payer: Cash Price |
$3,617.62
|
| Rate for Payer: Cofinity Commercial |
$3,165.42
|
| Rate for Payer: Cofinity Commercial |
$3,888.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,165.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,617.62
|
| Rate for Payer: Healthscope Commercial |
$4,069.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,165.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,391.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,843.73
|
| Rate for Payer: PHP Commercial |
$3,843.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,939.32
|
| Rate for Payer: Priority Health SBD |
$2,848.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,673.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,391.52
|
|
|
TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER, EACH TENDON
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 26445
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOLYSIS, FLEXOR, FOOT; MULTIPLE TENDONS
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 28222
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOLYSIS, FLEXOR, FOOT; SINGLE TENDON
|
Facility
|
OP
|
$4,393.64
|
|
|
Service Code
|
CPT 28220
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,982.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 25295
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; MULTIPLE TENDONS (THROUGH SEPARATE INCISION[S])
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 27681
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; SINGLE, EACH TENDON
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 27680
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOLYSIS, FLEXOR TENDON; PALM AND FINGER, EACH TENDON
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 26442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOLYSIS, FLEXOR TENDON; PALM OR FINGER, EACH TENDON
|
Facility
|
OP
|
$4,393.64
|
|
|
Service Code
|
CPT 26440
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,982.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
TENOTOMY, ELBOW, LATERAL OR MEDIAL (EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW); DEBRIDEMENT, SOFT TISSUE AND/OR BONE, OPEN
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 24358
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
|
TENOTOMY, ELBOW, LATERAL OR MEDIAL (EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW); PERCUTANEOUS
|
Facility
|
OP
|
$8,907.47
|
|
|
Service Code
|
CPT 24357
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| 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: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| 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: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| 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: VA VA |
$3,164.40
|
|
