|
ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV
|
Facility
|
IP
|
$310.88
|
|
|
Service Code
|
HCPCS J1806
|
| Hospital Charge Code |
29805
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$136.79 |
| Max. Negotiated Rate |
$279.79 |
| Rate for Payer: Aetna American Axle |
$202.07
|
| Rate for Payer: Aetna Commercial |
$264.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.07
|
| Rate for Payer: Cash Price |
$248.70
|
| Rate for Payer: Cofinity Commercial |
$217.62
|
| Rate for Payer: Cofinity Commercial |
$267.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$217.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.70
|
| Rate for Payer: Healthscope Commercial |
$279.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.25
|
| Rate for Payer: PHP Commercial |
$264.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.07
|
| Rate for Payer: Priority Health SBD |
$195.85
|
| Rate for Payer: UMR Bronson Commercial |
$136.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.16
|
|
|
ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$2,840.83
|
|
|
Service Code
|
NDC 00186502054
|
| Hospital Charge Code |
29745
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,249.97 |
| Max. Negotiated Rate |
$2,556.75 |
| Rate for Payer: Aetna American Axle |
$1,846.54
|
| Rate for Payer: Aetna Commercial |
$2,414.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,846.54
|
| Rate for Payer: Cash Price |
$2,272.66
|
| Rate for Payer: Cofinity Commercial |
$1,988.58
|
| Rate for Payer: Cofinity Commercial |
$2,443.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,988.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,272.66
|
| Rate for Payer: Healthscope Commercial |
$2,556.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,988.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,130.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,414.71
|
| Rate for Payer: PHP Commercial |
$2,414.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.54
|
| Rate for Payer: Priority Health SBD |
$1,789.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,249.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,130.62
|
|
|
ESOMEPRAZOLE MAGNESIUM 20 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$2,840.83
|
|
|
Service Code
|
NDC 00186502054
|
| Hospital Charge Code |
29745
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,051.11 |
| Max. Negotiated Rate |
$2,556.75 |
| Rate for Payer: Aetna American Axle |
$1,846.54
|
| Rate for Payer: Aetna Commercial |
$2,414.71
|
| Rate for Payer: Aetna Medicare |
$1,420.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,846.54
|
| Rate for Payer: BCBS Complete |
$1,136.33
|
| Rate for Payer: Cash Price |
$2,272.66
|
| Rate for Payer: Cofinity Commercial |
$1,988.58
|
| Rate for Payer: Cofinity Commercial |
$2,443.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,988.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,272.66
|
| Rate for Payer: Healthscope Commercial |
$2,556.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,988.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,130.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,414.71
|
| Rate for Payer: PHP Commercial |
$2,414.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.54
|
| Rate for Payer: Priority Health SBD |
$1,789.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,051.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,130.62
|
|
|
ESOMEPRAZOLE MAGNESIUM 40 MG CAPSULE,DELAYED RELEASE
|
Facility
|
IP
|
$2,840.83
|
|
|
Service Code
|
NDC 00186504054
|
| Hospital Charge Code |
29746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,249.97 |
| Max. Negotiated Rate |
$2,556.75 |
| Rate for Payer: Aetna American Axle |
$1,846.54
|
| Rate for Payer: Aetna Commercial |
$2,414.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,846.54
|
| Rate for Payer: Cash Price |
$2,272.66
|
| Rate for Payer: Cofinity Commercial |
$1,988.58
|
| Rate for Payer: Cofinity Commercial |
$2,443.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,988.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,272.66
|
| Rate for Payer: Healthscope Commercial |
$2,556.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,988.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,130.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,414.71
|
| Rate for Payer: PHP Commercial |
$2,414.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.54
|
| Rate for Payer: Priority Health SBD |
$1,789.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,249.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,130.62
|
|
|
ESOMEPRAZOLE MAGNESIUM 40 MG CAPSULE,DELAYED RELEASE
|
Facility
|
OP
|
$2,840.83
|
|
|
Service Code
|
NDC 00186504054
|
| Hospital Charge Code |
29746
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,051.11 |
| Max. Negotiated Rate |
$2,556.75 |
| Rate for Payer: Aetna American Axle |
$1,846.54
|
| Rate for Payer: Aetna Commercial |
$2,414.71
|
| Rate for Payer: Aetna Medicare |
$1,420.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,846.54
|
| Rate for Payer: BCBS Complete |
$1,136.33
|
| Rate for Payer: Cash Price |
$2,272.66
|
| Rate for Payer: Cofinity Commercial |
$1,988.58
|
| Rate for Payer: Cofinity Commercial |
$2,443.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,988.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,272.66
|
| Rate for Payer: Healthscope Commercial |
$2,556.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,988.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,130.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,414.71
|
| Rate for Payer: PHP Commercial |
$2,414.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.54
|
| Rate for Payer: Priority Health SBD |
$1,789.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,051.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,130.62
|
|
|
ESOMEPRAZOLE MAGNESIUM DR 10 MG GRANULES DELAYED RELEASE FOR SUSP
|
Facility
|
IP
|
$987.46
|
|
|
Service Code
|
NDC 00186401001
|
| Hospital Charge Code |
91031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$434.48 |
| Max. Negotiated Rate |
$888.71 |
| Rate for Payer: Aetna American Axle |
$641.85
|
| Rate for Payer: Aetna Commercial |
$839.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.85
|
| Rate for Payer: Cash Price |
$789.97
|
| Rate for Payer: Cofinity Commercial |
$691.22
|
| Rate for Payer: Cofinity Commercial |
$849.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$691.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.97
|
| Rate for Payer: Healthscope Commercial |
$888.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$839.34
|
| Rate for Payer: PHP Commercial |
$839.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.85
|
| Rate for Payer: Priority Health SBD |
$622.10
|
| Rate for Payer: UMR Bronson Commercial |
$434.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.60
|
|
|
ESOMEPRAZOLE MAGNESIUM DR 10 MG GRANULES DELAYED RELEASE FOR SUSP
|
Facility
|
OP
|
$987.46
|
|
|
Service Code
|
NDC 00186401001
|
| Hospital Charge Code |
91031
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$365.36 |
| Max. Negotiated Rate |
$888.71 |
| Rate for Payer: Aetna American Axle |
$641.85
|
| Rate for Payer: Aetna Commercial |
$839.34
|
| Rate for Payer: Aetna Medicare |
$493.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.85
|
| Rate for Payer: BCBS Complete |
$394.98
|
| Rate for Payer: Cash Price |
$789.97
|
| Rate for Payer: Cofinity Commercial |
$691.22
|
| Rate for Payer: Cofinity Commercial |
$849.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$691.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.97
|
| Rate for Payer: Healthscope Commercial |
$888.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$839.34
|
| Rate for Payer: PHP Commercial |
$839.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.85
|
| Rate for Payer: Priority Health SBD |
$622.10
|
| Rate for Payer: UMR Bronson Commercial |
$365.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.60
|
|
|
ESOMEPRAZOLE MAGNESIUM DR 2.5 MG GRANULES DELAYED RELEASE FOR SUSP
|
Facility
|
IP
|
$987.46
|
|
|
Service Code
|
NDC 00186402501
|
| Hospital Charge Code |
162053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$434.48 |
| Max. Negotiated Rate |
$888.71 |
| Rate for Payer: Aetna American Axle |
$641.85
|
| Rate for Payer: Aetna Commercial |
$839.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.85
|
| Rate for Payer: Cash Price |
$789.97
|
| Rate for Payer: Cofinity Commercial |
$691.22
|
| Rate for Payer: Cofinity Commercial |
$849.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$691.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.97
|
| Rate for Payer: Healthscope Commercial |
$888.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$839.34
|
| Rate for Payer: PHP Commercial |
$839.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.85
|
| Rate for Payer: Priority Health SBD |
$622.10
|
| Rate for Payer: UMR Bronson Commercial |
$434.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.60
|
|
|
ESOMEPRAZOLE MAGNESIUM DR 2.5 MG GRANULES DELAYED RELEASE FOR SUSP
|
Facility
|
OP
|
$987.46
|
|
|
Service Code
|
NDC 00186402501
|
| Hospital Charge Code |
162053
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$365.36 |
| Max. Negotiated Rate |
$888.71 |
| Rate for Payer: Aetna American Axle |
$641.85
|
| Rate for Payer: Aetna Commercial |
$839.34
|
| Rate for Payer: Aetna Medicare |
$493.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.85
|
| Rate for Payer: BCBS Complete |
$394.98
|
| Rate for Payer: Cash Price |
$789.97
|
| Rate for Payer: Cofinity Commercial |
$691.22
|
| Rate for Payer: Cofinity Commercial |
$849.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$691.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.97
|
| Rate for Payer: Healthscope Commercial |
$888.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$839.34
|
| Rate for Payer: PHP Commercial |
$839.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.85
|
| Rate for Payer: Priority Health SBD |
$622.10
|
| Rate for Payer: UMR Bronson Commercial |
$365.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.60
|
|
|
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$23.37
|
|
|
Service Code
|
NDC 55150018505
|
| Hospital Charge Code |
41174
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$21.03 |
| Rate for Payer: Aetna American Axle |
$15.19
|
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: Aetna Medicare |
$11.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.19
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Cofinity Commercial |
$20.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.70
|
| Rate for Payer: Healthscope Commercial |
$21.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.86
|
| Rate for Payer: PHP Commercial |
$19.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.19
|
| Rate for Payer: Priority Health SBD |
$14.72
|
| Rate for Payer: UMR Bronson Commercial |
$8.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.53
|
|
|
ESOMEPRAZOLE SODIUM 40 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$23.37
|
|
|
Service Code
|
NDC 55150018505
|
| Hospital Charge Code |
41174
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.28 |
| Max. Negotiated Rate |
$21.03 |
| Rate for Payer: Aetna American Axle |
$15.19
|
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.19
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cofinity Commercial |
$16.36
|
| Rate for Payer: Cofinity Commercial |
$20.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.70
|
| Rate for Payer: Healthscope Commercial |
$21.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.86
|
| Rate for Payer: PHP Commercial |
$19.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.19
|
| Rate for Payer: Priority Health SBD |
$14.72
|
| Rate for Payer: UMR Bronson Commercial |
$10.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.53
|
|
|
ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY WITH INTERPRETATION AND REPORT;
|
Facility
|
OP
|
$1,456.65
|
|
|
Service Code
|
CPT 91010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$1,456.65 |
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$988.96
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: VA VA |
$517.48
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,573.89
|
|
|
Service Code
|
CPT 43235
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,573.89
|
|
|
Service Code
|
CPT 43235
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43270
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF ESOPHAGEAL/GASTRIC VARICES
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43244
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$2,573.89
|
|
|
Service Code
|
CPT 43239
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH CONTROL OF BLEEDING, ANY METHOD
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43255
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATION OF ESOPHAGUS WITH BALLOON (30 MM DIAMETER OR LARGER) (INCLUDES FLUOROSCOPIC GUIDANCE, WHEN PERFORMED)
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43233
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATION OF GASTRIC/DUODENAL STRICTURE(S) (EG, BALLOON, BOUGIE)
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43245
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED PLACEMENT OF PERCUTANEOUS GASTROSTOMY TUBE
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43246
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED PLACEMENT OF PERCUTANEOUS GASTROSTOMY TUBE
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
|
Facility
|
OP
|
$2,573.89
|
|
|
Service Code
|
CPT 43236
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43254
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH ENDOSCOPIC ULTRASOUND EXAMINATION, INCLUDING THE ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM OR A SURGICALLY ALTERED STOMACH WHERE THE JEJUNUM IS EXAMINED DISTAL TO THE ANASTOMOSIS
|
Facility
|
OP
|
$5,207.85
|
|
|
Service Code
|
CPT 43259
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
