|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
IP
|
$9.55
|
|
|
Service Code
|
NDC 24357070105
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: UMR Bronson Commercial |
$4.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
IP
|
$14.89
|
|
|
Service Code
|
NDC 00496088207
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$13.40 |
| Rate for Payer: Aetna American Axle |
$9.68
|
| Rate for Payer: Aetna Commercial |
$12.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.68
|
| Rate for Payer: Cash Price |
$11.91
|
| Rate for Payer: Cofinity Advantage |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$12.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.91
|
| Rate for Payer: Healthscope Commercial |
$13.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.17
|
| Rate for Payer: PHP Commercial |
$12.66
|
| Rate for Payer: Priority Health SBD |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$6.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.17
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
IP
|
$59.61
|
|
|
Service Code
|
NDC 24357070107
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$26.23 |
| Max. Negotiated Rate |
$53.65 |
| Rate for Payer: Aetna American Axle |
$38.75
|
| Rate for Payer: Aetna Commercial |
$50.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: Cash Price |
$47.69
|
| Rate for Payer: Cofinity Advantage |
$41.73
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.69
|
| Rate for Payer: Healthscope Commercial |
$53.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.71
|
| Rate for Payer: PHP Commercial |
$50.67
|
| Rate for Payer: Priority Health SBD |
$37.55
|
| Rate for Payer: UMR Bronson Commercial |
$26.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.71
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
IP
|
$9.55
|
|
|
Service Code
|
NDC 24357070106
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: UMR Bronson Commercial |
$4.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$9.55
|
|
|
Service Code
|
NDC 24357070106
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna Medicare |
$4.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: BCBS Complete |
$3.82
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.21
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: UHC Exchange |
$3.75
|
| Rate for Payer: UMR Bronson Commercial |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
NDC 00496088205
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Advantage |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.80
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.76
|
| Rate for Payer: UHC Core |
$5.42
|
| Rate for Payer: UHC Exchange |
$4.09
|
| Rate for Payer: UMR Bronson Commercial |
$3.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$14.89
|
|
|
Service Code
|
NDC 00496088207
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$13.40 |
| Rate for Payer: Aetna American Axle |
$9.68
|
| Rate for Payer: Aetna Commercial |
$12.66
|
| Rate for Payer: Aetna Medicare |
$7.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.68
|
| Rate for Payer: BCBS Complete |
$5.96
|
| Rate for Payer: Cash Price |
$11.91
|
| Rate for Payer: Cofinity Advantage |
$10.42
|
| Rate for Payer: Cofinity Commercial |
$12.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.91
|
| Rate for Payer: Healthscope Commercial |
$13.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.17
|
| Rate for Payer: PHP Commercial |
$12.66
|
| Rate for Payer: Priority Health SBD |
$9.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.68
|
| Rate for Payer: UHC Core |
$7.76
|
| Rate for Payer: UHC Exchange |
$5.85
|
| Rate for Payer: UMR Bronson Commercial |
$5.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.17
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$9.55
|
|
|
Service Code
|
NDC 24357070105
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna Medicare |
$4.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: BCBS Complete |
$3.82
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.21
|
| Rate for Payer: UHC Core |
$4.98
|
| Rate for Payer: UHC Exchange |
$3.75
|
| Rate for Payer: UMR Bronson Commercial |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
LIDOCAINE-TRANSPARENT DRESSING 4 % TOPICAL KIT
|
Facility
|
OP
|
$59.61
|
|
|
Service Code
|
NDC 24357070107
|
| Hospital Charge Code |
30183
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$22.06 |
| Max. Negotiated Rate |
$53.65 |
| Rate for Payer: Aetna American Axle |
$38.75
|
| Rate for Payer: Aetna Commercial |
$50.67
|
| Rate for Payer: Aetna Medicare |
$29.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: BCBS Complete |
$23.84
|
| Rate for Payer: Cash Price |
$47.69
|
| Rate for Payer: Cofinity Advantage |
$41.73
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.69
|
| Rate for Payer: Healthscope Commercial |
$53.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.71
|
| Rate for Payer: PHP Commercial |
$50.67
|
| Rate for Payer: Priority Health SBD |
$37.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.75
|
| Rate for Payer: UHC Core |
$31.06
|
| Rate for Payer: UHC Exchange |
$23.43
|
| Rate for Payer: UMR Bronson Commercial |
$22.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.71
|
|
|
LIDOCAINE WITH EPINEPHRINE IN NS 50 ML
|
Facility
|
IP
|
$3.75
|
|
|
Service Code
|
NDC 99000000202
|
| Hospital Charge Code |
158459
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna American Axle |
$2.44
|
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.44
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cofinity Advantage |
$2.62
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: Priority Health SBD |
$2.36
|
| Rate for Payer: UMR Bronson Commercial |
$1.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
LIDOCAINE WITH EPINEPHRINE IN NS 50 ML
|
Facility
|
OP
|
$3.75
|
|
|
Service Code
|
NDC 99000000202
|
| Hospital Charge Code |
158459
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna American Axle |
$2.44
|
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: Aetna Medicare |
$1.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.44
|
| Rate for Payer: BCBS Complete |
$1.50
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cofinity Advantage |
$2.62
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.81
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: Priority Health SBD |
$2.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.44
|
| Rate for Payer: UHC Core |
$1.95
|
| Rate for Payer: UHC Exchange |
$1.47
|
| Rate for Payer: UMR Bronson Commercial |
$1.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
LIGATION AND DIVISION OF LONG SAPHENOUS VEIN AT SAPHENOFEMORAL JUNCTION, OR DISTAL INTERRUPTIONS
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 37700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
LIGATION AND DIVISION OF SHORT SAPHENOUS VEIN AT SAPHENOPOPLITEAL JUNCTION (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 37780
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,126.96
|
| Rate for Payer: BCN Commercial |
$2,126.96
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
LIGATION, DIVISION, AND/OR EXCISION OF VARICOSE VEIN CLUSTER(S), 1 LEG
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 37785
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS FROM SAPHENOFEMORAL JUNCTION TO KNEE OR BELOW
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 37722
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,800.30
|
| Rate for Payer: BCN Commercial |
$2,800.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 37718
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 37607
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
LIGATION OR BIOPSY, TEMPORAL ARTERY
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 37609
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,422.34
|
| Rate for Payer: BCN Commercial |
$3,422.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$127,987.54
|
|
|
Service Code
|
MSDRG 956
|
| Min. Negotiated Rate |
$30,458.71 |
| Max. Negotiated Rate |
$127,987.54 |
| Rate for Payer: Aetna Medicare |
$33,344.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40,077.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40,077.25
|
| Rate for Payer: BCBS MAPPO |
$32,061.80
|
| Rate for Payer: BCBS Trust/PPO |
$127,987.54
|
| Rate for Payer: BCN Commercial |
$127,987.54
|
| Rate for Payer: BCN Medicare Advantage |
$32,061.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32,061.80
|
| Rate for Payer: Mclaren Medicare |
$32,061.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33,664.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,871.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$35,267.98
|
| Rate for Payer: Nomi Health Commercial |
$48,542.70
|
| Rate for Payer: PACE Medicare |
$30,458.71
|
| Rate for Payer: PACE SWMI |
$32,061.80
|
| Rate for Payer: PHP Medicare Advantage |
$32,061.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$60,667.61
|
| Rate for Payer: Priority Health Medicare |
$32,061.80
|
| Rate for Payer: Priority Health Tiered Network |
$48,534.08
|
| Rate for Payer: Railroad Medicare Medicare |
$32,061.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,336.90
|
| Rate for Payer: UHC Core |
$51,316.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32,061.80
|
| Rate for Payer: UHC Exchange |
$41,908.53
|
| Rate for Payer: VA VA |
$32,061.80
|
|
|
LINACLOTIDE 145 MCG CAPSULE
|
Facility
|
OP
|
$226.27
|
|
|
Service Code
|
NDC 00456120104
|
| Hospital Charge Code |
163662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.72 |
| Max. Negotiated Rate |
$203.64 |
| Rate for Payer: Aetna American Axle |
$147.08
|
| Rate for Payer: Aetna Commercial |
$192.33
|
| Rate for Payer: Aetna Medicare |
$113.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.08
|
| Rate for Payer: BCBS Complete |
$90.51
|
| Rate for Payer: Cash Price |
$181.02
|
| Rate for Payer: Cofinity Advantage |
$158.39
|
| Rate for Payer: Cofinity Commercial |
$194.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.02
|
| Rate for Payer: Healthscope Commercial |
$203.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.70
|
| Rate for Payer: PHP Commercial |
$192.33
|
| Rate for Payer: Priority Health SBD |
$142.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.08
|
| Rate for Payer: UHC Core |
$117.89
|
| Rate for Payer: UHC Exchange |
$88.92
|
| Rate for Payer: UMR Bronson Commercial |
$83.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.70
|
|
|
LINACLOTIDE 145 MCG CAPSULE
|
Facility
|
IP
|
$971.59
|
|
|
Service Code
|
NDC 00456120130
|
| Hospital Charge Code |
163662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$427.50 |
| Max. Negotiated Rate |
$874.43 |
| Rate for Payer: Aetna American Axle |
$631.53
|
| Rate for Payer: Aetna Commercial |
$825.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.53
|
| Rate for Payer: Cash Price |
$777.27
|
| Rate for Payer: Cofinity Advantage |
$680.11
|
| Rate for Payer: Cofinity Commercial |
$835.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.27
|
| Rate for Payer: Healthscope Commercial |
$874.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.69
|
| Rate for Payer: PHP Commercial |
$825.85
|
| Rate for Payer: Priority Health SBD |
$612.10
|
| Rate for Payer: UMR Bronson Commercial |
$427.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.69
|
|
|
LINACLOTIDE 145 MCG CAPSULE
|
Facility
|
OP
|
$971.59
|
|
|
Service Code
|
NDC 00456120130
|
| Hospital Charge Code |
163662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$359.49 |
| Max. Negotiated Rate |
$874.43 |
| Rate for Payer: Aetna American Axle |
$631.53
|
| Rate for Payer: Aetna Commercial |
$825.85
|
| Rate for Payer: Aetna Medicare |
$485.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.53
|
| Rate for Payer: BCBS Complete |
$388.64
|
| Rate for Payer: Cash Price |
$777.27
|
| Rate for Payer: Cofinity Advantage |
$680.11
|
| Rate for Payer: Cofinity Commercial |
$835.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.27
|
| Rate for Payer: Healthscope Commercial |
$874.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$777.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.69
|
| Rate for Payer: PHP Commercial |
$825.85
|
| Rate for Payer: Priority Health SBD |
$612.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.53
|
| Rate for Payer: UHC Core |
$506.20
|
| Rate for Payer: UHC Exchange |
$381.83
|
| Rate for Payer: UMR Bronson Commercial |
$359.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.69
|
|
|
LINACLOTIDE 145 MCG CAPSULE
|
Facility
|
IP
|
$226.27
|
|
|
Service Code
|
NDC 00456120104
|
| Hospital Charge Code |
163662
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.56 |
| Max. Negotiated Rate |
$203.64 |
| Rate for Payer: Aetna American Axle |
$147.08
|
| Rate for Payer: Aetna Commercial |
$192.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.08
|
| Rate for Payer: Cash Price |
$181.02
|
| Rate for Payer: Cofinity Advantage |
$158.39
|
| Rate for Payer: Cofinity Commercial |
$194.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.02
|
| Rate for Payer: Healthscope Commercial |
$203.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.70
|
| Rate for Payer: PHP Commercial |
$192.33
|
| Rate for Payer: Priority Health SBD |
$142.55
|
| Rate for Payer: UMR Bronson Commercial |
$99.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.70
|
|
|
LINACLOTIDE 290 MCG CAPSULE
|
Facility
|
IP
|
$971.59
|
|
|
Service Code
|
NDC 00456120230
|
| Hospital Charge Code |
163663
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$427.50 |
| Max. Negotiated Rate |
$874.43 |
| Rate for Payer: Aetna American Axle |
$631.53
|
| Rate for Payer: Aetna Commercial |
$825.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.53
|
| Rate for Payer: Cash Price |
$777.27
|
| Rate for Payer: Cofinity Advantage |
$680.11
|
| Rate for Payer: Cofinity Commercial |
$835.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.27
|
| Rate for Payer: Healthscope Commercial |
$874.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.69
|
| Rate for Payer: PHP Commercial |
$825.85
|
| Rate for Payer: Priority Health SBD |
$612.10
|
| Rate for Payer: UMR Bronson Commercial |
$427.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.69
|
|
|
LINACLOTIDE 290 MCG CAPSULE
|
Facility
|
OP
|
$971.59
|
|
|
Service Code
|
NDC 00456120230
|
| Hospital Charge Code |
163663
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$359.49 |
| Max. Negotiated Rate |
$874.43 |
| Rate for Payer: Aetna American Axle |
$631.53
|
| Rate for Payer: Aetna Commercial |
$825.85
|
| Rate for Payer: Aetna Medicare |
$485.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.53
|
| Rate for Payer: BCBS Complete |
$388.64
|
| Rate for Payer: Cash Price |
$777.27
|
| Rate for Payer: Cofinity Advantage |
$680.11
|
| Rate for Payer: Cofinity Commercial |
$835.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.27
|
| Rate for Payer: Healthscope Commercial |
$874.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$680.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$777.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.69
|
| Rate for Payer: PHP Commercial |
$825.85
|
| Rate for Payer: Priority Health SBD |
$612.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.53
|
| Rate for Payer: UHC Core |
$506.20
|
| Rate for Payer: UHC Exchange |
$381.83
|
| Rate for Payer: UMR Bronson Commercial |
$359.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.69
|
|
