|
ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION
|
Facility
|
IP
|
$11.65
|
|
|
Service Code
|
HCPCS J2405
|
| Hospital Charge Code |
105614
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$10.48 |
| Rate for Payer: Aetna American Axle |
$7.57
|
| Rate for Payer: Aetna American Axle |
$3.64
|
| Rate for Payer: Aetna American Axle |
$5.53
|
| Rate for Payer: Aetna American Axle |
$6.66
|
| Rate for Payer: Aetna American Axle |
$7.02
|
| Rate for Payer: Aetna American Axle |
$7.01
|
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna American Axle |
$8.45
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Commercial |
$8.70
|
| Rate for Payer: Aetna Commercial |
$9.17
|
| Rate for Payer: Aetna Commercial |
$4.76
|
| Rate for Payer: Aetna Commercial |
$9.18
|
| Rate for Payer: Aetna Commercial |
$11.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.64
|
| Rate for Payer: Cash Price |
$8.63
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cash Price |
$9.32
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cash Price |
$8.64
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$4.48
|
| Rate for Payer: Cash Price |
$6.80
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Advantage |
$7.55
|
| Rate for Payer: Cofinity Advantage |
$8.15
|
| Rate for Payer: Cofinity Advantage |
$7.56
|
| Rate for Payer: Cofinity Advantage |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$3.92
|
| Rate for Payer: Cofinity Advantage |
$5.95
|
| Rate for Payer: Cofinity Advantage |
$9.10
|
| Rate for Payer: Cofinity Commercial |
$9.28
|
| Rate for Payer: Cofinity Commercial |
$8.81
|
| Rate for Payer: Cofinity Commercial |
$9.29
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Cofinity Commercial |
$11.18
|
| Rate for Payer: Cofinity Commercial |
$7.31
|
| Rate for Payer: Cofinity Commercial |
$4.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$10.48
|
| Rate for Payer: Healthscope Commercial |
$9.22
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Healthscope Commercial |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$5.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$9.90
|
| Rate for Payer: PHP Commercial |
$11.05
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: PHP Commercial |
$9.18
|
| Rate for Payer: PHP Commercial |
$9.17
|
| Rate for Payer: PHP Commercial |
$8.70
|
| Rate for Payer: PHP Commercial |
$4.76
|
| Rate for Payer: PHP Commercial |
$7.22
|
| Rate for Payer: Priority Health SBD |
$3.53
|
| Rate for Payer: Priority Health SBD |
$5.36
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: Priority Health SBD |
$6.80
|
| Rate for Payer: Priority Health SBD |
$6.45
|
| Rate for Payer: Priority Health SBD |
$6.80
|
| Rate for Payer: Priority Health SBD |
$7.34
|
| Rate for Payer: Priority Health SBD |
$8.19
|
| Rate for Payer: UMR Bronson Commercial |
$4.51
|
| Rate for Payer: UMR Bronson Commercial |
$5.72
|
| Rate for Payer: UMR Bronson Commercial |
$4.75
|
| Rate for Payer: UMR Bronson Commercial |
$4.20
|
| Rate for Payer: UMR Bronson Commercial |
$3.74
|
| Rate for Payer: UMR Bronson Commercial |
$5.13
|
| Rate for Payer: UMR Bronson Commercial |
$4.75
|
| Rate for Payer: UMR Bronson Commercial |
$2.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.38
|
|
|
OPEN CRANIOTOMY EXCEPT TRAUMA
|
Facility
|
IP
|
$22,546.54
|
|
|
Service Code
|
APR-DRG 0212
|
| Min. Negotiated Rate |
$21,472.90 |
| Max. Negotiated Rate |
$22,546.54 |
| Rate for Payer: BCBS Complete |
$22,546.54
|
| Rate for Payer: Mclaren Medicaid |
$21,472.90
|
| Rate for Payer: Meridian Medicaid |
$22,546.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,472.90
|
| Rate for Payer: UHC Medicaid |
$21,472.90
|
| Rate for Payer: UHCCP Medicaid |
$21,472.90
|
|
|
OPEN CRANIOTOMY EXCEPT TRAUMA
|
Facility
|
IP
|
$14,768.72
|
|
|
Service Code
|
APR-DRG 0211
|
| Min. Negotiated Rate |
$14,065.45 |
| Max. Negotiated Rate |
$14,768.72 |
| Rate for Payer: BCBS Complete |
$14,768.72
|
| Rate for Payer: Mclaren Medicaid |
$14,065.45
|
| Rate for Payer: Meridian Medicaid |
$14,768.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,065.45
|
| Rate for Payer: UHC Medicaid |
$14,065.45
|
| Rate for Payer: UHCCP Medicaid |
$14,065.45
|
|
|
OPEN CRANIOTOMY EXCEPT TRAUMA
|
Facility
|
IP
|
$29,299.55
|
|
|
Service Code
|
APR-DRG 0213
|
| Min. Negotiated Rate |
$27,904.33 |
| Max. Negotiated Rate |
$29,299.55 |
| Rate for Payer: BCBS Complete |
$29,299.55
|
| Rate for Payer: Mclaren Medicaid |
$27,904.33
|
| Rate for Payer: Meridian Medicaid |
$29,299.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$27,904.33
|
| Rate for Payer: UHC Medicaid |
$27,904.33
|
| Rate for Payer: UHCCP Medicaid |
$27,904.33
|
|
|
OPEN CRANIOTOMY EXCEPT TRAUMA
|
Facility
|
IP
|
$33,004.74
|
|
|
Service Code
|
APR-DRG 0214
|
| Min. Negotiated Rate |
$31,433.09 |
| Max. Negotiated Rate |
$33,004.74 |
| Rate for Payer: BCBS Complete |
$33,004.74
|
| Rate for Payer: Mclaren Medicaid |
$31,433.09
|
| Rate for Payer: Meridian Medicaid |
$33,004.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$31,433.09
|
| Rate for Payer: UHC Medicaid |
$31,433.09
|
| Rate for Payer: UHCCP Medicaid |
$31,433.09
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$10,581.08
|
|
|
Service Code
|
APR-DRG 0201
|
| Min. Negotiated Rate |
$10,077.22 |
| Max. Negotiated Rate |
$10,581.08 |
| Rate for Payer: BCBS Complete |
$10,581.08
|
| Rate for Payer: Mclaren Medicaid |
$10,077.22
|
| Rate for Payer: Meridian Medicaid |
$10,581.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,077.22
|
| Rate for Payer: UHC Medicaid |
$10,077.22
|
| Rate for Payer: UHCCP Medicaid |
$10,077.22
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$40,709.92
|
|
|
Service Code
|
APR-DRG 0204
|
| Min. Negotiated Rate |
$38,771.35 |
| Max. Negotiated Rate |
$40,709.92 |
| Rate for Payer: BCBS Complete |
$40,709.92
|
| Rate for Payer: Mclaren Medicaid |
$38,771.35
|
| Rate for Payer: Meridian Medicaid |
$40,709.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$38,771.35
|
| Rate for Payer: UHC Medicaid |
$38,771.35
|
| Rate for Payer: UHCCP Medicaid |
$38,771.35
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$16,286.27
|
|
|
Service Code
|
APR-DRG 0202
|
| Min. Negotiated Rate |
$15,510.73 |
| Max. Negotiated Rate |
$16,286.27 |
| Rate for Payer: BCBS Complete |
$16,286.27
|
| Rate for Payer: Mclaren Medicaid |
$15,510.73
|
| Rate for Payer: Meridian Medicaid |
$16,286.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,510.73
|
| Rate for Payer: UHC Medicaid |
$15,510.73
|
| Rate for Payer: UHCCP Medicaid |
$15,510.73
|
|
|
OPEN CRANIOTOMY FOR TRAUMA
|
Facility
|
IP
|
$26,232.97
|
|
|
Service Code
|
APR-DRG 0203
|
| Min. Negotiated Rate |
$24,983.78 |
| Max. Negotiated Rate |
$26,232.97 |
| Rate for Payer: BCBS Complete |
$26,232.97
|
| Rate for Payer: Mclaren Medicaid |
$24,983.78
|
| Rate for Payer: Meridian Medicaid |
$26,232.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$24,983.78
|
| Rate for Payer: UHC Medicaid |
$24,983.78
|
| Rate for Payer: UHCCP Medicaid |
$24,983.78
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$22,384.92
|
|
|
Service Code
|
APR-DRG 0244
|
| Min. Negotiated Rate |
$21,318.97 |
| Max. Negotiated Rate |
$22,384.92 |
| Rate for Payer: BCBS Complete |
$22,384.92
|
| Rate for Payer: Mclaren Medicaid |
$21,318.97
|
| Rate for Payer: Meridian Medicaid |
$22,384.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,318.97
|
| Rate for Payer: UHC Medicaid |
$21,318.97
|
| Rate for Payer: UHCCP Medicaid |
$21,318.97
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$14,657.94
|
|
|
Service Code
|
APR-DRG 0243
|
| Min. Negotiated Rate |
$13,959.95 |
| Max. Negotiated Rate |
$14,657.94 |
| Rate for Payer: BCBS Complete |
$14,657.94
|
| Rate for Payer: Mclaren Medicaid |
$13,959.95
|
| Rate for Payer: Meridian Medicaid |
$14,657.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,959.95
|
| Rate for Payer: UHC Medicaid |
$13,959.95
|
| Rate for Payer: UHCCP Medicaid |
$13,959.95
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$6,331.70
|
|
|
Service Code
|
APR-DRG 0241
|
| Min. Negotiated Rate |
$6,030.19 |
| Max. Negotiated Rate |
$6,331.70 |
| Rate for Payer: BCBS Complete |
$6,331.70
|
| Rate for Payer: Mclaren Medicaid |
$6,030.19
|
| Rate for Payer: Meridian Medicaid |
$6,331.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,030.19
|
| Rate for Payer: UHC Medicaid |
$6,030.19
|
| Rate for Payer: UHCCP Medicaid |
$6,030.19
|
|
|
OPEN EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$10,323.82
|
|
|
Service Code
|
APR-DRG 0242
|
| Min. Negotiated Rate |
$9,832.21 |
| Max. Negotiated Rate |
$10,323.82 |
| Rate for Payer: BCBS Complete |
$10,323.82
|
| Rate for Payer: Mclaren Medicaid |
$9,832.21
|
| Rate for Payer: Meridian Medicaid |
$10,323.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,832.21
|
| Rate for Payer: UHC Medicaid |
$9,832.21
|
| Rate for Payer: UHCCP Medicaid |
$9,832.21
|
|
|
OPEN IMPLANTATION OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR
|
Facility
|
OP
|
$131,664.27
|
|
|
Service Code
|
CPT 64568
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$22,953.47 |
| Max. Negotiated Rate |
$131,664.27 |
| Rate for Payer: Aetna Medicare |
$45,643.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54,860.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54,860.11
|
| Rate for Payer: BCBS Complete |
$24,103.34
|
| Rate for Payer: BCBS MAPPO |
$43,888.09
|
| Rate for Payer: BCBS Trust/PPO |
$28,515.13
|
| Rate for Payer: BCN Commercial |
$28,515.13
|
| Rate for Payer: BCN Medicare Advantage |
$43,888.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43,888.09
|
| Rate for Payer: Mclaren Medicaid |
$43,888.09
|
| Rate for Payer: Mclaren Medicare |
$43,888.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46,082.49
|
| Rate for Payer: Meridian Medicaid |
$46,082.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50,471.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$48,276.90
|
| Rate for Payer: Nomi Health Commercial |
$131,664.27
|
| Rate for Payer: PACE Medicare |
$41,693.69
|
| Rate for Payer: PACE SWMI |
$43,888.09
|
| Rate for Payer: PHP Medicare Advantage |
$43,888.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,953.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45,000.50
|
| Rate for Payer: Priority Health Medicare |
$43,888.09
|
| Rate for Payer: Priority Health Tiered Network |
$36,000.40
|
| Rate for Payer: Railroad Medicare Medicare |
$43,888.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43,888.09
|
| Rate for Payer: UHC Medicaid |
$22,953.47
|
| Rate for Payer: UHCCP Medicaid |
$22,953.47
|
| Rate for Payer: VA VA |
$43,888.09
|
|
|
OPEN IMPLANTATION OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY
|
Facility
|
OP
|
$99,432.20
|
|
|
Service Code
|
CPT 64582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,080.55 |
| Max. Negotiated Rate |
$99,432.20 |
| Rate for Payer: Aetna Medicare |
$31,976.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38,433.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38,433.43
|
| Rate for Payer: BCBS Complete |
$16,886.11
|
| Rate for Payer: BCBS MAPPO |
$30,746.74
|
| Rate for Payer: BCBS Trust/PPO |
$49,458.94
|
| Rate for Payer: BCN Commercial |
$49,458.94
|
| Rate for Payer: BCN Medicare Advantage |
$30,746.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30,746.74
|
| Rate for Payer: Mclaren Medicaid |
$30,746.74
|
| Rate for Payer: Mclaren Medicare |
$30,746.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,284.08
|
| Rate for Payer: Meridian Medicaid |
$32,284.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,358.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$33,821.41
|
| Rate for Payer: Nomi Health Commercial |
$92,240.22
|
| Rate for Payer: PACE Medicare |
$29,209.40
|
| Rate for Payer: PACE SWMI |
$30,746.74
|
| Rate for Payer: PHP Medicare Advantage |
$30,746.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,080.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99,432.20
|
| Rate for Payer: Priority Health Medicare |
$30,746.74
|
| Rate for Payer: Priority Health Tiered Network |
$79,545.76
|
| Rate for Payer: Railroad Medicare Medicare |
$30,746.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30,746.74
|
| Rate for Payer: UHC Medicaid |
$16,080.55
|
| Rate for Payer: UHCCP Medicaid |
$16,080.55
|
| Rate for Payer: VA VA |
$30,746.74
|
|
|
OPEN IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY; SACRAL NERVE (TRANSFORAMINAL PLACEMENT)
|
Facility
|
OP
|
$20,535.59
|
|
|
Service Code
|
CPT 64581
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,321.09 |
| Max. Negotiated Rate |
$20,535.59 |
| Rate for Payer: Aetna Medicare |
$6,604.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,937.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,937.60
|
| Rate for Payer: BCBS Complete |
$3,487.46
|
| Rate for Payer: BCBS MAPPO |
$6,350.08
|
| Rate for Payer: BCBS Trust/PPO |
$14,958.14
|
| Rate for Payer: BCN Commercial |
$14,958.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,350.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,350.08
|
| Rate for Payer: Mclaren Medicaid |
$6,350.08
|
| Rate for Payer: Mclaren Medicare |
$6,350.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,667.58
|
| Rate for Payer: Meridian Medicaid |
$6,667.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,302.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,985.09
|
| Rate for Payer: Nomi Health Commercial |
$19,050.24
|
| Rate for Payer: PACE Medicare |
$6,032.58
|
| Rate for Payer: PACE SWMI |
$6,350.08
|
| Rate for Payer: PHP Medicare Advantage |
$6,350.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,321.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,535.59
|
| Rate for Payer: Priority Health Medicare |
$6,350.08
|
| Rate for Payer: Priority Health Tiered Network |
$16,428.47
|
| Rate for Payer: Railroad Medicare Medicare |
$6,350.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,350.08
|
| Rate for Payer: UHC Medicaid |
$3,321.09
|
| Rate for Payer: UHCCP Medicaid |
$3,321.09
|
| Rate for Payer: VA VA |
$6,350.08
|
|
|
OPEN TREATMENT OF ACUTE OR CHRONIC ELBOW DISLOCATION
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 24615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$6,486.70
|
| Rate for Payer: BCN Commercial |
$6,486.70
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 26746
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,675.66
|
| Rate for Payer: BCN Commercial |
$2,675.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LATERAL AND POSTERIOR MALLEOLI, OR MEDIAL AND POSTERIOR MALLEOLI), INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 27814
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$7,017.31
|
| Rate for Payer: BCN Commercial |
$7,017.31
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF CALCANEAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED;
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 28415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$9,389.80
|
| Rate for Payer: BCN Commercial |
$9,389.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF CARPAL BONE FRACTURE (OTHER THAN CARPAL SCAPHOID [NAVICULAR]), EACH BONE
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 25645
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,357.23
|
| Rate for Payer: BCN Commercial |
$4,357.23
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
OPEN TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 25628
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,985.59
|
| Rate for Payer: BCN Commercial |
$4,985.59
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
|
OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH JOINT
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 26685
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,675.66
|
| Rate for Payer: BCN Commercial |
$2,675.66
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
OPEN TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$10,543.31
|
|
|
Service Code
|
CPT 26665
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,357.23
|
| Rate for Payer: BCN Commercial |
$4,357.23
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: VA VA |
$3,260.23
|
|
|
OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED
|
Facility
|
OP
|
$23,381.57
|
|
|
Service Code
|
CPT 23515
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,781.35 |
| Max. Negotiated Rate |
$23,381.57 |
| Rate for Payer: Aetna Medicare |
$7,519.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,037.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,037.65
|
| Rate for Payer: BCBS Complete |
$3,970.78
|
| Rate for Payer: BCBS MAPPO |
$7,230.12
|
| Rate for Payer: BCBS Trust/PPO |
$7,788.08
|
| Rate for Payer: BCN Commercial |
$7,788.08
|
| Rate for Payer: BCN Medicare Advantage |
$7,230.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,230.12
|
| Rate for Payer: Mclaren Medicaid |
$7,230.12
|
| Rate for Payer: Mclaren Medicare |
$7,230.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,591.63
|
| Rate for Payer: Meridian Medicaid |
$7,591.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,314.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,953.13
|
| Rate for Payer: Nomi Health Commercial |
$21,690.36
|
| Rate for Payer: PACE Medicare |
$6,868.61
|
| Rate for Payer: PACE SWMI |
$7,230.12
|
| Rate for Payer: PHP Medicare Advantage |
$7,230.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,781.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,381.57
|
| Rate for Payer: Priority Health Medicare |
$7,230.12
|
| Rate for Payer: Priority Health Tiered Network |
$18,705.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,230.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,230.12
|
| Rate for Payer: UHC Medicaid |
$3,781.35
|
| Rate for Payer: UHCCP Medicaid |
$3,781.35
|
| Rate for Payer: VA VA |
$7,230.12
|
|
