|
HC D & C POSTPARTUM
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,452.82 |
| Max. Negotiated Rate |
$7,789.74 |
| Rate for Payer: Aetna Commercial |
$7,010.77
|
| Rate for Payer: ASR ASR |
$7,556.05
|
| Rate for Payer: BCBS Trust/PPO |
$6,039.39
|
| Rate for Payer: BCN Commercial |
$6,039.39
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$7,322.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,789.74
|
| Rate for Payer: Healthscope Whirlpool |
$7,556.05
|
| Rate for Payer: Mclaren Commercial |
$7,010.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,854.97
|
|
|
HC DDAVP CMPT1
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.55 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Complete |
$13.18
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Mclaren Medicaid |
$12.55
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Medicaid |
$13.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.55
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.34
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$26.80
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC DDAVP CMPT1
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
|
|
HC DDAVP CMPT2
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.55 |
| Max. Negotiated Rate |
$184.71 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: Aetna Medicare |
$22.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Complete |
$13.18
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.94
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Mclaren Medicaid |
$12.55
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Medicaid |
$13.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicaid |
$12.55
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.71
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$147.77
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: VA VA |
$22.94
|
|
|
HC DDAVP CMPT2
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
|
|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: Aetna Medicare |
$17.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Complete |
$10.28
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.90
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Mclaren Medicaid |
$9.79
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Medicaid |
$10.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$19.69
|
| Rate for Payer: PHP Medicaid |
$9.79
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.34
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$26.80
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
| Rate for Payer: UHC Medicare Advantage |
$18.44
|
| Rate for Payer: VA VA |
$17.90
|
|
|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$37.74 |
| Rate for Payer: Aetna Commercial |
$33.97
|
| Rate for Payer: ASR ASR |
$36.61
|
| Rate for Payer: BCBS Trust/PPO |
$29.26
|
| Rate for Payer: BCN Commercial |
$29.26
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$37.74
|
| Rate for Payer: Healthscope Whirlpool |
$36.61
|
| Rate for Payer: Mclaren Commercial |
$33.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.21
|
|
|
HC D-DIMER QUANTITATIVE
|
Facility
|
OP
|
$122.20
|
|
|
Service Code
|
CPT 85380
|
| Hospital Charge Code |
30500081
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Commercial |
$109.98
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: ASR ASR |
$118.53
|
| Rate for Payer: BCBS Complete |
$5.85
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$94.74
|
| Rate for Payer: BCN Commercial |
$94.74
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$97.76
|
| Rate for Payer: Cash Price |
$97.76
|
| Rate for Payer: Cofinity Commercial |
$114.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$122.20
|
| Rate for Payer: Healthscope Whirlpool |
$118.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$10.18
|
| Rate for Payer: Mclaren Commercial |
$109.98
|
| Rate for Payer: Mclaren Medicaid |
$5.57
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Medicaid |
$5.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.87
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$11.20
|
| Rate for Payer: PHP Medicaid |
$5.57
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.20
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow Network |
$86.76
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.54
|
| Rate for Payer: UHC Medicare Advantage |
$10.49
|
| Rate for Payer: VA VA |
$10.18
|
|
|
HC D-DIMER QUANTITATIVE
|
Facility
|
IP
|
$122.20
|
|
|
Service Code
|
CPT 85380
|
| Hospital Charge Code |
30500081
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$85.54 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Commercial |
$109.98
|
| Rate for Payer: ASR ASR |
$118.53
|
| Rate for Payer: BCBS Trust/PPO |
$94.74
|
| Rate for Payer: BCN Commercial |
$94.74
|
| Rate for Payer: Cash Price |
$97.76
|
| Rate for Payer: Cofinity Commercial |
$114.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.76
|
| Rate for Payer: Healthscope Commercial |
$122.20
|
| Rate for Payer: Healthscope Whirlpool |
$118.53
|
| Rate for Payer: Mclaren Commercial |
$109.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.54
|
|
|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$2,165.56
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,515.89 |
| Max. Negotiated Rate |
$2,165.56 |
| Rate for Payer: Aetna Commercial |
$1,949.00
|
| Rate for Payer: ASR ASR |
$2,100.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.96
|
| Rate for Payer: BCN Commercial |
$1,678.96
|
| Rate for Payer: Cash Price |
$1,732.45
|
| Rate for Payer: Cofinity Commercial |
$2,035.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,732.45
|
| Rate for Payer: Healthscope Commercial |
$2,165.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,100.59
|
| Rate for Payer: Mclaren Commercial |
$1,949.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,840.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,515.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.69
|
|
|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$2,165.56
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$788.30 |
| Max. Negotiated Rate |
$2,165.56 |
| Rate for Payer: Aetna Commercial |
$1,949.00
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$2,100.59
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.96
|
| Rate for Payer: BCN Commercial |
$1,678.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,732.45
|
| Rate for Payer: Cash Price |
$1,732.45
|
| Rate for Payer: Cofinity Commercial |
$2,035.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,732.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,165.56
|
| Rate for Payer: Healthscope Whirlpool |
$2,100.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,949.00
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,840.73
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,515.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,970.66
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,537.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,905.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
OP
|
$524.69
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$697.82 |
| Rate for Payer: Aetna Commercial |
$472.22
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$508.95
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: BCN Commercial |
$406.79
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$419.75
|
| Rate for Payer: Cash Price |
$419.75
|
| Rate for Payer: Cofinity Commercial |
$493.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$524.69
|
| Rate for Payer: Healthscope Whirlpool |
$508.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$472.22
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.99
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$385.84
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$308.67
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.73
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
IP
|
$524.69
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.28 |
| Max. Negotiated Rate |
$524.69 |
| Rate for Payer: Aetna Commercial |
$472.22
|
| Rate for Payer: ASR ASR |
$508.95
|
| Rate for Payer: BCBS Trust/PPO |
$406.79
|
| Rate for Payer: BCN Commercial |
$406.79
|
| Rate for Payer: Cash Price |
$419.75
|
| Rate for Payer: Cofinity Commercial |
$493.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.75
|
| Rate for Payer: Healthscope Commercial |
$524.69
|
| Rate for Payer: Healthscope Whirlpool |
$508.95
|
| Rate for Payer: Mclaren Commercial |
$472.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$461.73
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.52 |
| Max. Negotiated Rate |
$1,316.00 |
| Rate for Payer: Aetna Commercial |
$1,184.40
|
| Rate for Payer: Aetna Medicare |
$489.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: ASR ASR |
$1,276.52
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.29
|
| Rate for Payer: BCN Commercial |
$1,020.29
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,237.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,316.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$489.06
|
| Rate for Payer: Mclaren Commercial |
$1,184.40
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$537.97
|
| Rate for Payer: PHP Medicaid |
$267.52
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,197.56
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$934.36
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,158.08
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$921.20 |
| Max. Negotiated Rate |
$1,316.00 |
| Rate for Payer: Aetna Commercial |
$1,184.40
|
| Rate for Payer: ASR ASR |
$1,276.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.29
|
| Rate for Payer: BCN Commercial |
$1,020.29
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,237.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Healthscope Commercial |
$1,316.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.52
|
| Rate for Payer: Mclaren Commercial |
$1,184.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,158.08
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$1,624.71
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,137.30 |
| Max. Negotiated Rate |
$1,624.71 |
| Rate for Payer: Aetna Commercial |
$1,462.24
|
| Rate for Payer: ASR ASR |
$1,575.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.64
|
| Rate for Payer: BCN Commercial |
$1,259.64
|
| Rate for Payer: Cash Price |
$1,299.77
|
| Rate for Payer: Cofinity Commercial |
$1,527.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.77
|
| Rate for Payer: Healthscope Commercial |
$1,624.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,575.97
|
| Rate for Payer: Mclaren Commercial |
$1,462.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,381.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,429.74
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$1,624.71
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$649.88 |
| Max. Negotiated Rate |
$1,624.71 |
| Rate for Payer: Aetna Commercial |
$1,462.24
|
| Rate for Payer: ASR ASR |
$1,575.97
|
| Rate for Payer: BCBS Complete |
$649.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.64
|
| Rate for Payer: BCN Commercial |
$1,259.64
|
| Rate for Payer: Cash Price |
$1,299.77
|
| Rate for Payer: Cofinity Commercial |
$1,527.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.77
|
| Rate for Payer: Healthscope Commercial |
$1,624.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,575.97
|
| Rate for Payer: Mclaren Commercial |
$1,462.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,381.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,478.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,429.74
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$368.00 |
| Rate for Payer: Aetna Commercial |
$331.20
|
| Rate for Payer: ASR ASR |
$356.96
|
| Rate for Payer: BCBS Trust/PPO |
$285.31
|
| Rate for Payer: BCN Commercial |
$285.31
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$345.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.40
|
| Rate for Payer: Healthscope Commercial |
$368.00
|
| Rate for Payer: Healthscope Whirlpool |
$356.96
|
| Rate for Payer: Mclaren Commercial |
$331.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.84
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.88 |
| Max. Negotiated Rate |
$368.00 |
| Rate for Payer: Aetna Commercial |
$331.20
|
| Rate for Payer: ASR ASR |
$356.96
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: BCBS Trust/PPO |
$285.31
|
| Rate for Payer: BCN Commercial |
$285.31
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$345.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.40
|
| Rate for Payer: Healthscope Commercial |
$368.00
|
| Rate for Payer: Healthscope Whirlpool |
$356.96
|
| Rate for Payer: Mclaren Commercial |
$331.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.60
|
| Rate for Payer: Priority Health Narrow Network |
$18.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.84
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$262.75 |
| Max. Negotiated Rate |
$375.36 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: ASR ASR |
$364.10
|
| Rate for Payer: BCBS Trust/PPO |
$291.02
|
| Rate for Payer: BCN Commercial |
$291.02
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$352.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$375.36
|
| Rate for Payer: Healthscope Whirlpool |
$364.10
|
| Rate for Payer: Mclaren Commercial |
$337.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.32
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.40 |
| Max. Negotiated Rate |
$375.36 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$364.10
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$291.02
|
| Rate for Payer: BCN Commercial |
$291.02
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$352.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$375.36
|
| Rate for Payer: Healthscope Whirlpool |
$364.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$337.82
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$319.06
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.25
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.32
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$494.70
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$395.40
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$479.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$510.00
|
| Rate for Payer: Healthscope Whirlpool |
$494.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$362.10
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.80
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: ASR ASR |
$494.70
|
| Rate for Payer: BCBS Trust/PPO |
$395.40
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$479.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$510.00
|
| Rate for Payer: Healthscope Whirlpool |
$494.70
|
| Rate for Payer: Mclaren Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.80
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$834.46
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$584.12 |
| Max. Negotiated Rate |
$834.46 |
| Rate for Payer: Aetna Commercial |
$751.01
|
| Rate for Payer: ASR ASR |
$809.43
|
| Rate for Payer: BCBS Trust/PPO |
$646.96
|
| Rate for Payer: BCN Commercial |
$646.96
|
| Rate for Payer: Cash Price |
$667.57
|
| Rate for Payer: Cofinity Commercial |
$784.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.57
|
| Rate for Payer: Healthscope Commercial |
$834.46
|
| Rate for Payer: Healthscope Whirlpool |
$809.43
|
| Rate for Payer: Mclaren Commercial |
$751.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$709.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$734.32
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$834.46
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$333.78 |
| Max. Negotiated Rate |
$834.46 |
| Rate for Payer: Aetna Commercial |
$751.01
|
| Rate for Payer: ASR ASR |
$809.43
|
| Rate for Payer: BCBS Complete |
$333.78
|
| Rate for Payer: BCBS Trust/PPO |
$646.96
|
| Rate for Payer: BCN Commercial |
$646.96
|
| Rate for Payer: Cash Price |
$667.57
|
| Rate for Payer: Cofinity Commercial |
$784.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.57
|
| Rate for Payer: Healthscope Commercial |
$834.46
|
| Rate for Payer: Healthscope Whirlpool |
$809.43
|
| Rate for Payer: Mclaren Commercial |
$751.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$709.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$759.36
|
| Rate for Payer: Priority Health Narrow Network |
$592.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$734.32
|
|
