|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,320.82
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$858.53 |
| Max. Negotiated Rate |
$1,320.82 |
| Rate for Payer: Aetna Commercial |
$1,188.74
|
| Rate for Payer: ASR ASR |
$1,281.20
|
| Rate for Payer: ASR Commercial |
$1,281.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,076.34
|
| Rate for Payer: BCN Commercial |
$1,024.03
|
| Rate for Payer: Cash Price |
$1,056.66
|
| Rate for Payer: Cofinity Commercial |
$1,241.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.66
|
| Rate for Payer: Healthscope Commercial |
$1,320.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,281.20
|
| Rate for Payer: Mclaren Commercial |
$1,188.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.70
|
| Rate for Payer: Nomi Health Commercial |
$1,083.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,162.32
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$816.54 |
| Rate for Payer: Aetna Commercial |
$734.89
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$792.04
|
| Rate for Payer: ASR Commercial |
$792.04
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$668.66
|
| Rate for Payer: BCN Commercial |
$633.06
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$767.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$792.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$734.89
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.45
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$572.39
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$816.54 |
| Rate for Payer: Aetna Commercial |
$734.89
|
| Rate for Payer: ASR ASR |
$792.04
|
| Rate for Payer: ASR Commercial |
$792.04
|
| Rate for Payer: BCBS Trust/PPO |
$665.40
|
| Rate for Payer: BCN Commercial |
$633.06
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$767.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$816.54
|
| Rate for Payer: Healthscope Whirlpool |
$792.04
|
| Rate for Payer: Mclaren Commercial |
$734.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$718.56
|
|
|
HC APHERESIS
|
Facility
|
IP
|
$2,555.49
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,661.07 |
| Max. Negotiated Rate |
$2,555.49 |
| Rate for Payer: Aetna Commercial |
$2,299.94
|
| Rate for Payer: ASR ASR |
$2,478.83
|
| Rate for Payer: ASR Commercial |
$2,478.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.47
|
| Rate for Payer: BCN Commercial |
$1,981.27
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cofinity Commercial |
$2,402.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.39
|
| Rate for Payer: Healthscope Commercial |
$2,555.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,478.83
|
| Rate for Payer: Mclaren Commercial |
$2,299.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,172.17
|
| Rate for Payer: Nomi Health Commercial |
$2,095.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,248.83
|
|
|
HC APHERESIS
|
Facility
|
OP
|
$2,555.49
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,022.20 |
| Max. Negotiated Rate |
$2,555.49 |
| Rate for Payer: Aetna Commercial |
$2,299.94
|
| Rate for Payer: Aetna Medicare |
$1,277.74
|
| Rate for Payer: ASR ASR |
$2,478.83
|
| Rate for Payer: ASR Commercial |
$2,478.83
|
| Rate for Payer: BCBS Complete |
$1,022.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.69
|
| Rate for Payer: BCN Commercial |
$1,981.27
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cofinity Commercial |
$2,402.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.39
|
| Rate for Payer: Healthscope Commercial |
$2,555.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,478.83
|
| Rate for Payer: Mclaren Commercial |
$2,299.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,172.17
|
| Rate for Payer: Nomi Health Commercial |
$2,095.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,239.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,791.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,248.83
|
|
|
HC APIXABAN
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: ASR ASR |
$148.41
|
| Rate for Payer: ASR Commercial |
$148.41
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$125.29
|
| Rate for Payer: BCN Commercial |
$118.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$143.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Healthscope Whirlpool |
$148.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$137.70
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.50
|
| Rate for Payer: PHP Medicaid |
$9.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.06
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$107.25
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC APIXABAN
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$99.45 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: ASR ASR |
$148.41
|
| Rate for Payer: ASR Commercial |
$148.41
|
| Rate for Payer: BCBS Trust/PPO |
$124.68
|
| Rate for Payer: BCN Commercial |
$118.62
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$143.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Healthscope Whirlpool |
$148.41
|
| Rate for Payer: Mclaren Commercial |
$137.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.64
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
IP
|
$131.72
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$85.62 |
| Max. Negotiated Rate |
$131.72 |
| Rate for Payer: Aetna Commercial |
$118.55
|
| Rate for Payer: ASR ASR |
$127.77
|
| Rate for Payer: ASR Commercial |
$127.77
|
| Rate for Payer: BCBS Trust/PPO |
$107.34
|
| Rate for Payer: BCN Commercial |
$102.12
|
| Rate for Payer: Cash Price |
$105.38
|
| Rate for Payer: Cofinity Commercial |
$123.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.38
|
| Rate for Payer: Healthscope Commercial |
$131.72
|
| Rate for Payer: Healthscope Whirlpool |
$127.77
|
| Rate for Payer: Mclaren Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.96
|
| Rate for Payer: Nomi Health Commercial |
$108.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.91
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
OP
|
$131.72
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.69 |
| Max. Negotiated Rate |
$131.72 |
| Rate for Payer: Aetna Commercial |
$118.55
|
| Rate for Payer: Aetna Medicare |
$65.86
|
| Rate for Payer: ASR ASR |
$127.77
|
| Rate for Payer: ASR Commercial |
$127.77
|
| Rate for Payer: BCBS Complete |
$52.69
|
| Rate for Payer: BCBS Trust/PPO |
$107.87
|
| Rate for Payer: BCN Commercial |
$102.12
|
| Rate for Payer: Cash Price |
$105.38
|
| Rate for Payer: Cofinity Commercial |
$123.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.38
|
| Rate for Payer: Healthscope Commercial |
$131.72
|
| Rate for Payer: Healthscope Whirlpool |
$127.77
|
| Rate for Payer: Mclaren Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.96
|
| Rate for Payer: Nomi Health Commercial |
$108.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.41
|
| Rate for Payer: Priority Health Narrow Network |
$92.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.91
|
|
|
HC APNEALINK PLUS
|
Facility
|
OP
|
$747.76
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$747.76 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$725.33
|
| Rate for Payer: ASR Commercial |
$725.33
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$612.34
|
| Rate for Payer: BCN Commercial |
$579.74
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$598.21
|
| Rate for Payer: Cash Price |
$598.21
|
| Rate for Payer: Cofinity Commercial |
$702.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$747.76
|
| Rate for Payer: Healthscope Whirlpool |
$725.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$672.98
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$635.60
|
| Rate for Payer: Nomi Health Commercial |
$613.16
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.19
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$524.18
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$658.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC APNEALINK PLUS
|
Facility
|
IP
|
$747.76
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$486.04 |
| Max. Negotiated Rate |
$747.76 |
| Rate for Payer: Aetna Commercial |
$672.98
|
| Rate for Payer: ASR ASR |
$725.33
|
| Rate for Payer: ASR Commercial |
$725.33
|
| Rate for Payer: BCBS Trust/PPO |
$609.35
|
| Rate for Payer: BCN Commercial |
$579.74
|
| Rate for Payer: Cash Price |
$598.21
|
| Rate for Payer: Cofinity Commercial |
$702.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.21
|
| Rate for Payer: Healthscope Commercial |
$747.76
|
| Rate for Payer: Healthscope Whirlpool |
$725.33
|
| Rate for Payer: Mclaren Commercial |
$672.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$635.60
|
| Rate for Payer: Nomi Health Commercial |
$613.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$658.03
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Aetna Commercial |
$63.34
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: ASR ASR |
$68.27
|
| Rate for Payer: ASR Commercial |
$68.27
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$57.63
|
| Rate for Payer: BCN Commercial |
$54.57
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$66.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$70.38
|
| Rate for Payer: Healthscope Whirlpool |
$68.27
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.09
|
| Rate for Payer: Mclaren Commercial |
$63.34
|
| Rate for Payer: Mclaren Medicaid |
$11.30
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Medicaid |
$11.30
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.67
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health Narrow Network |
$49.34
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.09
|
| Rate for Payer: UHC Exchange |
$32.69
|
| Rate for Payer: UHC Medicare Advantage |
$21.09
|
| Rate for Payer: UHCCP DNSP |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$11.30
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Aetna Commercial |
$63.34
|
| Rate for Payer: ASR ASR |
$68.27
|
| Rate for Payer: ASR Commercial |
$68.27
|
| Rate for Payer: BCBS Trust/PPO |
$57.35
|
| Rate for Payer: BCN Commercial |
$54.57
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$66.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$70.38
|
| Rate for Payer: Healthscope Whirlpool |
$68.27
|
| Rate for Payer: Mclaren Commercial |
$63.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$61.93
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$41.75
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.09
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$11.30
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Medicaid |
$11.30
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.67
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health Narrow Network |
$35.74
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.09
|
| Rate for Payer: UHC Exchange |
$32.69
|
| Rate for Payer: UHC Medicare Advantage |
$21.09
|
| Rate for Payer: UHCCP DNSP |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$11.30
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC APOLIPOPROTEIN B LMPP
|
Facility
|
OP
|
$39.54
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100637
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$39.54 |
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: ASR ASR |
$38.35
|
| Rate for Payer: ASR Commercial |
$38.35
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$32.38
|
| Rate for Payer: BCN Commercial |
$30.66
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$31.63
|
| Rate for Payer: Cash Price |
$31.63
|
| Rate for Payer: Cofinity Commercial |
$37.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$39.54
|
| Rate for Payer: Healthscope Whirlpool |
$38.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.09
|
| Rate for Payer: Mclaren Commercial |
$35.59
|
| Rate for Payer: Mclaren Medicaid |
$11.30
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.61
|
| Rate for Payer: Nomi Health Commercial |
$32.42
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Medicaid |
$11.30
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.64
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health Narrow Network |
$27.72
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.09
|
| Rate for Payer: UHC Exchange |
$32.69
|
| Rate for Payer: UHC Medicare Advantage |
$21.09
|
| Rate for Payer: UHCCP DNSP |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$11.30
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN B LMPP
|
Facility
|
IP
|
$39.54
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100637
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$39.54 |
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: ASR ASR |
$38.35
|
| Rate for Payer: ASR Commercial |
$38.35
|
| Rate for Payer: BCBS Trust/PPO |
$32.22
|
| Rate for Payer: BCN Commercial |
$30.66
|
| Rate for Payer: Cash Price |
$31.63
|
| Rate for Payer: Cofinity Commercial |
$37.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.63
|
| Rate for Payer: Healthscope Commercial |
$39.54
|
| Rate for Payer: Healthscope Whirlpool |
$38.35
|
| Rate for Payer: Mclaren Commercial |
$35.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.61
|
| Rate for Payer: Nomi Health Commercial |
$32.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.80
|
|
|
HC APPLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200072
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC APPLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200072
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC APPLIANCE BELT
|
Facility
|
OP
|
$24.91
|
|
| Hospital Charge Code |
27000027
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.96 |
| Max. Negotiated Rate |
$24.91 |
| Rate for Payer: Aetna Commercial |
$22.42
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: ASR ASR |
$24.16
|
| Rate for Payer: ASR Commercial |
$24.16
|
| Rate for Payer: BCBS Complete |
$9.96
|
| Rate for Payer: BCBS Trust/PPO |
$20.40
|
| Rate for Payer: BCN Commercial |
$19.31
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Cofinity Commercial |
$23.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.93
|
| Rate for Payer: Healthscope Commercial |
$24.91
|
| Rate for Payer: Healthscope Whirlpool |
$24.16
|
| Rate for Payer: Mclaren Commercial |
$22.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.17
|
| Rate for Payer: Nomi Health Commercial |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.83
|
| Rate for Payer: Priority Health Narrow Network |
$17.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.92
|
|
|
HC APPLIANCE BELT
|
Facility
|
IP
|
$24.91
|
|
| Hospital Charge Code |
27000027
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$24.91 |
| Rate for Payer: Aetna Commercial |
$22.42
|
| Rate for Payer: ASR ASR |
$24.16
|
| Rate for Payer: ASR Commercial |
$24.16
|
| Rate for Payer: BCBS Trust/PPO |
$20.30
|
| Rate for Payer: BCN Commercial |
$19.31
|
| Rate for Payer: Cash Price |
$19.93
|
| Rate for Payer: Cofinity Commercial |
$23.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.93
|
| Rate for Payer: Healthscope Commercial |
$24.91
|
| Rate for Payer: Healthscope Whirlpool |
$24.16
|
| Rate for Payer: Mclaren Commercial |
$22.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.17
|
| Rate for Payer: Nomi Health Commercial |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.92
|
|
|
HC APPLICATION OF TOPICAL FLUORIDE VARNISH BY PHYS/QHP
|
Facility
|
OP
|
$35.50
|
|
|
Service Code
|
CPT 99188
|
| Hospital Charge Code |
51000097
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$35.50 |
| Rate for Payer: Aetna Commercial |
$31.95
|
| Rate for Payer: Aetna Medicare |
$17.75
|
| Rate for Payer: ASR ASR |
$34.44
|
| Rate for Payer: ASR Commercial |
$34.44
|
| Rate for Payer: BCBS Complete |
$14.20
|
| Rate for Payer: BCBS Trust/PPO |
$29.07
|
| Rate for Payer: BCN Commercial |
$27.52
|
| Rate for Payer: Cash Price |
$28.40
|
| Rate for Payer: Cofinity Commercial |
$33.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.40
|
| Rate for Payer: Healthscope Commercial |
$35.50
|
| Rate for Payer: Healthscope Whirlpool |
$34.44
|
| Rate for Payer: Mclaren Commercial |
$31.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.18
|
| Rate for Payer: Nomi Health Commercial |
$29.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.11
|
| Rate for Payer: Priority Health Narrow Network |
$24.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.24
|
|
|
HC APPLICATION OF TOPICAL FLUORIDE VARNISH BY PHYS/QHP
|
Facility
|
IP
|
$35.50
|
|
|
Service Code
|
CPT 99188
|
| Hospital Charge Code |
51000097
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.07 |
| Max. Negotiated Rate |
$35.50 |
| Rate for Payer: Aetna Commercial |
$31.95
|
| Rate for Payer: ASR ASR |
$34.44
|
| Rate for Payer: ASR Commercial |
$34.44
|
| Rate for Payer: BCBS Trust/PPO |
$28.93
|
| Rate for Payer: BCN Commercial |
$27.52
|
| Rate for Payer: Cash Price |
$28.40
|
| Rate for Payer: Cofinity Commercial |
$33.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.40
|
| Rate for Payer: Healthscope Commercial |
$35.50
|
| Rate for Payer: Healthscope Whirlpool |
$34.44
|
| Rate for Payer: Mclaren Commercial |
$31.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.18
|
| Rate for Payer: Nomi Health Commercial |
$29.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.24
|
|
|
HC APPLICATION ON-BODY INJECTOR
|
Facility
|
IP
|
$149.79
|
|
|
Service Code
|
CPT 96377
|
| Hospital Charge Code |
76100069
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.36 |
| Max. Negotiated Rate |
$149.79 |
| Rate for Payer: Aetna Commercial |
$134.81
|
| Rate for Payer: ASR ASR |
$145.30
|
| Rate for Payer: ASR Commercial |
$145.30
|
| Rate for Payer: BCBS Trust/PPO |
$122.06
|
| Rate for Payer: BCN Commercial |
$116.13
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Healthscope Commercial |
$149.79
|
| Rate for Payer: Healthscope Whirlpool |
$145.30
|
| Rate for Payer: Mclaren Commercial |
$134.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.82
|
|
|
HC APPLICATION ON-BODY INJECTOR
|
Facility
|
OP
|
$149.79
|
|
|
Service Code
|
CPT 96377
|
| Hospital Charge Code |
76100069
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.12 |
| Max. Negotiated Rate |
$149.79 |
| Rate for Payer: Aetna Commercial |
$134.81
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: ASR ASR |
$145.30
|
| Rate for Payer: ASR Commercial |
$145.30
|
| Rate for Payer: BCBS Complete |
$25.33
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCBS Trust/PPO |
$122.66
|
| Rate for Payer: BCN Commercial |
$116.13
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$149.79
|
| Rate for Payer: Healthscope Whirlpool |
$145.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$45.00
|
| Rate for Payer: Mclaren Commercial |
$134.81
|
| Rate for Payer: Mclaren Medicaid |
$24.12
|
| Rate for Payer: Mclaren Medicare |
$45.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: Meridian Medicaid |
$25.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: PACE Medicare |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$49.50
|
| Rate for Payer: PHP Medicaid |
$24.12
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.25
|
| Rate for Payer: Priority Health Medicare |
$45.00
|
| Rate for Payer: Priority Health Narrow Network |
$105.00
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.00
|
| Rate for Payer: UHC Exchange |
$69.75
|
| Rate for Payer: UHC Medicare Advantage |
$45.00
|
| Rate for Payer: UHCCP DNSP |
$45.00
|
| Rate for Payer: UHCCP Medicaid |
$24.12
|
| Rate for Payer: VA VA |
$45.00
|
|
