|
HC DEFINITY CONTRAST 1ST ML
|
Facility
|
OP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600002
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$116.12 |
| Max. Negotiated Rate |
$290.29 |
| Rate for Payer: Aetna Commercial |
$261.26
|
| Rate for Payer: ASR ASR |
$281.58
|
| Rate for Payer: BCBS Complete |
$116.12
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$225.06
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$272.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$290.29
|
| Rate for Payer: Healthscope Whirlpool |
$281.58
|
| Rate for Payer: Mclaren Commercial |
$261.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.16
|
| Rate for Payer: Priority Health Narrow Network |
$206.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$255.46
|
|
|
HC DEFINITY CONTRAST 2ND ML
|
Facility
|
IP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$203.20 |
| Max. Negotiated Rate |
$290.29 |
| Rate for Payer: Aetna Commercial |
$261.26
|
| Rate for Payer: ASR ASR |
$281.58
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$225.06
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$272.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$290.29
|
| Rate for Payer: Healthscope Whirlpool |
$281.58
|
| Rate for Payer: Mclaren Commercial |
$261.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$255.46
|
|
|
HC DEFINITY CONTRAST 2ND ML
|
Facility
|
OP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$116.12 |
| Max. Negotiated Rate |
$290.29 |
| Rate for Payer: Aetna Commercial |
$261.26
|
| Rate for Payer: ASR ASR |
$281.58
|
| Rate for Payer: BCBS Complete |
$116.12
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$225.06
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$272.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$290.29
|
| Rate for Payer: Healthscope Whirlpool |
$281.58
|
| Rate for Payer: Mclaren Commercial |
$261.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.16
|
| Rate for Payer: Priority Health Narrow Network |
$206.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$255.46
|
|
|
HC DEGARELIX INJECTION PER 1MG
|
Facility
|
IP
|
$6.12
|
|
|
Service Code
|
HCPCS J9155
|
| Hospital Charge Code |
63600146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.28 |
| Max. Negotiated Rate |
$6.12 |
| Rate for Payer: Aetna Commercial |
$5.51
|
| Rate for Payer: ASR ASR |
$5.94
|
| Rate for Payer: BCBS Trust/PPO |
$4.74
|
| Rate for Payer: BCN Commercial |
$4.74
|
| Rate for Payer: Cash Price |
$4.90
|
| Rate for Payer: Cofinity Commercial |
$5.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.90
|
| Rate for Payer: Healthscope Commercial |
$6.12
|
| Rate for Payer: Healthscope Whirlpool |
$5.94
|
| Rate for Payer: Mclaren Commercial |
$5.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.39
|
|
|
HC DEGARELIX INJECTION PER 1MG
|
Facility
|
OP
|
$6.12
|
|
|
Service Code
|
HCPCS J9155
|
| Hospital Charge Code |
63600146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$6.12 |
| Rate for Payer: Aetna Commercial |
$5.51
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.23
|
| Rate for Payer: ASR ASR |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.19
|
| Rate for Payer: BCBS Trust/PPO |
$4.74
|
| Rate for Payer: BCN Commercial |
$4.74
|
| Rate for Payer: BCN Medicare Advantage |
$4.19
|
| Rate for Payer: Cash Price |
$4.90
|
| Rate for Payer: Cash Price |
$4.90
|
| Rate for Payer: Cofinity Commercial |
$5.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.19
|
| Rate for Payer: Healthscope Commercial |
$6.12
|
| Rate for Payer: Healthscope Whirlpool |
$5.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.19
|
| Rate for Payer: Mclaren Commercial |
$5.51
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.19
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.20
|
| Rate for Payer: PACE Medicare |
$3.98
|
| Rate for Payer: PACE SWMI |
$4.19
|
| Rate for Payer: PHP Commercial |
$4.61
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.57
|
| Rate for Payer: Priority Health Medicare |
$4.19
|
| Rate for Payer: Priority Health Narrow Network |
$4.35
|
| Rate for Payer: Railroad Medicare Medicare |
$4.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.39
|
| Rate for Payer: UHC Medicare Advantage |
$4.31
|
| Rate for Payer: VA VA |
$4.19
|
|
|
HC DEGLYCEROLIZED RED BLOOD CELLS
|
Facility
|
IP
|
$925.55
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
39000049
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$647.88 |
| Max. Negotiated Rate |
$925.55 |
| Rate for Payer: Aetna Commercial |
$833.00
|
| Rate for Payer: ASR ASR |
$897.78
|
| Rate for Payer: BCBS Trust/PPO |
$717.58
|
| Rate for Payer: BCN Commercial |
$717.58
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cofinity Commercial |
$870.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$740.44
|
| Rate for Payer: Healthscope Commercial |
$925.55
|
| Rate for Payer: Healthscope Whirlpool |
$897.78
|
| Rate for Payer: Mclaren Commercial |
$833.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$786.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$814.48
|
|
|
HC DEGLYCEROLIZED RED BLOOD CELLS
|
Facility
|
OP
|
$925.55
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
39000049
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$158.76 |
| Max. Negotiated Rate |
$925.55 |
| Rate for Payer: Aetna Commercial |
$833.00
|
| Rate for Payer: Aetna Medicare |
$290.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.80
|
| Rate for Payer: ASR ASR |
$897.78
|
| Rate for Payer: BCBS Complete |
$166.71
|
| Rate for Payer: BCBS MAPPO |
$290.24
|
| Rate for Payer: BCBS Trust/PPO |
$717.58
|
| Rate for Payer: BCN Commercial |
$717.58
|
| Rate for Payer: BCN Medicare Advantage |
$290.24
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cofinity Commercial |
$870.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$740.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.24
|
| Rate for Payer: Healthscope Commercial |
$925.55
|
| Rate for Payer: Healthscope Whirlpool |
$897.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$290.24
|
| Rate for Payer: Mclaren Commercial |
$833.00
|
| Rate for Payer: Mclaren Medicaid |
$158.76
|
| Rate for Payer: Mclaren Medicare |
$290.24
|
| Rate for Payer: Meridian Medicaid |
$166.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$304.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$786.72
|
| Rate for Payer: PACE Medicare |
$275.73
|
| Rate for Payer: PACE SWMI |
$290.24
|
| Rate for Payer: PHP Commercial |
$319.26
|
| Rate for Payer: PHP Medicaid |
$158.76
|
| Rate for Payer: PHP Medicare Advantage |
$290.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$842.25
|
| Rate for Payer: Priority Health Medicare |
$290.24
|
| Rate for Payer: Priority Health Narrow Network |
$657.14
|
| Rate for Payer: Railroad Medicare Medicare |
$290.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$814.48
|
| Rate for Payer: UHC Medicare Advantage |
$298.95
|
| Rate for Payer: VA VA |
$290.24
|
|
|
HC DELIVERY/BIRTH RM RESUSCITATION
|
Facility
|
OP
|
$820.78
|
|
|
Service Code
|
CPT 99465
|
| Hospital Charge Code |
72000011
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$316.44 |
| Max. Negotiated Rate |
$820.78 |
| Rate for Payer: Aetna Commercial |
$738.70
|
| Rate for Payer: Aetna Medicare |
$578.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.12
|
| Rate for Payer: ASR ASR |
$796.16
|
| Rate for Payer: BCBS Complete |
$332.29
|
| Rate for Payer: BCBS MAPPO |
$578.50
|
| Rate for Payer: BCBS Trust/PPO |
$636.35
|
| Rate for Payer: BCN Commercial |
$636.35
|
| Rate for Payer: BCN Medicare Advantage |
$578.50
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cofinity Commercial |
$771.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.50
|
| Rate for Payer: Healthscope Commercial |
$820.78
|
| Rate for Payer: Healthscope Whirlpool |
$796.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$578.50
|
| Rate for Payer: Mclaren Commercial |
$738.70
|
| Rate for Payer: Mclaren Medicaid |
$316.44
|
| Rate for Payer: Mclaren Medicare |
$578.50
|
| Rate for Payer: Meridian Medicaid |
$332.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$607.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$697.66
|
| Rate for Payer: PACE Medicare |
$549.58
|
| Rate for Payer: PACE SWMI |
$578.50
|
| Rate for Payer: PHP Commercial |
$636.35
|
| Rate for Payer: PHP Medicaid |
$316.44
|
| Rate for Payer: PHP Medicare Advantage |
$578.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$398.16
|
| Rate for Payer: Priority Health Medicare |
$578.50
|
| Rate for Payer: Priority Health Narrow Network |
$318.53
|
| Rate for Payer: Railroad Medicare Medicare |
$578.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$722.29
|
| Rate for Payer: UHC Medicare Advantage |
$595.86
|
| Rate for Payer: VA VA |
$578.50
|
|
|
HC DELIVERY/BIRTH RM RESUSCITATION
|
Facility
|
IP
|
$820.78
|
|
|
Service Code
|
CPT 99465
|
| Hospital Charge Code |
72000011
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$574.55 |
| Max. Negotiated Rate |
$820.78 |
| Rate for Payer: Aetna Commercial |
$738.70
|
| Rate for Payer: ASR ASR |
$796.16
|
| Rate for Payer: BCBS Trust/PPO |
$636.35
|
| Rate for Payer: BCN Commercial |
$636.35
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cofinity Commercial |
$771.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.62
|
| Rate for Payer: Healthscope Commercial |
$820.78
|
| Rate for Payer: Healthscope Whirlpool |
$796.16
|
| Rate for Payer: Mclaren Commercial |
$738.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$697.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$722.29
|
|
|
HC DEMO EVAL NEB MDI IPPB
|
Facility
|
IP
|
$240.13
|
|
|
Service Code
|
CPT 94664
|
| Hospital Charge Code |
41000009
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$168.09 |
| Max. Negotiated Rate |
$240.13 |
| Rate for Payer: Aetna Commercial |
$216.12
|
| Rate for Payer: ASR ASR |
$232.93
|
| Rate for Payer: BCBS Trust/PPO |
$186.17
|
| Rate for Payer: BCN Commercial |
$186.17
|
| Rate for Payer: Cash Price |
$192.10
|
| Rate for Payer: Cofinity Commercial |
$225.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.10
|
| Rate for Payer: Healthscope Commercial |
$240.13
|
| Rate for Payer: Healthscope Whirlpool |
$232.93
|
| Rate for Payer: Mclaren Commercial |
$216.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$211.31
|
|
|
HC DEMO EVAL NEB MDI IPPB
|
Facility
|
OP
|
$240.13
|
|
|
Service Code
|
CPT 94664
|
| Hospital Charge Code |
41000009
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$77.99 |
| Max. Negotiated Rate |
$240.13 |
| Rate for Payer: Aetna Commercial |
$216.12
|
| Rate for Payer: Aetna Medicare |
$189.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: ASR ASR |
$232.93
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$186.17
|
| Rate for Payer: BCN Commercial |
$186.17
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$192.10
|
| Rate for Payer: Cash Price |
$192.10
|
| Rate for Payer: Cofinity Commercial |
$225.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$240.13
|
| Rate for Payer: Healthscope Whirlpool |
$232.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$189.59
|
| Rate for Payer: Mclaren Commercial |
$216.12
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.11
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$208.55
|
| Rate for Payer: PHP Medicaid |
$103.71
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.49
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$77.99
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$211.31
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: VA VA |
$189.59
|
|
|
HC DEMO HOME USE INR MONITOR
|
Facility
|
OP
|
$555.42
|
|
|
Service Code
|
HCPCS G0248
|
| Hospital Charge Code |
51000042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$555.42 |
| Rate for Payer: Aetna Commercial |
$499.88
|
| Rate for Payer: Aetna Medicare |
$117.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: ASR ASR |
$538.76
|
| Rate for Payer: BCBS Complete |
$67.49
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCBS Trust/PPO |
$430.62
|
| Rate for Payer: BCN Commercial |
$430.62
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$444.34
|
| Rate for Payer: Cash Price |
$444.34
|
| Rate for Payer: Cofinity Commercial |
$522.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$555.42
|
| Rate for Payer: Healthscope Whirlpool |
$538.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$117.50
|
| Rate for Payer: Mclaren Commercial |
$499.88
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Mclaren Medicare |
$117.50
|
| Rate for Payer: Meridian Medicaid |
$67.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$472.11
|
| Rate for Payer: PACE Medicare |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$129.25
|
| Rate for Payer: PHP Medicaid |
$64.27
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.43
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow Network |
$394.35
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.77
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: VA VA |
$117.50
|
|
|
HC DEMO HOME USE INR MONITOR
|
Facility
|
IP
|
$555.42
|
|
|
Service Code
|
HCPCS G0248
|
| Hospital Charge Code |
51000042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$388.79 |
| Max. Negotiated Rate |
$555.42 |
| Rate for Payer: Aetna Commercial |
$499.88
|
| Rate for Payer: ASR ASR |
$538.76
|
| Rate for Payer: BCBS Trust/PPO |
$430.62
|
| Rate for Payer: BCN Commercial |
$430.62
|
| Rate for Payer: Cash Price |
$444.34
|
| Rate for Payer: Cofinity Commercial |
$522.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.34
|
| Rate for Payer: Healthscope Commercial |
$555.42
|
| Rate for Payer: Healthscope Whirlpool |
$538.76
|
| Rate for Payer: Mclaren Commercial |
$499.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$472.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$488.77
|
|
|
HC DENTAL NERVE BLOCK TRIGEMINAL
|
Facility
|
IP
|
$484.32
|
|
|
Service Code
|
CPT 64400
|
| Hospital Charge Code |
45000014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.02 |
| Max. Negotiated Rate |
$484.32 |
| Rate for Payer: Aetna Commercial |
$435.89
|
| Rate for Payer: ASR ASR |
$469.79
|
| Rate for Payer: BCBS Trust/PPO |
$375.49
|
| Rate for Payer: BCN Commercial |
$375.49
|
| Rate for Payer: Cash Price |
$387.46
|
| Rate for Payer: Cofinity Commercial |
$455.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.46
|
| Rate for Payer: Healthscope Commercial |
$484.32
|
| Rate for Payer: Healthscope Whirlpool |
$469.79
|
| Rate for Payer: Mclaren Commercial |
$435.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.20
|
|
|
HC DENTAL NERVE BLOCK TRIGEMINAL
|
Facility
|
OP
|
$484.32
|
|
|
Service Code
|
CPT 64400
|
| Hospital Charge Code |
45000014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$484.32 |
| Rate for Payer: Aetna Commercial |
$435.89
|
| Rate for Payer: Aetna Medicare |
$263.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: ASR ASR |
$469.79
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$375.49
|
| Rate for Payer: BCN Commercial |
$375.49
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$387.46
|
| Rate for Payer: Cash Price |
$387.46
|
| Rate for Payer: Cofinity Commercial |
$455.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$484.32
|
| Rate for Payer: Healthscope Whirlpool |
$469.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$263.27
|
| Rate for Payer: Mclaren Commercial |
$435.89
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.67
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$289.60
|
| Rate for Payer: PHP Medicaid |
$144.01
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.73
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$343.87
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$426.20
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: VA VA |
$263.27
|
|
|
HC DERMAGRAFT PER SQ CM
|
Facility
|
IP
|
$83.88
|
|
|
Service Code
|
HCPCS Q4106
|
| Hospital Charge Code |
63600004
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.72 |
| Max. Negotiated Rate |
$83.88 |
| Rate for Payer: Aetna Commercial |
$75.49
|
| Rate for Payer: ASR ASR |
$81.36
|
| Rate for Payer: BCBS Trust/PPO |
$65.03
|
| Rate for Payer: BCN Commercial |
$65.03
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cofinity Commercial |
$78.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.10
|
| Rate for Payer: Healthscope Commercial |
$83.88
|
| Rate for Payer: Healthscope Whirlpool |
$81.36
|
| Rate for Payer: Mclaren Commercial |
$75.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.81
|
|
|
HC DERMAGRAFT PER SQ CM
|
Facility
|
OP
|
$83.88
|
|
|
Service Code
|
HCPCS Q4106
|
| Hospital Charge Code |
63600004
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.55 |
| Max. Negotiated Rate |
$83.88 |
| Rate for Payer: Aetna Commercial |
$75.49
|
| Rate for Payer: ASR ASR |
$81.36
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS Trust/PPO |
$65.03
|
| Rate for Payer: BCN Commercial |
$65.03
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cofinity Commercial |
$78.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.10
|
| Rate for Payer: Healthscope Commercial |
$83.88
|
| Rate for Payer: Healthscope Whirlpool |
$81.36
|
| Rate for Payer: Mclaren Commercial |
$75.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.33
|
| Rate for Payer: Priority Health Narrow Network |
$59.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.81
|
|
|
HC DES ADD.BRANCH
|
Facility
|
IP
|
$16,677.03
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
48100076
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,673.92 |
| Max. Negotiated Rate |
$16,677.03 |
| Rate for Payer: Aetna Commercial |
$15,009.33
|
| Rate for Payer: ASR ASR |
$16,176.72
|
| Rate for Payer: BCBS Trust/PPO |
$12,929.70
|
| Rate for Payer: BCN Commercial |
$12,929.70
|
| Rate for Payer: Cash Price |
$13,341.62
|
| Rate for Payer: Cofinity Commercial |
$15,676.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,341.62
|
| Rate for Payer: Healthscope Commercial |
$16,677.03
|
| Rate for Payer: Healthscope Whirlpool |
$16,176.72
|
| Rate for Payer: Mclaren Commercial |
$15,009.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,175.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,673.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,675.79
|
|
|
HC DES ADD.BRANCH
|
Facility
|
OP
|
$16,677.03
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
48100076
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,645.28 |
| Max. Negotiated Rate |
$16,677.03 |
| Rate for Payer: Aetna Commercial |
$15,009.33
|
| Rate for Payer: ASR ASR |
$16,176.72
|
| Rate for Payer: BCBS Complete |
$6,670.81
|
| Rate for Payer: BCBS Trust/PPO |
$12,929.70
|
| Rate for Payer: BCN Commercial |
$12,929.70
|
| Rate for Payer: Cash Price |
$13,341.62
|
| Rate for Payer: Cash Price |
$13,341.62
|
| Rate for Payer: Cofinity Commercial |
$15,676.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,341.62
|
| Rate for Payer: Healthscope Commercial |
$16,677.03
|
| Rate for Payer: Healthscope Whirlpool |
$16,176.72
|
| Rate for Payer: Mclaren Commercial |
$15,009.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,175.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,673.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,306.60
|
| Rate for Payer: Priority Health Narrow Network |
$6,645.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14,675.79
|
|
|
HC DESTR LESION ROOF OF MOUTH
|
Facility
|
IP
|
$7,950.00
|
|
|
Service Code
|
CPT 42160
|
| Hospital Charge Code |
76100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,565.00 |
| Max. Negotiated Rate |
$7,950.00 |
| Rate for Payer: Aetna Commercial |
$7,155.00
|
| Rate for Payer: ASR ASR |
$7,711.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,163.64
|
| Rate for Payer: BCN Commercial |
$6,163.64
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$7,473.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
| Rate for Payer: Healthscope Commercial |
$7,950.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,711.50
|
| Rate for Payer: Mclaren Commercial |
$7,155.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,996.00
|
|
|
HC DESTR LESION ROOF OF MOUTH
|
Facility
|
OP
|
$7,950.00
|
|
|
Service Code
|
CPT 42160
|
| Hospital Charge Code |
76100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,565.43 |
| Max. Negotiated Rate |
$7,950.00 |
| Rate for Payer: Aetna Commercial |
$7,155.00
|
| Rate for Payer: Aetna Medicare |
$2,861.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: ASR ASR |
$7,711.50
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,163.64
|
| Rate for Payer: BCN Commercial |
$6,163.64
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$7,473.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,950.00
|
| Rate for Payer: Healthscope Whirlpool |
$7,711.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,861.84
|
| Rate for Payer: Mclaren Commercial |
$7,155.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$3,148.02
|
| Rate for Payer: PHP Medicaid |
$1,565.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,234.50
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$5,644.50
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,996.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: VA VA |
$2,861.84
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
IP
|
$237.86
|
|
|
Service Code
|
CPT 17280
|
| Hospital Charge Code |
76100155
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$237.86 |
| Rate for Payer: Aetna Commercial |
$214.07
|
| Rate for Payer: ASR ASR |
$230.72
|
| Rate for Payer: BCBS Trust/PPO |
$184.41
|
| Rate for Payer: BCN Commercial |
$184.41
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cofinity Commercial |
$223.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.29
|
| Rate for Payer: Healthscope Commercial |
$237.86
|
| Rate for Payer: Healthscope Whirlpool |
$230.72
|
| Rate for Payer: Mclaren Commercial |
$214.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.32
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
OP
|
$237.86
|
|
|
Service Code
|
CPT 17280
|
| Hospital Charge Code |
76100155
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$237.86 |
| Rate for Payer: Aetna Commercial |
$214.07
|
| 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 |
$230.72
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$184.41
|
| Rate for Payer: BCN Commercial |
$184.41
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cofinity Commercial |
$223.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$237.86
|
| Rate for Payer: Healthscope Whirlpool |
$230.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$214.07
|
| 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 |
$202.18
|
| 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 |
$166.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.45
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$168.88
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.32
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
IP
|
$384.54
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.18 |
| Max. Negotiated Rate |
$384.54 |
| Rate for Payer: Aetna Commercial |
$346.09
|
| Rate for Payer: ASR ASR |
$373.00
|
| Rate for Payer: BCBS Trust/PPO |
$298.13
|
| Rate for Payer: BCN Commercial |
$298.13
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$361.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
| Rate for Payer: Healthscope Commercial |
$384.54
|
| Rate for Payer: Healthscope Whirlpool |
$373.00
|
| Rate for Payer: Mclaren Commercial |
$346.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.40
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
OP
|
$384.54
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$346.09
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$373.00
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$298.13
|
| Rate for Payer: BCN Commercial |
$298.13
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$361.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$384.54
|
| Rate for Payer: Healthscope Whirlpool |
$373.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$346.09
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$349.93
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$273.02
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$338.40
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
