|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
IP
|
$55.11
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.82 |
| Max. Negotiated Rate |
$55.11 |
| Rate for Payer: Aetna Commercial |
$49.60
|
| Rate for Payer: ASR ASR |
$53.46
|
| Rate for Payer: ASR Commercial |
$53.46
|
| Rate for Payer: BCBS Trust/PPO |
$44.91
|
| Rate for Payer: BCN Commercial |
$42.73
|
| Rate for Payer: Cash Price |
$44.09
|
| Rate for Payer: Cofinity Commercial |
$51.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.09
|
| Rate for Payer: Healthscope Commercial |
$55.11
|
| Rate for Payer: Healthscope Whirlpool |
$53.46
|
| Rate for Payer: Mclaren Commercial |
$49.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.84
|
| Rate for Payer: Nomi Health Commercial |
$45.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.50
|
|
|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
OP
|
$55.11
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$55.11 |
| Rate for Payer: Aetna Commercial |
$49.60
|
| Rate for Payer: Aetna Medicare |
$27.55
|
| Rate for Payer: ASR ASR |
$53.46
|
| Rate for Payer: ASR Commercial |
$53.46
|
| Rate for Payer: BCBS Complete |
$22.04
|
| Rate for Payer: BCBS Trust/PPO |
$45.13
|
| Rate for Payer: BCN Commercial |
$42.73
|
| Rate for Payer: Cash Price |
$44.09
|
| Rate for Payer: Cofinity Commercial |
$51.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.09
|
| Rate for Payer: Healthscope Commercial |
$55.11
|
| Rate for Payer: Healthscope Whirlpool |
$53.46
|
| Rate for Payer: Mclaren Commercial |
$49.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.84
|
| Rate for Payer: Nomi Health Commercial |
$45.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.29
|
| Rate for Payer: Priority Health Narrow Network |
$38.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.50
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
IP
|
$463.45
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$301.24 |
| Max. Negotiated Rate |
$463.45 |
| Rate for Payer: Aetna Commercial |
$417.11
|
| Rate for Payer: ASR ASR |
$449.55
|
| Rate for Payer: ASR Commercial |
$449.55
|
| Rate for Payer: BCBS Trust/PPO |
$377.67
|
| Rate for Payer: BCN Commercial |
$359.31
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$435.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Healthscope Commercial |
$463.45
|
| Rate for Payer: Healthscope Whirlpool |
$449.55
|
| Rate for Payer: Mclaren Commercial |
$417.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$380.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.84
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
OP
|
$463.45
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$463.45 |
| Rate for Payer: Aetna Commercial |
$417.11
|
| 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 |
$449.55
|
| Rate for Payer: ASR Commercial |
$449.55
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$379.52
|
| Rate for Payer: BCN Commercial |
$359.31
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$435.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$463.45
|
| Rate for Payer: Healthscope Whirlpool |
$449.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$417.11
|
| 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 |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$380.03
|
| 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 |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$406.07
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$324.88
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$407.84
|
| 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 AUTOLOGOUS UNIT
|
Facility
|
IP
|
$825.28
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$536.43 |
| Max. Negotiated Rate |
$825.28 |
| Rate for Payer: Aetna Commercial |
$742.75
|
| Rate for Payer: ASR ASR |
$800.52
|
| Rate for Payer: ASR Commercial |
$800.52
|
| Rate for Payer: BCBS Trust/PPO |
$672.52
|
| Rate for Payer: BCN Commercial |
$639.84
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$775.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Healthscope Commercial |
$825.28
|
| Rate for Payer: Healthscope Whirlpool |
$800.52
|
| Rate for Payer: Mclaren Commercial |
$742.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$676.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.25
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
OP
|
$825.28
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$75.44 |
| Max. Negotiated Rate |
$825.28 |
| Rate for Payer: Aetna Commercial |
$742.75
|
| Rate for Payer: Aetna Medicare |
$140.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.94
|
| Rate for Payer: ASR ASR |
$800.52
|
| Rate for Payer: ASR Commercial |
$800.52
|
| Rate for Payer: BCBS Complete |
$79.21
|
| Rate for Payer: BCBS MAPPO |
$140.75
|
| Rate for Payer: BCBS Trust/PPO |
$675.82
|
| Rate for Payer: BCN Commercial |
$639.84
|
| Rate for Payer: BCN Medicare Advantage |
$140.75
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$775.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.75
|
| Rate for Payer: Healthscope Commercial |
$825.28
|
| Rate for Payer: Healthscope Whirlpool |
$800.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$140.75
|
| Rate for Payer: Mclaren Commercial |
$742.75
|
| Rate for Payer: Mclaren Medicaid |
$75.44
|
| Rate for Payer: Mclaren Medicare |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.79
|
| Rate for Payer: Meridian Medicaid |
$79.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$676.73
|
| Rate for Payer: PACE Medicare |
$133.71
|
| Rate for Payer: PACE SWMI |
$140.75
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: PHP Medicaid |
$75.44
|
| Rate for Payer: PHP Medicare Advantage |
$140.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.11
|
| Rate for Payer: Priority Health Medicare |
$140.75
|
| Rate for Payer: Priority Health Narrow Network |
$578.52
|
| Rate for Payer: Railroad Medicare Medicare |
$140.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.75
|
| Rate for Payer: UHC Exchange |
$218.16
|
| Rate for Payer: UHC Medicare Advantage |
$140.75
|
| Rate for Payer: UHCCP DNSP |
$140.75
|
| Rate for Payer: UHCCP Medicaid |
$75.44
|
| Rate for Payer: VA VA |
$140.75
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
IP
|
$181.53
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$181.53 |
| Rate for Payer: Aetna Commercial |
$163.38
|
| Rate for Payer: ASR ASR |
$176.08
|
| Rate for Payer: ASR Commercial |
$176.08
|
| Rate for Payer: BCBS Trust/PPO |
$147.93
|
| Rate for Payer: BCN Commercial |
$140.74
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cofinity Commercial |
$170.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.22
|
| Rate for Payer: Healthscope Commercial |
$181.53
|
| Rate for Payer: Healthscope Whirlpool |
$176.08
|
| Rate for Payer: Mclaren Commercial |
$163.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.30
|
| Rate for Payer: Nomi Health Commercial |
$148.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.75
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
OP
|
$181.53
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$194.85 |
| Rate for Payer: Aetna Commercial |
$163.38
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$176.08
|
| Rate for Payer: ASR Commercial |
$176.08
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$148.65
|
| Rate for Payer: BCN Commercial |
$140.74
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cash Price |
$145.22
|
| Rate for Payer: Cofinity Commercial |
$170.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$181.53
|
| Rate for Payer: Healthscope Whirlpool |
$176.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$163.38
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.30
|
| Rate for Payer: Nomi Health Commercial |
$148.85
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.06
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$127.25
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$159.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
IP
|
$363.05
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$235.98 |
| Max. Negotiated Rate |
$363.05 |
| Rate for Payer: Aetna Commercial |
$326.75
|
| Rate for Payer: ASR ASR |
$352.16
|
| Rate for Payer: ASR Commercial |
$352.16
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$281.47
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$341.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Healthscope Commercial |
$363.05
|
| Rate for Payer: Healthscope Whirlpool |
$352.16
|
| Rate for Payer: Mclaren Commercial |
$326.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: Nomi Health Commercial |
$297.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.48
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
OP
|
$363.05
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$363.05 |
| Rate for Payer: Aetna Commercial |
$326.75
|
| 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 |
$352.16
|
| Rate for Payer: ASR Commercial |
$352.16
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$297.30
|
| Rate for Payer: BCN Commercial |
$281.47
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$341.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$363.05
|
| Rate for Payer: Healthscope Whirlpool |
$352.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$326.75
|
| 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 |
$308.59
|
| Rate for Payer: Nomi Health Commercial |
$297.70
|
| 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 |
$235.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.10
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$254.50
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.48
|
| 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 AUTONOMIC FUNC QSART
|
Facility
|
IP
|
$363.05
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$235.98 |
| Max. Negotiated Rate |
$363.05 |
| Rate for Payer: Aetna Commercial |
$326.75
|
| Rate for Payer: ASR ASR |
$352.16
|
| Rate for Payer: ASR Commercial |
$352.16
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$281.47
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$341.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Healthscope Commercial |
$363.05
|
| Rate for Payer: Healthscope Whirlpool |
$352.16
|
| Rate for Payer: Mclaren Commercial |
$326.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: Nomi Health Commercial |
$297.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.48
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
OP
|
$363.05
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$363.05 |
| Rate for Payer: Aetna Commercial |
$326.75
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$352.16
|
| Rate for Payer: ASR Commercial |
$352.16
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$297.30
|
| Rate for Payer: BCN Commercial |
$281.47
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cash Price |
$290.44
|
| Rate for Payer: Cofinity Commercial |
$341.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$363.05
|
| Rate for Payer: Healthscope Whirlpool |
$352.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$326.75
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.59
|
| Rate for Payer: Nomi Health Commercial |
$297.70
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.10
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$254.50
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
OP
|
$518.64
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$518.64 |
| Rate for Payer: Aetna Commercial |
$466.78
|
| Rate for Payer: Aetna Medicare |
$303.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: ASR ASR |
$503.08
|
| Rate for Payer: ASR Commercial |
$503.08
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCBS Trust/PPO |
$424.71
|
| Rate for Payer: BCN Commercial |
$402.10
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cofinity Commercial |
$487.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$518.64
|
| Rate for Payer: Healthscope Whirlpool |
$503.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$303.70
|
| Rate for Payer: Mclaren Commercial |
$466.78
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.84
|
| Rate for Payer: Nomi Health Commercial |
$425.28
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$334.07
|
| Rate for Payer: PHP Medicaid |
$162.78
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.43
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health Narrow Network |
$363.57
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$456.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$470.74
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP DNSP |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
IP
|
$518.64
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$337.12 |
| Max. Negotiated Rate |
$518.64 |
| Rate for Payer: Aetna Commercial |
$466.78
|
| Rate for Payer: ASR ASR |
$503.08
|
| Rate for Payer: ASR Commercial |
$503.08
|
| Rate for Payer: BCBS Trust/PPO |
$422.64
|
| Rate for Payer: BCN Commercial |
$402.10
|
| Rate for Payer: Cash Price |
$414.91
|
| Rate for Payer: Cofinity Commercial |
$487.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.91
|
| Rate for Payer: Healthscope Commercial |
$518.64
|
| Rate for Payer: Healthscope Whirlpool |
$503.08
|
| Rate for Payer: Mclaren Commercial |
$466.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.84
|
| Rate for Payer: Nomi Health Commercial |
$425.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$456.40
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
IP
|
$319.94
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.96 |
| Max. Negotiated Rate |
$319.94 |
| Rate for Payer: Aetna Commercial |
$287.95
|
| Rate for Payer: ASR ASR |
$310.34
|
| Rate for Payer: ASR Commercial |
$310.34
|
| Rate for Payer: BCBS Trust/PPO |
$260.72
|
| Rate for Payer: BCN Commercial |
$248.05
|
| Rate for Payer: Cash Price |
$255.95
|
| Rate for Payer: Cofinity Commercial |
$300.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.95
|
| Rate for Payer: Healthscope Commercial |
$319.94
|
| Rate for Payer: Healthscope Whirlpool |
$310.34
|
| Rate for Payer: Mclaren Commercial |
$287.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.95
|
| Rate for Payer: Nomi Health Commercial |
$262.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.55
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
OP
|
$319.94
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$319.94 |
| Rate for Payer: Aetna Commercial |
$287.95
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$310.34
|
| Rate for Payer: ASR Commercial |
$310.34
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$262.00
|
| Rate for Payer: BCN Commercial |
$248.05
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$255.95
|
| Rate for Payer: Cash Price |
$255.95
|
| Rate for Payer: Cofinity Commercial |
$300.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$319.94
|
| Rate for Payer: Healthscope Whirlpool |
$310.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$287.95
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.95
|
| Rate for Payer: Nomi Health Commercial |
$262.35
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.33
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$224.28
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
OP
|
$8.13
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$8.13 |
| Rate for Payer: Aetna Commercial |
$7.32
|
| Rate for Payer: Aetna Medicare |
$4.07
|
| Rate for Payer: ASR ASR |
$7.89
|
| Rate for Payer: ASR Commercial |
$7.89
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS Trust/PPO |
$6.66
|
| Rate for Payer: BCN Commercial |
$6.30
|
| Rate for Payer: Cash Price |
$6.50
|
| Rate for Payer: Cofinity Commercial |
$7.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$8.13
|
| Rate for Payer: Healthscope Whirlpool |
$7.89
|
| Rate for Payer: Mclaren Commercial |
$7.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.91
|
| Rate for Payer: Nomi Health Commercial |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.12
|
| Rate for Payer: Priority Health Narrow Network |
$5.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.15
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
IP
|
$8.13
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$8.13 |
| Rate for Payer: Aetna Commercial |
$7.32
|
| Rate for Payer: ASR ASR |
$7.89
|
| Rate for Payer: ASR Commercial |
$7.89
|
| Rate for Payer: BCBS Trust/PPO |
$6.63
|
| Rate for Payer: BCN Commercial |
$6.30
|
| Rate for Payer: Cash Price |
$6.50
|
| Rate for Payer: Cofinity Commercial |
$7.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$8.13
|
| Rate for Payer: Healthscope Whirlpool |
$7.89
|
| Rate for Payer: Mclaren Commercial |
$7.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.91
|
| Rate for Payer: Nomi Health Commercial |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.15
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
IP
|
$30.98
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$30.98 |
| Rate for Payer: Aetna Commercial |
$27.88
|
| Rate for Payer: ASR ASR |
$30.05
|
| Rate for Payer: ASR Commercial |
$30.05
|
| Rate for Payer: BCBS Trust/PPO |
$25.25
|
| Rate for Payer: BCN Commercial |
$24.02
|
| Rate for Payer: Cash Price |
$24.78
|
| Rate for Payer: Cofinity Commercial |
$29.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.78
|
| Rate for Payer: Healthscope Commercial |
$30.98
|
| Rate for Payer: Healthscope Whirlpool |
$30.05
|
| Rate for Payer: Mclaren Commercial |
$27.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.33
|
| Rate for Payer: Nomi Health Commercial |
$25.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.26
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
OP
|
$30.98
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$30.98 |
| Rate for Payer: Aetna Commercial |
$27.88
|
| Rate for Payer: Aetna Medicare |
$15.49
|
| Rate for Payer: ASR ASR |
$30.05
|
| Rate for Payer: ASR Commercial |
$30.05
|
| Rate for Payer: BCBS Complete |
$12.39
|
| Rate for Payer: BCBS Trust/PPO |
$25.37
|
| Rate for Payer: BCN Commercial |
$24.02
|
| Rate for Payer: Cash Price |
$24.78
|
| Rate for Payer: Cofinity Commercial |
$29.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.78
|
| Rate for Payer: Healthscope Commercial |
$30.98
|
| Rate for Payer: Healthscope Whirlpool |
$30.05
|
| Rate for Payer: Mclaren Commercial |
$27.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.33
|
| Rate for Payer: Nomi Health Commercial |
$25.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.14
|
| Rate for Payer: Priority Health Narrow Network |
$21.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.26
|
|
|
HC BACK SCREEN
|
Facility
|
IP
|
$52.02
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BACK SCREEN
|
Facility
|
OP
|
$52.02
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$26.01
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
OP
|
$68.34
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$27.34 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna Medicare |
$34.17
|
| Rate for Payer: ASR ASR |
$66.29
|
| Rate for Payer: ASR Commercial |
$66.29
|
| Rate for Payer: BCBS Complete |
$27.34
|
| Rate for Payer: BCBS Trust/PPO |
$55.96
|
| Rate for Payer: BCN Commercial |
$52.98
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$68.34
|
| Rate for Payer: Healthscope Whirlpool |
$66.29
|
| Rate for Payer: Mclaren Commercial |
$61.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.88
|
| Rate for Payer: Priority Health Narrow Network |
$47.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.14
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
IP
|
$68.34
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: ASR ASR |
$66.29
|
| Rate for Payer: ASR Commercial |
$66.29
|
| Rate for Payer: BCBS Trust/PPO |
$55.69
|
| Rate for Payer: BCN Commercial |
$52.98
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$68.34
|
| Rate for Payer: Healthscope Whirlpool |
$66.29
|
| Rate for Payer: Mclaren Commercial |
$61.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.14
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: ASR ASR |
$148.41
|
| Rate for Payer: ASR Commercial |
$148.41
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$125.29
|
| 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: Priority Health HMO/PPO/Tiered Network |
$134.06
|
| Rate for Payer: Priority Health Narrow Network |
$107.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.64
|
|
