|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
IP
|
$359.40
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.58 |
| Max. Negotiated Rate |
$359.40 |
| Rate for Payer: Aetna Commercial |
$323.46
|
| Rate for Payer: ASR ASR |
$348.62
|
| Rate for Payer: BCBS Trust/PPO |
$278.64
|
| Rate for Payer: BCN Commercial |
$278.64
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$337.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.52
|
| Rate for Payer: Healthscope Commercial |
$359.40
|
| Rate for Payer: Healthscope Whirlpool |
$348.62
|
| Rate for Payer: Mclaren Commercial |
$323.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.27
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
IP
|
$23.66
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.56 |
| Max. Negotiated Rate |
$23.66 |
| Rate for Payer: Aetna Commercial |
$21.29
|
| Rate for Payer: ASR ASR |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$18.34
|
| Rate for Payer: BCN Commercial |
$18.34
|
| Rate for Payer: Cash Price |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$22.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.93
|
| Rate for Payer: Healthscope Commercial |
$23.66
|
| Rate for Payer: Healthscope Whirlpool |
$22.95
|
| Rate for Payer: Mclaren Commercial |
$21.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.82
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
OP
|
$23.66
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$23.66 |
| Rate for Payer: Aetna Commercial |
$21.29
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$22.95
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$18.34
|
| Rate for Payer: BCN Commercial |
$18.34
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$18.93
|
| Rate for Payer: Cash Price |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$22.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.66
|
| Rate for Payer: Healthscope Whirlpool |
$22.95
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$21.29
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.11
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.53
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$16.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.82
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$33.64
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$26.89
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$33.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| 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 |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.56
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$24.62
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.52
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: ASR ASR |
$33.64
|
| Rate for Payer: BCBS Trust/PPO |
$26.89
|
| Rate for Payer: BCN Commercial |
$26.89
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$32.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$34.68
|
| Rate for Payer: Healthscope Whirlpool |
$33.64
|
| Rate for Payer: Mclaren Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.52
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$483.43 |
| Max. Negotiated Rate |
$690.61 |
| Rate for Payer: Aetna Commercial |
$621.55
|
| Rate for Payer: ASR ASR |
$669.89
|
| Rate for Payer: BCBS Trust/PPO |
$535.43
|
| Rate for Payer: BCN Commercial |
$535.43
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$649.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$690.61
|
| Rate for Payer: Healthscope Whirlpool |
$669.89
|
| Rate for Payer: Mclaren Commercial |
$621.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.74
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.24 |
| Max. Negotiated Rate |
$690.61 |
| Rate for Payer: Aetna Commercial |
$621.55
|
| Rate for Payer: ASR ASR |
$669.89
|
| Rate for Payer: BCBS Complete |
$276.24
|
| Rate for Payer: BCBS Trust/PPO |
$535.43
|
| Rate for Payer: BCN Commercial |
$535.43
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$649.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$690.61
|
| Rate for Payer: Healthscope Whirlpool |
$669.89
|
| Rate for Payer: Mclaren Commercial |
$621.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.46
|
| Rate for Payer: Priority Health Narrow Network |
$490.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.74
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
OP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,216.60 |
| Max. Negotiated Rate |
$3,041.50 |
| Rate for Payer: Aetna Commercial |
$2,737.35
|
| Rate for Payer: ASR ASR |
$2,950.26
|
| Rate for Payer: BCBS Complete |
$1,216.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,358.07
|
| Rate for Payer: BCN Commercial |
$2,358.07
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,859.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$3,041.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,950.26
|
| Rate for Payer: Mclaren Commercial |
$2,737.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,585.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,767.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,159.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,676.52
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
IP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,129.05 |
| Max. Negotiated Rate |
$3,041.50 |
| Rate for Payer: Aetna Commercial |
$2,737.35
|
| Rate for Payer: ASR ASR |
$2,950.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,358.07
|
| Rate for Payer: BCN Commercial |
$2,358.07
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,859.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$3,041.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,950.26
|
| Rate for Payer: Mclaren Commercial |
$2,737.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,585.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,676.52
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$301.00 |
| Max. Negotiated Rate |
$430.00 |
| Rate for Payer: Aetna Commercial |
$387.00
|
| Rate for Payer: ASR ASR |
$417.10
|
| Rate for Payer: BCBS Trust/PPO |
$333.38
|
| Rate for Payer: BCN Commercial |
$333.38
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$404.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Healthscope Commercial |
$430.00
|
| Rate for Payer: Healthscope Whirlpool |
$417.10
|
| Rate for Payer: Mclaren Commercial |
$387.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.40
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$430.00 |
| Rate for Payer: Aetna Commercial |
$387.00
|
| Rate for Payer: Aetna Medicare |
$57.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.30
|
| Rate for Payer: ASR ASR |
$417.10
|
| Rate for Payer: BCBS Complete |
$32.76
|
| Rate for Payer: BCBS MAPPO |
$57.04
|
| Rate for Payer: BCBS Trust/PPO |
$333.38
|
| Rate for Payer: BCN Commercial |
$333.38
|
| Rate for Payer: BCN Medicare Advantage |
$57.04
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$404.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.04
|
| Rate for Payer: Healthscope Commercial |
$430.00
|
| Rate for Payer: Healthscope Whirlpool |
$417.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.04
|
| Rate for Payer: Mclaren Commercial |
$387.00
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$57.04
|
| Rate for Payer: Meridian Medicaid |
$32.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.50
|
| Rate for Payer: PACE Medicare |
$54.19
|
| Rate for Payer: PACE SWMI |
$57.04
|
| Rate for Payer: PHP Commercial |
$62.74
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$57.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.55
|
| Rate for Payer: Priority Health Medicare |
$57.04
|
| Rate for Payer: Priority Health Narrow Network |
$69.24
|
| Rate for Payer: Railroad Medicare Medicare |
$57.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$378.40
|
| Rate for Payer: UHC Medicare Advantage |
$58.75
|
| Rate for Payer: VA VA |
$57.04
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: ASR ASR |
$244.44
|
| Rate for Payer: BCBS Trust/PPO |
$195.38
|
| Rate for Payer: BCN Commercial |
$195.38
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$236.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.60
|
| Rate for Payer: Healthscope Commercial |
$252.00
|
| Rate for Payer: Healthscope Whirlpool |
$244.44
|
| Rate for Payer: Mclaren Commercial |
$226.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.76
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.12 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Aetna Commercial |
$226.80
|
| Rate for Payer: Aetna Medicare |
$44.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.11
|
| Rate for Payer: ASR ASR |
$244.44
|
| Rate for Payer: BCBS Complete |
$25.78
|
| Rate for Payer: BCBS MAPPO |
$44.89
|
| Rate for Payer: BCBS Trust/PPO |
$195.38
|
| Rate for Payer: BCN Commercial |
$195.38
|
| Rate for Payer: BCN Medicare Advantage |
$44.89
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$236.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.89
|
| Rate for Payer: Healthscope Commercial |
$252.00
|
| Rate for Payer: Healthscope Whirlpool |
$244.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$44.89
|
| Rate for Payer: Mclaren Commercial |
$226.80
|
| Rate for Payer: Mclaren Medicaid |
$24.55
|
| Rate for Payer: Mclaren Medicare |
$44.89
|
| Rate for Payer: Meridian Medicaid |
$25.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.20
|
| Rate for Payer: PACE Medicare |
$42.65
|
| Rate for Payer: PACE SWMI |
$44.89
|
| Rate for Payer: PHP Commercial |
$49.38
|
| Rate for Payer: PHP Medicaid |
$24.55
|
| Rate for Payer: PHP Medicare Advantage |
$44.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.65
|
| Rate for Payer: Priority Health Medicare |
$44.89
|
| Rate for Payer: Priority Health Narrow Network |
$22.12
|
| Rate for Payer: Railroad Medicare Medicare |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$221.76
|
| Rate for Payer: UHC Medicare Advantage |
$46.24
|
| Rate for Payer: VA VA |
$44.89
|
|
|
HC FREE FATTY ACIDS
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$61.00 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.46
|
| Rate for Payer: ASR ASR |
$59.17
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$18.77
|
| Rate for Payer: BCBS Trust/PPO |
$47.29
|
| Rate for Payer: BCN Commercial |
$47.29
|
| Rate for Payer: BCN Medicare Advantage |
$18.77
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$61.00
|
| Rate for Payer: Healthscope Whirlpool |
$59.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.77
|
| Rate for Payer: Mclaren Commercial |
$54.90
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Mclaren Medicare |
$18.77
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Medicare |
$17.83
|
| Rate for Payer: PACE SWMI |
$18.77
|
| Rate for Payer: PHP Commercial |
$20.65
|
| Rate for Payer: PHP Medicaid |
$10.27
|
| Rate for Payer: PHP Medicare Advantage |
$18.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.51
|
| Rate for Payer: Priority Health Medicare |
$18.77
|
| Rate for Payer: Priority Health Narrow Network |
$43.31
|
| Rate for Payer: Railroad Medicare Medicare |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.68
|
| Rate for Payer: UHC Medicare Advantage |
$19.33
|
| Rate for Payer: VA VA |
$18.77
|
|
|
HC FREE FATTY ACIDS
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$61.00 |
| Rate for Payer: Aetna Commercial |
$54.90
|
| Rate for Payer: ASR ASR |
$59.17
|
| Rate for Payer: BCBS Trust/PPO |
$47.29
|
| Rate for Payer: BCN Commercial |
$47.29
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Healthscope Commercial |
$61.00
|
| Rate for Payer: Healthscope Whirlpool |
$59.17
|
| Rate for Payer: Mclaren Commercial |
$54.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.68
|
|
|
HC FREE PLASMA HEMOGLOBIN
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
30100240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: ASR ASR |
$63.05
|
| Rate for Payer: BCBS Trust/PPO |
$50.39
|
| Rate for Payer: BCN Commercial |
$50.39
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$65.00
|
| Rate for Payer: Healthscope Whirlpool |
$63.05
|
| Rate for Payer: Mclaren Commercial |
$58.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.20
|
|
|
HC FREE PLASMA HEMOGLOBIN
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
30100240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$7.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.14
|
| Rate for Payer: ASR ASR |
$63.05
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$50.39
|
| Rate for Payer: BCN Commercial |
$50.39
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Healthscope Commercial |
$65.00
|
| Rate for Payer: Healthscope Whirlpool |
$63.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$7.31
|
| Rate for Payer: Mclaren Commercial |
$58.50
|
| Rate for Payer: Mclaren Medicaid |
$4.00
|
| Rate for Payer: Mclaren Medicare |
$7.31
|
| Rate for Payer: Meridian Medicaid |
$4.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PHP Commercial |
$8.04
|
| Rate for Payer: PHP Medicaid |
$4.00
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health Narrow Network |
$46.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.20
|
| Rate for Payer: UHC Medicare Advantage |
$7.53
|
| Rate for Payer: VA VA |
$7.31
|
|
|
HC FRENOTOMY
|
Facility
|
OP
|
$1,952.71
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
36100471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$741.50 |
| Max. Negotiated Rate |
$1,952.71 |
| Rate for Payer: Aetna Commercial |
$1,757.44
|
| Rate for Payer: Aetna Medicare |
$1,355.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: ASR ASR |
$1,894.13
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.94
|
| Rate for Payer: BCN Commercial |
$1,513.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Cash Price |
$1,562.17
|
| Rate for Payer: Cash Price |
$1,562.17
|
| Rate for Payer: Cofinity Commercial |
$1,835.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,562.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Healthscope Commercial |
$1,952.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,894.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,355.58
|
| Rate for Payer: Mclaren Commercial |
$1,757.44
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,659.80
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Commercial |
$1,491.14
|
| Rate for Payer: PHP Medicaid |
$741.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,776.97
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,386.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,718.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: VA VA |
$1,355.58
|
|
|
HC FRENOTOMY
|
Facility
|
IP
|
$1,952.71
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
36100471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,366.90 |
| Max. Negotiated Rate |
$1,952.71 |
| Rate for Payer: Aetna Commercial |
$1,757.44
|
| Rate for Payer: ASR ASR |
$1,894.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.94
|
| Rate for Payer: BCN Commercial |
$1,513.94
|
| Rate for Payer: Cash Price |
$1,562.17
|
| Rate for Payer: Cofinity Commercial |
$1,835.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,562.17
|
| Rate for Payer: Healthscope Commercial |
$1,952.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,894.13
|
| Rate for Payer: Mclaren Commercial |
$1,757.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,659.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,718.38
|
|
|
HC FRESH FROZEN PLASMA
|
Facility
|
OP
|
$357.89
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000051
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$357.89 |
| Rate for Payer: Aetna Commercial |
$322.10
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$347.15
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$277.47
|
| Rate for Payer: BCN Commercial |
$277.47
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cofinity Commercial |
$336.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$357.89
|
| Rate for Payer: Healthscope Whirlpool |
$347.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$322.10
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.21
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.94
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
|
HC FRESH FROZEN PLASMA
|
Facility
|
IP
|
$357.89
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000051
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$250.52 |
| Max. Negotiated Rate |
$357.89 |
| Rate for Payer: Aetna Commercial |
$322.10
|
| Rate for Payer: ASR ASR |
$347.15
|
| Rate for Payer: BCBS Trust/PPO |
$277.47
|
| Rate for Payer: BCN Commercial |
$277.47
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cofinity Commercial |
$336.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.31
|
| Rate for Payer: Healthscope Commercial |
$357.89
|
| Rate for Payer: Healthscope Whirlpool |
$347.15
|
| Rate for Payer: Mclaren Commercial |
$322.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.94
|
|
|
HC FRESH FROZEN PLASMA 2X
|
Facility
|
OP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000052
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$262.85 |
| Rate for Payer: Aetna Commercial |
$236.56
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$254.96
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$203.79
|
| Rate for Payer: BCN Commercial |
$203.79
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$247.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$262.85
|
| Rate for Payer: Healthscope Whirlpool |
$254.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$236.56
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.31
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
|
HC FRESH FROZEN PLASMA 2X
|
Facility
|
IP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000052
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$262.85 |
| Rate for Payer: Aetna Commercial |
$236.56
|
| Rate for Payer: ASR ASR |
$254.96
|
| Rate for Payer: BCBS Trust/PPO |
$203.79
|
| Rate for Payer: BCN Commercial |
$203.79
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$247.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Healthscope Commercial |
$262.85
|
| Rate for Payer: Healthscope Whirlpool |
$254.96
|
| Rate for Payer: Mclaren Commercial |
$236.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.31
|
|
|
HC FRESH FROZEN PLASMA 2X CMPT
|
Facility
|
IP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000050
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$262.85 |
| Rate for Payer: Aetna Commercial |
$236.56
|
| Rate for Payer: ASR ASR |
$254.96
|
| Rate for Payer: BCBS Trust/PPO |
$203.79
|
| Rate for Payer: BCN Commercial |
$203.79
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$247.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Healthscope Commercial |
$262.85
|
| Rate for Payer: Healthscope Whirlpool |
$254.96
|
| Rate for Payer: Mclaren Commercial |
$236.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.31
|
|
|
HC FRESH FROZEN PLASMA 2X CMPT
|
Facility
|
OP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000050
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$262.85 |
| Rate for Payer: Aetna Commercial |
$236.56
|
| Rate for Payer: Aetna Medicare |
$74.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: ASR ASR |
$254.96
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$203.79
|
| Rate for Payer: BCN Commercial |
$203.79
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$247.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$262.85
|
| Rate for Payer: Healthscope Whirlpool |
$254.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$74.60
|
| Rate for Payer: Mclaren Commercial |
$236.56
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$82.06
|
| Rate for Payer: PHP Medicaid |
$40.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.83
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$88.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.31
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: VA VA |
$74.60
|
|
