|
HC DPPX AB IFA, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.69 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.36
|
| Rate for Payer: BCN Commercial |
$65.36
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
|
|
HC DPPX AB IFA, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$65.62
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.69 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Trust/PPO |
$65.36
|
| Rate for Payer: BCN Commercial |
$65.36
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$77.20
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$65.62
|
| Rate for Payer: BCN Commercial |
$65.62
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$77.20
|
| Rate for Payer: Healthscope Whirlpool |
$79.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
IP
|
$378.42
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$283.81 |
| Max. Negotiated Rate |
$378.42 |
| Rate for Payer: Aetna Commercial |
$340.58
|
| Rate for Payer: ASR ASR |
$367.07
|
| Rate for Payer: BCBS Trust/PPO |
$310.76
|
| Rate for Payer: BCN Commercial |
$310.76
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cofinity Commercial |
$355.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.74
|
| Rate for Payer: Healthscope Commercial |
$367.07
|
| Rate for Payer: Healthscope Whirlpool |
$378.42
|
| Rate for Payer: Mclaren Commercial |
$340.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.66
|
| Rate for Payer: Nomi Health Commercial |
$310.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.01
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
OP
|
$378.42
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$378.42 |
| Rate for Payer: Aetna Commercial |
$340.58
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$367.07
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$312.01
|
| Rate for Payer: BCN Commercial |
$312.01
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cofinity Commercial |
$355.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$367.07
|
| Rate for Payer: Healthscope Whirlpool |
$378.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$340.58
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.66
|
| Rate for Payer: Nomi Health Commercial |
$310.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.81
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.01
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$205.61
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
|
HC DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
IP
|
$653.51
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
76100559
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$490.13 |
| Max. Negotiated Rate |
$653.51 |
| Rate for Payer: Aetna Commercial |
$588.16
|
| Rate for Payer: ASR ASR |
$633.90
|
| Rate for Payer: BCBS Trust/PPO |
$536.66
|
| Rate for Payer: BCN Commercial |
$536.66
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cofinity Commercial |
$614.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.81
|
| Rate for Payer: Healthscope Commercial |
$633.90
|
| Rate for Payer: Healthscope Whirlpool |
$653.51
|
| Rate for Payer: Mclaren Commercial |
$588.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555.48
|
| Rate for Payer: Nomi Health Commercial |
$535.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$575.09
|
|
|
HC DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
OP
|
$653.51
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
76100559
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$653.51 |
| Rate for Payer: Aetna Commercial |
$588.16
|
| Rate for Payer: Aetna Medicare |
$236.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: ASR ASR |
$633.90
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$538.82
|
| Rate for Payer: BCN Commercial |
$538.82
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cofinity Commercial |
$614.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$633.90
|
| Rate for Payer: Healthscope Whirlpool |
$653.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$236.00
|
| Rate for Payer: Mclaren Commercial |
$588.16
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$129.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555.48
|
| Rate for Payer: Nomi Health Commercial |
$535.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.13
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$259.60
|
| Rate for Payer: PHP Medicaid |
$126.50
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$572.61
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health Narrow Network |
$458.11
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$575.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP DNSP |
$236.00
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: VA VA |
$236.00
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: BCBS Trust/PPO |
$17.94
|
| Rate for Payer: BCN Commercial |
$17.94
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$21.19
|
| Rate for Payer: Healthscope Whirlpool |
$21.85
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$21.85 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: ASR ASR |
$21.19
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$18.02
|
| Rate for Payer: BCN Commercial |
$18.02
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$21.19
|
| Rate for Payer: Healthscope Whirlpool |
$21.85
|
| Rate for Payer: Mclaren Commercial |
$19.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$19.14
|
| Rate for Payer: Priority Health Narrow Network |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.23
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$588.30 |
| Max. Negotiated Rate |
$1,590.00 |
| Rate for Payer: Aetna Commercial |
$1,431.00
|
| Rate for Payer: Aetna Medicare |
$588.30
|
| Rate for Payer: ASR ASR |
$1,542.30
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.95
|
| Rate for Payer: BCN Commercial |
$1,310.95
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,494.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,542.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,590.00
|
| Rate for Payer: Mclaren Commercial |
$1,431.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,272.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,393.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,114.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,399.20
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,192.50 |
| Max. Negotiated Rate |
$1,590.00 |
| Rate for Payer: Aetna Commercial |
$1,431.00
|
| Rate for Payer: ASR ASR |
$1,542.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.71
|
| Rate for Payer: BCN Commercial |
$1,305.71
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,494.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,542.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,590.00
|
| Rate for Payer: Mclaren Commercial |
$1,431.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,399.20
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
IP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.42 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Aetna Commercial |
$209.30
|
| Rate for Payer: ASR ASR |
$225.58
|
| Rate for Payer: BCBS Trust/PPO |
$190.98
|
| Rate for Payer: BCN Commercial |
$190.98
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$218.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$225.58
|
| Rate for Payer: Healthscope Whirlpool |
$232.56
|
| Rate for Payer: Mclaren Commercial |
$209.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.65
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
OP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$232.56 |
| Rate for Payer: Aetna Commercial |
$209.30
|
| Rate for Payer: Aetna Medicare |
$86.05
|
| Rate for Payer: ASR ASR |
$225.58
|
| Rate for Payer: BCBS Complete |
$93.02
|
| Rate for Payer: BCBS Trust/PPO |
$191.75
|
| Rate for Payer: BCN Commercial |
$191.75
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$218.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$225.58
|
| Rate for Payer: Healthscope Whirlpool |
$232.56
|
| Rate for Payer: Mclaren Commercial |
$209.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.77
|
| Rate for Payer: Priority Health Narrow Network |
$163.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.65
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
OP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$142.66 |
| Max. Negotiated Rate |
$385.56 |
| Rate for Payer: Aetna Commercial |
$347.00
|
| Rate for Payer: Aetna Medicare |
$142.66
|
| Rate for Payer: ASR ASR |
$373.99
|
| Rate for Payer: BCBS Complete |
$154.22
|
| Rate for Payer: BCBS Trust/PPO |
$317.89
|
| Rate for Payer: BCN Commercial |
$317.89
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$362.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$373.99
|
| Rate for Payer: Healthscope Whirlpool |
$385.56
|
| Rate for Payer: Mclaren Commercial |
$347.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$337.83
|
| Rate for Payer: Priority Health Narrow Network |
$270.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.29
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
IP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.17 |
| Max. Negotiated Rate |
$385.56 |
| Rate for Payer: Aetna Commercial |
$347.00
|
| Rate for Payer: ASR ASR |
$373.99
|
| Rate for Payer: BCBS Trust/PPO |
$316.62
|
| Rate for Payer: BCN Commercial |
$316.62
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$362.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$373.99
|
| Rate for Payer: Healthscope Whirlpool |
$385.56
|
| Rate for Payer: Mclaren Commercial |
$347.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.29
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
OP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,291.67 |
| Max. Negotiated Rate |
$3,491.00 |
| Rate for Payer: Aetna Commercial |
$3,141.90
|
| Rate for Payer: Aetna Medicare |
$1,291.67
|
| Rate for Payer: ASR ASR |
$3,386.27
|
| Rate for Payer: BCBS Complete |
$1,396.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,878.33
|
| Rate for Payer: BCN Commercial |
$2,878.33
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Commercial |
$3,281.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,386.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,491.00
|
| Rate for Payer: Mclaren Commercial |
$3,141.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,792.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Nomi Health Commercial |
$2,862.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,058.81
|
| Rate for Payer: Priority Health Narrow Network |
$2,447.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,072.08
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
IP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,618.25 |
| Max. Negotiated Rate |
$3,491.00 |
| Rate for Payer: Aetna Commercial |
$3,141.90
|
| Rate for Payer: ASR ASR |
$3,386.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,866.81
|
| Rate for Payer: BCN Commercial |
$2,866.81
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Commercial |
$3,281.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,386.27
|
| Rate for Payer: Healthscope Whirlpool |
$3,491.00
|
| Rate for Payer: Mclaren Commercial |
$3,141.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Nomi Health Commercial |
$2,862.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,072.08
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
IP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$403.92 |
| Max. Negotiated Rate |
$538.56 |
| Rate for Payer: Aetna Commercial |
$484.70
|
| Rate for Payer: ASR ASR |
$522.40
|
| Rate for Payer: BCBS Trust/PPO |
$442.27
|
| Rate for Payer: BCN Commercial |
$442.27
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$506.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$522.40
|
| Rate for Payer: Healthscope Whirlpool |
$538.56
|
| Rate for Payer: Mclaren Commercial |
$484.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.93
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.27 |
| Max. Negotiated Rate |
$538.56 |
| Rate for Payer: Aetna Commercial |
$484.70
|
| Rate for Payer: Aetna Medicare |
$199.27
|
| Rate for Payer: ASR ASR |
$522.40
|
| Rate for Payer: BCBS Complete |
$215.42
|
| Rate for Payer: BCBS Trust/PPO |
$444.04
|
| Rate for Payer: BCN Commercial |
$444.04
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$506.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$522.40
|
| Rate for Payer: Healthscope Whirlpool |
$538.56
|
| Rate for Payer: Mclaren Commercial |
$484.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$430.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$471.89
|
| Rate for Payer: Priority Health Narrow Network |
$377.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.93
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$340.08 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$827.22
|
| Rate for Payer: Aetna Medicare |
$340.08
|
| Rate for Payer: ASR ASR |
$891.56
|
| Rate for Payer: BCBS Complete |
$367.65
|
| Rate for Payer: BCBS Trust/PPO |
$757.82
|
| Rate for Payer: BCN Commercial |
$757.82
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$863.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$891.56
|
| Rate for Payer: Healthscope Whirlpool |
$919.13
|
| Rate for Payer: Mclaren Commercial |
$827.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$735.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$805.34
|
| Rate for Payer: Priority Health Narrow Network |
$644.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.83
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$689.35 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$827.22
|
| Rate for Payer: ASR ASR |
$891.56
|
| Rate for Payer: BCBS Trust/PPO |
$754.79
|
| Rate for Payer: BCN Commercial |
$754.79
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$863.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$891.56
|
| Rate for Payer: Healthscope Whirlpool |
$919.13
|
| Rate for Payer: Mclaren Commercial |
$827.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.83
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,276.27 |
| Max. Negotiated Rate |
$4,368.36 |
| Rate for Payer: Aetna Commercial |
$3,931.52
|
| Rate for Payer: ASR ASR |
$4,237.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,587.30
|
| Rate for Payer: BCN Commercial |
$3,587.30
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Commercial |
$4,106.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Healthscope Commercial |
$4,237.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,368.36
|
| Rate for Payer: Mclaren Commercial |
$3,931.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Nomi Health Commercial |
$3,582.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,844.16
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$4,368.36 |
| Rate for Payer: Aetna Commercial |
$3,931.52
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$4,237.31
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,601.71
|
| Rate for Payer: BCN Commercial |
$3,601.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Commercial |
$4,106.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,237.31
|
| Rate for Payer: Healthscope Whirlpool |
$4,368.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$3,931.52
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Nomi Health Commercial |
$3,582.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,827.56
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,062.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,844.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$530.60 |
| Rate for Payer: Aetna Commercial |
$477.54
|
| Rate for Payer: Aetna Medicare |
$199.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: ASR ASR |
$514.68
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$437.48
|
| Rate for Payer: BCN Commercial |
$437.48
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Commercial |
$498.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$514.68
|
| Rate for Payer: Healthscope Whirlpool |
$530.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$199.91
|
| Rate for Payer: Mclaren Commercial |
$477.54
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$109.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Nomi Health Commercial |
$435.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$219.90
|
| Rate for Payer: PHP Medicaid |
$107.15
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.01
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health Narrow Network |
$205.61
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$466.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$309.86
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP DNSP |
$199.91
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: VA VA |
$199.91
|
|
