|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$984.16 |
| Max. Negotiated Rate |
$1,514.09 |
| Rate for Payer: Aetna Commercial |
$1,362.68
|
| Rate for Payer: ASR ASR |
$1,468.67
|
| Rate for Payer: ASR Commercial |
$1,468.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,233.83
|
| Rate for Payer: BCN Commercial |
$1,173.87
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,423.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Commercial |
$1,514.09
|
| Rate for Payer: Healthscope Whirlpool |
$1,468.67
|
| Rate for Payer: Mclaren Commercial |
$1,362.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: Nomi Health Commercial |
$1,241.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,332.40
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$2,055.93 |
| Rate for Payer: Aetna Commercial |
$1,850.34
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$1,994.25
|
| Rate for Payer: ASR Commercial |
$1,994.25
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,683.60
|
| Rate for Payer: BCN Commercial |
$1,593.96
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,932.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$2,055.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,994.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,850.34
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$1,685.86
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,801.41
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,441.21
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,336.35 |
| Max. Negotiated Rate |
$2,055.93 |
| Rate for Payer: Aetna Commercial |
$1,850.34
|
| Rate for Payer: ASR ASR |
$1,994.25
|
| Rate for Payer: ASR Commercial |
$1,994.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,675.38
|
| Rate for Payer: BCN Commercial |
$1,593.96
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,932.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Healthscope Commercial |
$2,055.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,994.25
|
| Rate for Payer: Mclaren Commercial |
$1,850.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$1,685.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,809.22
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$897.27 |
| Max. Negotiated Rate |
$1,380.41 |
| Rate for Payer: Aetna Commercial |
$1,242.37
|
| Rate for Payer: ASR ASR |
$1,339.00
|
| Rate for Payer: ASR Commercial |
$1,339.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.90
|
| Rate for Payer: BCN Commercial |
$1,070.23
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,297.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Healthscope Commercial |
$1,380.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,339.00
|
| Rate for Payer: Mclaren Commercial |
$1,242.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,131.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.76
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,380.41 |
| Rate for Payer: Aetna Commercial |
$1,242.37
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$1,339.00
|
| Rate for Payer: ASR Commercial |
$1,339.00
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.42
|
| Rate for Payer: BCN Commercial |
$1,070.23
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,297.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,380.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,339.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,242.37
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,131.94
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.52
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$967.67
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$438.63 |
| Max. Negotiated Rate |
$1,096.58 |
| Rate for Payer: Aetna Commercial |
$986.92
|
| Rate for Payer: Aetna Medicare |
$548.29
|
| Rate for Payer: ASR ASR |
$1,063.68
|
| Rate for Payer: ASR Commercial |
$1,063.68
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: BCBS Trust/PPO |
$897.99
|
| Rate for Payer: BCN Commercial |
$850.18
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$1,096.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.68
|
| Rate for Payer: Mclaren Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.82
|
| Rate for Payer: Priority Health Narrow Network |
$768.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.99
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$712.78 |
| Max. Negotiated Rate |
$1,096.58 |
| Rate for Payer: Aetna Commercial |
$986.92
|
| Rate for Payer: ASR ASR |
$1,063.68
|
| Rate for Payer: ASR Commercial |
$1,063.68
|
| Rate for Payer: BCBS Trust/PPO |
$893.60
|
| Rate for Payer: BCN Commercial |
$850.18
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$1,030.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$1,096.58
|
| Rate for Payer: Healthscope Whirlpool |
$1,063.68
|
| Rate for Payer: Mclaren Commercial |
$986.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$964.99
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,591.71 |
| Rate for Payer: Aetna Commercial |
$1,432.54
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$1,543.96
|
| Rate for Payer: ASR Commercial |
$1,543.96
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.45
|
| Rate for Payer: BCN Commercial |
$1,234.05
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,496.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,591.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,543.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,432.54
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: Nomi Health Commercial |
$1,305.20
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,394.66
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.79
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,400.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,591.71
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,034.61 |
| Max. Negotiated Rate |
$1,591.71 |
| Rate for Payer: Aetna Commercial |
$1,432.54
|
| Rate for Payer: ASR ASR |
$1,543.96
|
| Rate for Payer: ASR Commercial |
$1,543.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,297.08
|
| Rate for Payer: BCN Commercial |
$1,234.05
|
| Rate for Payer: Cash Price |
$1,273.37
|
| Rate for Payer: Cofinity Commercial |
$1,496.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.37
|
| Rate for Payer: Healthscope Commercial |
$1,591.71
|
| Rate for Payer: Healthscope Whirlpool |
$1,543.96
|
| Rate for Payer: Mclaren Commercial |
$1,432.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,352.95
|
| Rate for Payer: Nomi Health Commercial |
$1,305.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,400.70
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$917.07 |
| Max. Negotiated Rate |
$1,410.88 |
| Rate for Payer: Aetna Commercial |
$1,269.79
|
| Rate for Payer: ASR ASR |
$1,368.55
|
| Rate for Payer: ASR Commercial |
$1,368.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.73
|
| Rate for Payer: BCN Commercial |
$1,093.86
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,326.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Healthscope Commercial |
$1,410.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,368.55
|
| Rate for Payer: Mclaren Commercial |
$1,269.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,241.57
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,410.88
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,410.88 |
| Rate for Payer: Aetna Commercial |
$1,269.79
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$1,368.55
|
| Rate for Payer: ASR Commercial |
$1,368.55
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.37
|
| Rate for Payer: BCN Commercial |
$1,093.86
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cash Price |
$1,128.70
|
| Rate for Payer: Cofinity Commercial |
$1,326.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,128.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,410.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,368.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,269.79
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,199.25
|
| Rate for Payer: Nomi Health Commercial |
$1,156.92
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$917.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,236.21
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$989.03
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,241.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$974.15 |
| Max. Negotiated Rate |
$1,498.69 |
| Rate for Payer: Aetna Commercial |
$1,348.82
|
| Rate for Payer: ASR ASR |
$1,453.73
|
| Rate for Payer: ASR Commercial |
$1,453.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,221.28
|
| Rate for Payer: BCN Commercial |
$1,161.93
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,408.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Healthscope Commercial |
$1,498.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,453.73
|
| Rate for Payer: Mclaren Commercial |
$1,348.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$1,228.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,318.85
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,498.69
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,498.69 |
| Rate for Payer: Aetna Commercial |
$1,348.82
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$1,453.73
|
| Rate for Payer: ASR Commercial |
$1,453.73
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.28
|
| Rate for Payer: BCN Commercial |
$1,161.93
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,408.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,498.69
|
| Rate for Payer: Healthscope Whirlpool |
$1,453.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,348.82
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$1,228.93
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,313.15
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,050.58
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,318.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
OP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$579.42 |
| Max. Negotiated Rate |
$1,448.55 |
| Rate for Payer: Aetna Commercial |
$1,303.69
|
| Rate for Payer: Aetna Medicare |
$724.27
|
| Rate for Payer: ASR ASR |
$1,405.09
|
| Rate for Payer: ASR Commercial |
$1,405.09
|
| Rate for Payer: BCBS Complete |
$579.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.22
|
| Rate for Payer: BCN Commercial |
$1,123.06
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,361.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,448.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.09
|
| Rate for Payer: Mclaren Commercial |
$1,303.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,015.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.72
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
IP
|
$1,448.55
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$941.56 |
| Max. Negotiated Rate |
$1,448.55 |
| Rate for Payer: Aetna Commercial |
$1,303.69
|
| Rate for Payer: ASR ASR |
$1,405.09
|
| Rate for Payer: ASR Commercial |
$1,405.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.42
|
| Rate for Payer: BCN Commercial |
$1,123.06
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,361.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,448.55
|
| Rate for Payer: Healthscope Whirlpool |
$1,405.09
|
| Rate for Payer: Mclaren Commercial |
$1,303.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,274.72
|
|
|
HC CT GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,310.90
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000028
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$524.36 |
| Max. Negotiated Rate |
$1,310.90 |
| Rate for Payer: Aetna Commercial |
$1,179.81
|
| Rate for Payer: Aetna Medicare |
$655.45
|
| Rate for Payer: ASR ASR |
$1,271.57
|
| Rate for Payer: ASR Commercial |
$1,271.57
|
| Rate for Payer: BCBS Complete |
$524.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.50
|
| Rate for Payer: BCN Commercial |
$1,016.34
|
| Rate for Payer: Cash Price |
$1,048.72
|
| Rate for Payer: Cofinity Commercial |
$1,232.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,048.72
|
| Rate for Payer: Healthscope Commercial |
$1,310.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,271.57
|
| Rate for Payer: Mclaren Commercial |
$1,179.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,114.27
|
| Rate for Payer: Nomi Health Commercial |
$1,074.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.61
|
| Rate for Payer: Priority Health Narrow Network |
$918.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,153.59
|
|
|
HC CT GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,310.90
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000028
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$852.09 |
| Max. Negotiated Rate |
$1,310.90 |
| Rate for Payer: Aetna Commercial |
$1,179.81
|
| Rate for Payer: ASR ASR |
$1,271.57
|
| Rate for Payer: ASR Commercial |
$1,271.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.25
|
| Rate for Payer: BCN Commercial |
$1,016.34
|
| Rate for Payer: Cash Price |
$1,048.72
|
| Rate for Payer: Cofinity Commercial |
$1,232.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,048.72
|
| Rate for Payer: Healthscope Commercial |
$1,310.90
|
| Rate for Payer: Healthscope Whirlpool |
$1,271.57
|
| Rate for Payer: Mclaren Commercial |
$1,179.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,114.27
|
| Rate for Payer: Nomi Health Commercial |
$1,074.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,153.59
|
|
|
HC CT GUIDE PLACEMENT OF THERAPY FIELDS
|
Facility
|
OP
|
$710.59
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
33300001
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$284.24 |
| Max. Negotiated Rate |
$710.59 |
| Rate for Payer: Aetna Commercial |
$639.53
|
| Rate for Payer: Aetna Medicare |
$355.30
|
| Rate for Payer: ASR ASR |
$689.27
|
| Rate for Payer: ASR Commercial |
$689.27
|
| Rate for Payer: BCBS Complete |
$284.24
|
| Rate for Payer: BCBS Trust/PPO |
$581.90
|
| Rate for Payer: BCN Commercial |
$550.92
|
| Rate for Payer: Cash Price |
$568.47
|
| Rate for Payer: Cofinity Commercial |
$667.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.47
|
| Rate for Payer: Healthscope Commercial |
$710.59
|
| Rate for Payer: Healthscope Whirlpool |
$689.27
|
| Rate for Payer: Mclaren Commercial |
$639.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.00
|
| Rate for Payer: Nomi Health Commercial |
$582.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.62
|
| Rate for Payer: Priority Health Narrow Network |
$498.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.32
|
|
|
HC CT GUIDE PLACEMENT OF THERAPY FIELDS
|
Facility
|
IP
|
$710.59
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
33300001
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$461.88 |
| Max. Negotiated Rate |
$710.59 |
| Rate for Payer: Aetna Commercial |
$639.53
|
| Rate for Payer: ASR ASR |
$689.27
|
| Rate for Payer: ASR Commercial |
$689.27
|
| Rate for Payer: BCBS Trust/PPO |
$579.06
|
| Rate for Payer: BCN Commercial |
$550.92
|
| Rate for Payer: Cash Price |
$568.47
|
| Rate for Payer: Cofinity Commercial |
$667.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.47
|
| Rate for Payer: Healthscope Commercial |
$710.59
|
| Rate for Payer: Healthscope Whirlpool |
$689.27
|
| Rate for Payer: Mclaren Commercial |
$639.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.00
|
| Rate for Payer: Nomi Health Commercial |
$582.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.32
|
|
|
HC CT GUIDE STEREOTACTIC LOCAL
|
Facility
|
OP
|
$1,197.50
|
|
|
Service Code
|
CPT 77011
|
| Hospital Charge Code |
35000033
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$479.00 |
| Max. Negotiated Rate |
$1,197.50 |
| Rate for Payer: Aetna Commercial |
$1,077.75
|
| Rate for Payer: Aetna Medicare |
$598.75
|
| Rate for Payer: ASR ASR |
$1,161.58
|
| Rate for Payer: ASR Commercial |
$1,161.58
|
| Rate for Payer: BCBS Complete |
$479.00
|
| Rate for Payer: BCBS Trust/PPO |
$980.63
|
| Rate for Payer: BCN Commercial |
$928.42
|
| Rate for Payer: Cash Price |
$958.00
|
| Rate for Payer: Cofinity Commercial |
$1,125.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.00
|
| Rate for Payer: Healthscope Commercial |
$1,197.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.58
|
| Rate for Payer: Mclaren Commercial |
$1,077.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.88
|
| Rate for Payer: Nomi Health Commercial |
$981.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.25
|
| Rate for Payer: Priority Health Narrow Network |
$839.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,053.80
|
|
|
HC CT GUIDE STEREOTACTIC LOCAL
|
Facility
|
IP
|
$1,197.50
|
|
|
Service Code
|
CPT 77011
|
| Hospital Charge Code |
35000033
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$778.38 |
| Max. Negotiated Rate |
$1,197.50 |
| Rate for Payer: Aetna Commercial |
$1,077.75
|
| Rate for Payer: ASR ASR |
$1,161.58
|
| Rate for Payer: ASR Commercial |
$1,161.58
|
| Rate for Payer: BCBS Trust/PPO |
$975.84
|
| Rate for Payer: BCN Commercial |
$928.42
|
| Rate for Payer: Cash Price |
$958.00
|
| Rate for Payer: Cofinity Commercial |
$1,125.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.00
|
| Rate for Payer: Healthscope Commercial |
$1,197.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,161.58
|
| Rate for Payer: Mclaren Commercial |
$1,077.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.88
|
| Rate for Payer: Nomi Health Commercial |
$981.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,053.80
|
|
|
HC CT HEAD ANGIO
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
35100010
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$894.58
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.18
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$765.79
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT HEAD ANGIO
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
35100010
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$1,092.42 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: ASR ASR |
$1,059.65
|
| Rate for Payer: ASR Commercial |
$1,059.65
|
| Rate for Payer: BCBS Trust/PPO |
$890.21
|
| Rate for Payer: BCN Commercial |
$846.95
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$1,026.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$1,092.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,059.65
|
| Rate for Payer: Mclaren Commercial |
$983.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$961.33
|
|
|
HC CT HEART SCAN
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
35000015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: ASR ASR |
$194.00
|
| Rate for Payer: ASR Commercial |
$194.00
|
| Rate for Payer: BCBS Trust/PPO |
$162.98
|
| Rate for Payer: BCN Commercial |
$155.06
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$200.00
|
| Rate for Payer: Healthscope Whirlpool |
$194.00
|
| Rate for Payer: Mclaren Commercial |
$180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.00
|
|
|
HC CT HEART SCAN
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
35000015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$194.00
|
| Rate for Payer: ASR Commercial |
$194.00
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$163.78
|
| Rate for Payer: BCN Commercial |
$155.06
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$188.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$200.00
|
| Rate for Payer: Healthscope Whirlpool |
$194.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$180.00
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.24
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$140.20
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
