|
HC CT HEART W CON CONGEN HEART DI
|
Facility
|
IP
|
$1,353.34
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
35000017
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$879.67 |
| Max. Negotiated Rate |
$1,353.34 |
| Rate for Payer: Aetna Commercial |
$1,218.01
|
| Rate for Payer: ASR ASR |
$1,312.74
|
| Rate for Payer: ASR Commercial |
$1,312.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.84
|
| Rate for Payer: BCN Commercial |
$1,049.24
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cofinity Commercial |
$1,272.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.67
|
| Rate for Payer: Healthscope Commercial |
$1,353.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.74
|
| Rate for Payer: Mclaren Commercial |
$1,218.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,150.34
|
| Rate for Payer: Nomi Health Commercial |
$1,109.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,190.94
|
|
|
HC CT HEART W CON CONGEN HEART DI
|
Facility
|
OP
|
$1,353.34
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
35000017
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$1,353.34 |
| Rate for Payer: Aetna Commercial |
$1,218.01
|
| 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 |
$1,312.74
|
| Rate for Payer: ASR Commercial |
$1,312.74
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.25
|
| Rate for Payer: BCN Commercial |
$1,049.24
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cofinity Commercial |
$1,272.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$1,353.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,312.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$1,218.01
|
| 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 |
$1,150.34
|
| Rate for Payer: Nomi Health Commercial |
$1,109.74
|
| 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 |
$879.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,185.80
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$948.69
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,190.94
|
| 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 HEART WITH CONTRAST
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
35000016
|
|
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 HEART WITH CONTRAST
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
35000016
|
|
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 LIMITED OR FOLLOW-UP
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000022
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| Rate for Payer: ASR ASR |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Trust/PPO |
$574.90
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
|
|
HC CT LIMITED OR FOLLOW-UP
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000022
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$705.49 |
| Rate for Payer: Aetna Commercial |
$634.94
|
| 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 |
$684.33
|
| Rate for Payer: ASR Commercial |
$684.33
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$577.73
|
| Rate for Payer: BCN Commercial |
$546.97
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$663.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$705.49
|
| Rate for Payer: Healthscope Whirlpool |
$684.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$634.94
|
| 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 |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| 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 |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.15
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$494.55
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.83
|
| 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
|
|
|
HC CT LOWER EXTREM ANGIO
|
Facility
|
IP
|
$1,904.14
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
35000011
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,237.69 |
| Max. Negotiated Rate |
$1,904.14 |
| Rate for Payer: Aetna Commercial |
$1,713.73
|
| Rate for Payer: ASR ASR |
$1,847.02
|
| Rate for Payer: ASR Commercial |
$1,847.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.68
|
| Rate for Payer: BCN Commercial |
$1,476.28
|
| Rate for Payer: Cash Price |
$1,523.31
|
| Rate for Payer: Cofinity Commercial |
$1,789.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.31
|
| Rate for Payer: Healthscope Commercial |
$1,904.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.02
|
| Rate for Payer: Mclaren Commercial |
$1,713.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,618.52
|
| Rate for Payer: Nomi Health Commercial |
$1,561.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,675.64
|
|
|
HC CT LOWER EXTREM ANGIO
|
Facility
|
OP
|
$1,904.14
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
35000011
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,904.14 |
| Rate for Payer: Aetna Commercial |
$1,713.73
|
| 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 |
$1,847.02
|
| Rate for Payer: ASR Commercial |
$1,847.02
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,559.30
|
| Rate for Payer: BCN Commercial |
$1,476.28
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,523.31
|
| Rate for Payer: Cash Price |
$1,523.31
|
| Rate for Payer: Cofinity Commercial |
$1,789.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,904.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,847.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,713.73
|
| 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 |
$1,618.52
|
| Rate for Payer: Nomi Health Commercial |
$1,561.39
|
| 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 |
$1,237.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,668.41
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,334.80
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,675.64
|
| 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 LOWER EXTREM BILAT W CON
|
Facility
|
IP
|
$1,611.38
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200030
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,047.40 |
| Max. Negotiated Rate |
$1,611.38 |
| Rate for Payer: Aetna Commercial |
$1,450.24
|
| Rate for Payer: ASR ASR |
$1,563.04
|
| Rate for Payer: ASR Commercial |
$1,563.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,313.11
|
| Rate for Payer: BCN Commercial |
$1,249.30
|
| Rate for Payer: Cash Price |
$1,289.10
|
| Rate for Payer: Cofinity Commercial |
$1,514.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,289.10
|
| Rate for Payer: Healthscope Commercial |
$1,611.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,563.04
|
| Rate for Payer: Mclaren Commercial |
$1,450.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,369.67
|
| Rate for Payer: Nomi Health Commercial |
$1,321.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,418.01
|
|
|
HC CT LOWER EXTREM BILAT W CON
|
Facility
|
OP
|
$1,611.38
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200030
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,611.38 |
| Rate for Payer: Aetna Commercial |
$1,450.24
|
| 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 |
$1,563.04
|
| Rate for Payer: ASR Commercial |
$1,563.04
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.56
|
| Rate for Payer: BCN Commercial |
$1,249.30
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,289.10
|
| Rate for Payer: Cash Price |
$1,289.10
|
| Rate for Payer: Cofinity Commercial |
$1,514.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,289.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,611.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,563.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,450.24
|
| 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 |
$1,369.67
|
| Rate for Payer: Nomi Health Commercial |
$1,321.33
|
| 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 |
$1,047.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,411.89
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,129.58
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,418.01
|
| 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 LOWER EXTREM BILAT WO CON
|
Facility
|
OP
|
$1,376.45
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200017
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,376.45 |
| Rate for Payer: Aetna Commercial |
$1,238.81
|
| 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 |
$1,335.16
|
| Rate for Payer: ASR Commercial |
$1,335.16
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,127.17
|
| Rate for Payer: BCN Commercial |
$1,067.16
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cofinity Commercial |
$1,293.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,376.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,238.81
|
| 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 |
$1,169.98
|
| Rate for Payer: Nomi Health Commercial |
$1,128.69
|
| 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 |
$894.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.05
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$964.89
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.28
|
| 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 LOWER EXTREM BILAT WO CON
|
Facility
|
IP
|
$1,376.45
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200017
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$894.69 |
| Max. Negotiated Rate |
$1,376.45 |
| Rate for Payer: Aetna Commercial |
$1,238.81
|
| Rate for Payer: ASR ASR |
$1,335.16
|
| Rate for Payer: ASR Commercial |
$1,335.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,121.67
|
| Rate for Payer: BCN Commercial |
$1,067.16
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cofinity Commercial |
$1,293.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.16
|
| Rate for Payer: Healthscope Commercial |
$1,376.45
|
| Rate for Payer: Healthscope Whirlpool |
$1,335.16
|
| Rate for Payer: Mclaren Commercial |
$1,238.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.98
|
| Rate for Payer: Nomi Health Commercial |
$1,128.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,211.28
|
|
|
HC CT LOWER EXTREM BILAT WO W CON
|
Facility
|
IP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200020
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,134.72 |
| Max. Negotiated Rate |
$1,745.73 |
| Rate for Payer: Aetna Commercial |
$1,571.16
|
| Rate for Payer: ASR ASR |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$1,693.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.60
|
| Rate for Payer: BCN Commercial |
$1,353.46
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,640.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Healthscope Commercial |
$1,745.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.36
|
| Rate for Payer: Mclaren Commercial |
$1,571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.24
|
|
|
HC CT LOWER EXTREM BILAT WO W CON
|
Facility
|
OP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200020
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,745.73 |
| Rate for Payer: Aetna Commercial |
$1,571.16
|
| 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 |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$1,693.36
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.58
|
| Rate for Payer: BCN Commercial |
$1,353.46
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,640.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,745.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,571.16
|
| 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 |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| 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 |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.61
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.76
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.24
|
| 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 LOWER EXTREM BIL W CON
|
Facility
|
OP
|
$2,061.33
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200032
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$2,061.33 |
| Rate for Payer: Aetna Commercial |
$1,855.20
|
| 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 |
$1,999.49
|
| Rate for Payer: ASR Commercial |
$1,999.49
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.02
|
| Rate for Payer: BCN Commercial |
$1,598.15
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,649.06
|
| Rate for Payer: Cash Price |
$1,649.06
|
| Rate for Payer: Cofinity Commercial |
$1,937.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,649.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$2,061.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,999.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,855.20
|
| 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 |
$1,752.13
|
| Rate for Payer: Nomi Health Commercial |
$1,690.29
|
| 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 |
$1,339.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,806.14
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,444.99
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,813.97
|
| 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 LOWER EXTREM BIL W CON
|
Facility
|
IP
|
$2,061.33
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200032
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,339.86 |
| Max. Negotiated Rate |
$2,061.33 |
| Rate for Payer: Aetna Commercial |
$1,855.20
|
| Rate for Payer: ASR ASR |
$1,999.49
|
| Rate for Payer: ASR Commercial |
$1,999.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,679.78
|
| Rate for Payer: BCN Commercial |
$1,598.15
|
| Rate for Payer: Cash Price |
$1,649.06
|
| Rate for Payer: Cofinity Commercial |
$1,937.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,649.06
|
| Rate for Payer: Healthscope Commercial |
$2,061.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,999.49
|
| Rate for Payer: Mclaren Commercial |
$1,855.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,752.13
|
| Rate for Payer: Nomi Health Commercial |
$1,690.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,813.97
|
|
|
HC CT LOWER EXTREM BIL WO CON
|
Facility
|
IP
|
$1,745.73
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200031
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,134.72 |
| Max. Negotiated Rate |
$1,745.73 |
| Rate for Payer: Aetna Commercial |
$1,571.16
|
| Rate for Payer: ASR ASR |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$1,693.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.60
|
| Rate for Payer: BCN Commercial |
$1,353.46
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,640.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Healthscope Commercial |
$1,745.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.36
|
| Rate for Payer: Mclaren Commercial |
$1,571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.24
|
|
|
HC CT LOWER EXTREM BIL WO CON
|
Facility
|
OP
|
$1,745.73
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200031
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,745.73 |
| Rate for Payer: Aetna Commercial |
$1,571.16
|
| 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 |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$1,693.36
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.58
|
| Rate for Payer: BCN Commercial |
$1,353.46
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,640.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,745.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,571.16
|
| 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 |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| 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 |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.61
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.76
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.24
|
| 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 LOWER EXTREMITY WO W CON
|
Facility
|
IP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200019
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,134.72 |
| Max. Negotiated Rate |
$1,745.73 |
| Rate for Payer: Aetna Commercial |
$1,571.16
|
| Rate for Payer: Aetna Commercial |
$2,356.73
|
| Rate for Payer: ASR ASR |
$2,540.03
|
| Rate for Payer: ASR ASR |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$2,540.03
|
| Rate for Payer: ASR Commercial |
$1,693.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,133.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.60
|
| Rate for Payer: BCN Commercial |
$2,030.19
|
| Rate for Payer: BCN Commercial |
$1,353.46
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$2,094.87
|
| Rate for Payer: Cofinity Commercial |
$2,461.47
|
| Rate for Payer: Cofinity Commercial |
$1,640.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,094.87
|
| Rate for Payer: Healthscope Commercial |
$1,745.73
|
| Rate for Payer: Healthscope Commercial |
$2,618.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,540.03
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.36
|
| Rate for Payer: Mclaren Commercial |
$1,571.16
|
| Rate for Payer: Mclaren Commercial |
$2,356.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,225.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$2,147.24
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,304.36
|
|
|
HC CT LOWER EXTREMITY WO W CON
|
Facility
|
OP
|
$2,618.59
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200019
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$2,618.59 |
| Rate for Payer: Aetna Commercial |
$2,356.73
|
| Rate for Payer: Aetna Commercial |
$1,571.16
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$2,540.03
|
| Rate for Payer: ASR ASR |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$1,693.36
|
| Rate for Payer: ASR Commercial |
$2,540.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,144.36
|
| Rate for Payer: BCN Commercial |
$1,353.46
|
| Rate for Payer: BCN Commercial |
$2,030.19
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$2,094.87
|
| Rate for Payer: Cash Price |
$2,094.87
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$2,461.47
|
| Rate for Payer: Cofinity Commercial |
$1,640.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,094.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$2,618.59
|
| Rate for Payer: Healthscope Commercial |
$1,745.73
|
| Rate for Payer: Healthscope Whirlpool |
$1,693.36
|
| Rate for Payer: Healthscope Whirlpool |
$2,540.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,571.16
|
| Rate for Payer: Mclaren Commercial |
$2,356.73
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,225.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: Nomi Health Commercial |
$2,147.24
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,294.41
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,835.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.76
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,536.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,304.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: VA VA |
$173.62
|
|
|
HC CT LOWER EXTREM W CON
|
Facility
|
OP
|
$1,545.62
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200018
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,545.62 |
| Rate for Payer: Aetna Commercial |
$1,391.06
|
| 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 |
$1,499.25
|
| Rate for Payer: ASR Commercial |
$1,499.25
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,265.71
|
| Rate for Payer: BCN Commercial |
$1,198.32
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$1,236.50
|
| Rate for Payer: Cash Price |
$1,236.50
|
| Rate for Payer: Cofinity Commercial |
$1,452.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,545.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$1,391.06
|
| 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 |
$1,313.78
|
| Rate for Payer: Nomi Health Commercial |
$1,267.41
|
| 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 |
$1,004.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.27
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,083.48
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.15
|
| 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 LOWER EXTREM W CON
|
Facility
|
IP
|
$1,545.62
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200018
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,004.65 |
| Max. Negotiated Rate |
$1,545.62 |
| Rate for Payer: Aetna Commercial |
$1,391.06
|
| Rate for Payer: ASR ASR |
$1,499.25
|
| Rate for Payer: ASR Commercial |
$1,499.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.53
|
| Rate for Payer: BCN Commercial |
$1,198.32
|
| Rate for Payer: Cash Price |
$1,236.50
|
| Rate for Payer: Cofinity Commercial |
$1,452.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.50
|
| Rate for Payer: Healthscope Commercial |
$1,545.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,499.25
|
| Rate for Payer: Mclaren Commercial |
$1,391.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.78
|
| Rate for Payer: Nomi Health Commercial |
$1,267.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,360.15
|
|
|
HC CT LOWER EXTREM WO CON
|
Facility
|
OP
|
$2,024.19
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200016
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$2,024.19 |
| Rate for Payer: Aetna Commercial |
$1,821.77
|
| Rate for Payer: Aetna Commercial |
$1,214.51
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$1,963.46
|
| Rate for Payer: ASR ASR |
$1,308.98
|
| Rate for Payer: ASR Commercial |
$1,308.98
|
| Rate for Payer: ASR Commercial |
$1,963.46
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,105.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,657.61
|
| Rate for Payer: BCN Commercial |
$1,046.24
|
| Rate for Payer: BCN Commercial |
$1,569.35
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,079.57
|
| Rate for Payer: Cash Price |
$1,079.57
|
| Rate for Payer: Cofinity Commercial |
$1,902.74
|
| Rate for Payer: Cofinity Commercial |
$1,268.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Commercial |
$1,349.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,963.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$1,214.51
|
| Rate for Payer: Mclaren Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,720.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,147.04
|
| Rate for Payer: Nomi Health Commercial |
$1,106.56
|
| Rate for Payer: Nomi Health Commercial |
$1,659.84
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$877.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,182.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,773.60
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,418.96
|
| Rate for Payer: Priority Health Narrow Network |
$945.97
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,187.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,781.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC CT LOWER EXTREM WO CON
|
Facility
|
IP
|
$1,349.46
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200016
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$877.15 |
| Max. Negotiated Rate |
$1,349.46 |
| Rate for Payer: Aetna Commercial |
$1,214.51
|
| Rate for Payer: Aetna Commercial |
$1,821.77
|
| Rate for Payer: ASR ASR |
$1,963.46
|
| Rate for Payer: ASR ASR |
$1,308.98
|
| Rate for Payer: ASR Commercial |
$1,963.46
|
| Rate for Payer: ASR Commercial |
$1,308.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,649.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.67
|
| Rate for Payer: BCN Commercial |
$1,569.35
|
| Rate for Payer: BCN Commercial |
$1,046.24
|
| Rate for Payer: Cash Price |
$1,079.57
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,902.74
|
| Rate for Payer: Cofinity Commercial |
$1,268.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Healthscope Commercial |
$1,349.46
|
| Rate for Payer: Healthscope Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Whirlpool |
$1,963.46
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.98
|
| Rate for Payer: Mclaren Commercial |
$1,214.51
|
| Rate for Payer: Mclaren Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,720.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,147.04
|
| Rate for Payer: Nomi Health Commercial |
$1,659.84
|
| Rate for Payer: Nomi Health Commercial |
$1,106.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$877.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,187.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,781.29
|
|
|
HC CT LOWER EXTREM WO W CON
|
Facility
|
OP
|
$691.66
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200029
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$691.66 |
| Rate for Payer: Aetna Commercial |
$622.49
|
| Rate for Payer: Aetna Commercial |
$933.74
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Aetna Medicare |
$173.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: ASR ASR |
$670.91
|
| Rate for Payer: ASR ASR |
$1,006.37
|
| Rate for Payer: ASR Commercial |
$1,006.37
|
| Rate for Payer: ASR Commercial |
$670.91
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCBS Trust/PPO |
$849.60
|
| Rate for Payer: BCBS Trust/PPO |
$566.40
|
| Rate for Payer: BCN Commercial |
$804.37
|
| Rate for Payer: BCN Commercial |
$536.24
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cash Price |
$829.99
|
| Rate for Payer: Cash Price |
$829.99
|
| Rate for Payer: Cofinity Commercial |
$650.16
|
| Rate for Payer: Cofinity Commercial |
$975.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$691.66
|
| Rate for Payer: Healthscope Commercial |
$1,037.49
|
| Rate for Payer: Healthscope Whirlpool |
$1,006.37
|
| Rate for Payer: Healthscope Whirlpool |
$670.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.62
|
| Rate for Payer: Mclaren Commercial |
$933.74
|
| Rate for Payer: Mclaren Commercial |
$622.49
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.87
|
| Rate for Payer: Nomi Health Commercial |
$850.74
|
| Rate for Payer: Nomi Health Commercial |
$567.16
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Commercial |
$190.98
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicaid |
$93.06
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.03
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health Narrow Network |
$484.85
|
| Rate for Payer: Priority Health Narrow Network |
$727.28
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$912.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$608.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Exchange |
$269.11
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP DNSP |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: VA VA |
$173.62
|
|
