|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
OP
|
$1,887.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.50 |
| Max. Negotiated Rate |
$1,887.00 |
| Rate for Payer: Aetna Commercial |
$1,698.30
|
| Rate for Payer: Aetna Medicare |
$689.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: ASR ASR |
$1,830.39
|
| Rate for Payer: ASR Commercial |
$1,830.39
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,545.26
|
| Rate for Payer: BCN Commercial |
$1,462.99
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,773.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,887.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,830.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$689.36
|
| Rate for Payer: Mclaren Commercial |
$1,698.30
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.95
|
| Rate for Payer: Nomi Health Commercial |
$1,547.34
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$758.30
|
| Rate for Payer: PHP Medicaid |
$369.50
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,226.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.70
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$615.76
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,660.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$1,068.51
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP DNSP |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
IP
|
$1,887.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,226.55 |
| Max. Negotiated Rate |
$1,887.00 |
| Rate for Payer: Aetna Commercial |
$1,698.30
|
| Rate for Payer: ASR ASR |
$1,830.39
|
| Rate for Payer: ASR Commercial |
$1,830.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,537.72
|
| Rate for Payer: BCN Commercial |
$1,462.99
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,773.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.60
|
| Rate for Payer: Healthscope Commercial |
$1,887.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,830.39
|
| Rate for Payer: Mclaren Commercial |
$1,698.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.95
|
| Rate for Payer: Nomi Health Commercial |
$1,547.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,226.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,660.56
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$3,672.00
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$3,957.60
|
| Rate for Payer: ASR Commercial |
$3,957.60
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,341.11
|
| Rate for Payer: BCN Commercial |
$3,163.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,835.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$4,080.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,957.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$3,672.00
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$3,345.60
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,574.90
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,860.08
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,590.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,652.00 |
| Max. Negotiated Rate |
$4,080.00 |
| Rate for Payer: Aetna Commercial |
$3,672.00
|
| Rate for Payer: ASR ASR |
$3,957.60
|
| Rate for Payer: ASR Commercial |
$3,957.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,324.79
|
| Rate for Payer: BCN Commercial |
$3,163.22
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,835.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Healthscope Commercial |
$4,080.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,957.60
|
| Rate for Payer: Mclaren Commercial |
$3,672.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$3,345.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,590.40
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
IP
|
$509.07
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$330.90 |
| Max. Negotiated Rate |
$509.07 |
| Rate for Payer: Aetna Commercial |
$458.16
|
| Rate for Payer: ASR ASR |
$493.80
|
| Rate for Payer: ASR Commercial |
$493.80
|
| Rate for Payer: BCBS Trust/PPO |
$414.84
|
| Rate for Payer: BCN Commercial |
$394.68
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cofinity Commercial |
$478.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.26
|
| Rate for Payer: Healthscope Commercial |
$509.07
|
| Rate for Payer: Healthscope Whirlpool |
$493.80
|
| Rate for Payer: Mclaren Commercial |
$458.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.71
|
| Rate for Payer: Nomi Health Commercial |
$417.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.98
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
OP
|
$509.07
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$509.07 |
| Rate for Payer: Aetna Commercial |
$458.16
|
| Rate for Payer: Aetna Medicare |
$254.54
|
| Rate for Payer: ASR ASR |
$493.80
|
| Rate for Payer: ASR Commercial |
$493.80
|
| Rate for Payer: BCBS Complete |
$203.63
|
| Rate for Payer: BCBS Trust/PPO |
$416.88
|
| Rate for Payer: BCN Commercial |
$394.68
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cofinity Commercial |
$478.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.26
|
| Rate for Payer: Healthscope Commercial |
$509.07
|
| Rate for Payer: Healthscope Whirlpool |
$493.80
|
| Rate for Payer: Mclaren Commercial |
$458.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.71
|
| Rate for Payer: Nomi Health Commercial |
$417.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.05
|
| Rate for Payer: Priority Health Narrow Network |
$356.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$447.98
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$645.08
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$419.30 |
| Max. Negotiated Rate |
$645.08 |
| Rate for Payer: Aetna Commercial |
$580.57
|
| Rate for Payer: ASR ASR |
$625.73
|
| Rate for Payer: ASR Commercial |
$625.73
|
| Rate for Payer: BCBS Trust/PPO |
$525.68
|
| Rate for Payer: BCN Commercial |
$500.13
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cofinity Commercial |
$606.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.06
|
| Rate for Payer: Healthscope Commercial |
$645.08
|
| Rate for Payer: Healthscope Whirlpool |
$625.73
|
| Rate for Payer: Mclaren Commercial |
$580.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.32
|
| Rate for Payer: Nomi Health Commercial |
$528.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.67
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$645.08
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.82 |
| Max. Negotiated Rate |
$645.08 |
| Rate for Payer: Aetna Commercial |
$580.57
|
| Rate for Payer: Aetna Medicare |
$391.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: ASR ASR |
$625.73
|
| Rate for Payer: ASR Commercial |
$625.73
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$528.26
|
| Rate for Payer: BCN Commercial |
$500.13
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cofinity Commercial |
$606.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$645.08
|
| Rate for Payer: Healthscope Whirlpool |
$625.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$391.45
|
| Rate for Payer: Mclaren Commercial |
$580.57
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.32
|
| Rate for Payer: Nomi Health Commercial |
$528.97
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$430.60
|
| Rate for Payer: PHP Medicaid |
$209.82
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.84
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$346.27
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$567.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$606.75
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP DNSP |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC DECALCIFICATION
|
Facility
|
IP
|
$37.56
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$37.56 |
| Rate for Payer: Aetna Commercial |
$33.80
|
| Rate for Payer: ASR ASR |
$36.43
|
| Rate for Payer: ASR Commercial |
$36.43
|
| Rate for Payer: BCBS Trust/PPO |
$30.61
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$35.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$37.56
|
| Rate for Payer: Healthscope Whirlpool |
$36.43
|
| Rate for Payer: Mclaren Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$30.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.05
|
|
|
HC DECALCIFICATION
|
Facility
|
OP
|
$37.56
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$73.57 |
| Rate for Payer: Aetna Commercial |
$33.80
|
| Rate for Payer: Aetna Medicare |
$18.78
|
| Rate for Payer: ASR ASR |
$36.43
|
| Rate for Payer: ASR Commercial |
$36.43
|
| Rate for Payer: BCBS Complete |
$15.02
|
| Rate for Payer: BCBS Trust/PPO |
$30.76
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$35.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$37.56
|
| Rate for Payer: Healthscope Whirlpool |
$36.43
|
| Rate for Payer: Mclaren Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$30.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.57
|
| Rate for Payer: Priority Health Narrow Network |
$58.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.05
|
|
|
HC DECLOT BY THROMBOLYTIC
|
Facility
|
OP
|
$483.16
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
76100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$174.19 |
| Max. Negotiated Rate |
$503.72 |
| Rate for Payer: Aetna Commercial |
$434.84
|
| Rate for Payer: Aetna Medicare |
$324.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: ASR ASR |
$468.67
|
| Rate for Payer: ASR Commercial |
$468.67
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$395.66
|
| Rate for Payer: BCN Commercial |
$374.59
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$386.53
|
| Rate for Payer: Cash Price |
$386.53
|
| Rate for Payer: Cofinity Commercial |
$454.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$483.16
|
| Rate for Payer: Healthscope Whirlpool |
$468.67
|
| Rate for Payer: Humana Choice PPO Medicare |
$324.98
|
| Rate for Payer: Mclaren Commercial |
$434.84
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.69
|
| Rate for Payer: Nomi Health Commercial |
$396.19
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$357.48
|
| Rate for Payer: PHP Medicaid |
$174.19
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.34
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$338.70
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$425.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$503.72
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP DNSP |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: VA VA |
$324.98
|
|
|
HC DECLOT BY THROMBOLYTIC
|
Facility
|
IP
|
$483.16
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
76100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.05 |
| Max. Negotiated Rate |
$483.16 |
| Rate for Payer: Aetna Commercial |
$434.84
|
| Rate for Payer: ASR ASR |
$468.67
|
| Rate for Payer: ASR Commercial |
$468.67
|
| Rate for Payer: BCBS Trust/PPO |
$393.73
|
| Rate for Payer: BCN Commercial |
$374.59
|
| Rate for Payer: Cash Price |
$386.53
|
| Rate for Payer: Cofinity Commercial |
$454.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.53
|
| Rate for Payer: Healthscope Commercial |
$483.16
|
| Rate for Payer: Healthscope Whirlpool |
$468.67
|
| Rate for Payer: Mclaren Commercial |
$434.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.69
|
| Rate for Payer: Nomi Health Commercial |
$396.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$425.18
|
|
|
HC DECONTAMINATION AMB/SELF-DIRECTED
|
Facility
|
OP
|
$143.38
|
|
| Hospital Charge Code |
27000613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.35 |
| Max. Negotiated Rate |
$143.38 |
| Rate for Payer: Aetna Commercial |
$129.04
|
| Rate for Payer: Aetna Medicare |
$71.69
|
| Rate for Payer: ASR ASR |
$139.08
|
| Rate for Payer: ASR Commercial |
$139.08
|
| Rate for Payer: BCBS Complete |
$57.35
|
| Rate for Payer: BCBS Trust/PPO |
$117.41
|
| Rate for Payer: BCN Commercial |
$111.16
|
| Rate for Payer: Cash Price |
$114.70
|
| Rate for Payer: Cofinity Commercial |
$134.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.70
|
| Rate for Payer: Healthscope Commercial |
$143.38
|
| Rate for Payer: Healthscope Whirlpool |
$139.08
|
| Rate for Payer: Mclaren Commercial |
$129.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.87
|
| Rate for Payer: Nomi Health Commercial |
$117.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.63
|
| Rate for Payer: Priority Health Narrow Network |
$100.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.17
|
|
|
HC DECONTAMINATION AMB/SELF-DIRECTED
|
Facility
|
IP
|
$143.38
|
|
| Hospital Charge Code |
27000613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$143.38 |
| Rate for Payer: Aetna Commercial |
$129.04
|
| Rate for Payer: ASR ASR |
$139.08
|
| Rate for Payer: ASR Commercial |
$139.08
|
| Rate for Payer: BCBS Trust/PPO |
$116.84
|
| Rate for Payer: BCN Commercial |
$111.16
|
| Rate for Payer: Cash Price |
$114.70
|
| Rate for Payer: Cofinity Commercial |
$134.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.70
|
| Rate for Payer: Healthscope Commercial |
$143.38
|
| Rate for Payer: Healthscope Whirlpool |
$139.08
|
| Rate for Payer: Mclaren Commercial |
$129.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.87
|
| Rate for Payer: Nomi Health Commercial |
$117.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.17
|
|
|
HC DECONTAMINATION AMB W/ASSIST
|
Facility
|
IP
|
$823.25
|
|
| Hospital Charge Code |
27000026
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$535.11 |
| Max. Negotiated Rate |
$823.25 |
| Rate for Payer: Aetna Commercial |
$740.92
|
| Rate for Payer: ASR ASR |
$798.55
|
| Rate for Payer: ASR Commercial |
$798.55
|
| Rate for Payer: BCBS Trust/PPO |
$670.87
|
| Rate for Payer: BCN Commercial |
$638.27
|
| Rate for Payer: Cash Price |
$658.60
|
| Rate for Payer: Cofinity Commercial |
$773.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$658.60
|
| Rate for Payer: Healthscope Commercial |
$823.25
|
| Rate for Payer: Healthscope Whirlpool |
$798.55
|
| Rate for Payer: Mclaren Commercial |
$740.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$699.76
|
| Rate for Payer: Nomi Health Commercial |
$675.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$535.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$724.46
|
|
|
HC DECONTAMINATION AMB W/ASSIST
|
Facility
|
OP
|
$823.25
|
|
| Hospital Charge Code |
27000026
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$329.30 |
| Max. Negotiated Rate |
$823.25 |
| Rate for Payer: Aetna Commercial |
$740.92
|
| Rate for Payer: Aetna Medicare |
$411.62
|
| Rate for Payer: ASR ASR |
$798.55
|
| Rate for Payer: ASR Commercial |
$798.55
|
| Rate for Payer: BCBS Complete |
$329.30
|
| Rate for Payer: BCBS Trust/PPO |
$674.16
|
| Rate for Payer: BCN Commercial |
$638.27
|
| Rate for Payer: Cash Price |
$658.60
|
| Rate for Payer: Cofinity Commercial |
$773.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$658.60
|
| Rate for Payer: Healthscope Commercial |
$823.25
|
| Rate for Payer: Healthscope Whirlpool |
$798.55
|
| Rate for Payer: Mclaren Commercial |
$740.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$699.76
|
| Rate for Payer: Nomi Health Commercial |
$675.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$535.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.33
|
| Rate for Payer: Priority Health Narrow Network |
$577.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$724.46
|
|
|
HC DECONTAMINATION NON AMBULATORY
|
Facility
|
OP
|
$1,646.48
|
|
| Hospital Charge Code |
27000126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$658.59 |
| Max. Negotiated Rate |
$1,646.48 |
| Rate for Payer: Aetna Commercial |
$1,481.83
|
| Rate for Payer: Aetna Medicare |
$823.24
|
| Rate for Payer: ASR ASR |
$1,597.09
|
| Rate for Payer: ASR Commercial |
$1,597.09
|
| Rate for Payer: BCBS Complete |
$658.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,348.30
|
| Rate for Payer: BCN Commercial |
$1,276.52
|
| Rate for Payer: Cash Price |
$1,317.18
|
| Rate for Payer: Cofinity Commercial |
$1,547.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,317.18
|
| Rate for Payer: Healthscope Commercial |
$1,646.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,597.09
|
| Rate for Payer: Mclaren Commercial |
$1,481.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,399.51
|
| Rate for Payer: Nomi Health Commercial |
$1,350.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,442.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,448.90
|
|
|
HC DECONTAMINATION NON AMBULATORY
|
Facility
|
IP
|
$1,646.48
|
|
| Hospital Charge Code |
27000126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,070.21 |
| Max. Negotiated Rate |
$1,646.48 |
| Rate for Payer: Aetna Commercial |
$1,481.83
|
| Rate for Payer: ASR ASR |
$1,597.09
|
| Rate for Payer: ASR Commercial |
$1,597.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,341.72
|
| Rate for Payer: BCN Commercial |
$1,276.52
|
| Rate for Payer: Cash Price |
$1,317.18
|
| Rate for Payer: Cofinity Commercial |
$1,547.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,317.18
|
| Rate for Payer: Healthscope Commercial |
$1,646.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,597.09
|
| Rate for Payer: Mclaren Commercial |
$1,481.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,399.51
|
| Rate for Payer: Nomi Health Commercial |
$1,350.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,070.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,448.90
|
|
|
HC DEFINITY CONTRAST 1ST ML
|
Facility
|
OP
|
$296.10
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600002
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.77 |
| Max. Negotiated Rate |
$296.10 |
| Rate for Payer: Aetna Commercial |
$266.49
|
| Rate for Payer: Aetna Medicare |
$148.05
|
| Rate for Payer: ASR ASR |
$287.22
|
| Rate for Payer: ASR Commercial |
$287.22
|
| Rate for Payer: BCBS Complete |
$118.44
|
| Rate for Payer: BCBS Trust/PPO |
$242.48
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: Cash Price |
$236.88
|
| Rate for Payer: Cash Price |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$278.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.88
|
| Rate for Payer: Healthscope Commercial |
$296.10
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$266.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.68
|
| Rate for Payer: Nomi Health Commercial |
$242.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.46
|
| Rate for Payer: Priority Health Narrow Network |
$34.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.57
|
|
|
HC DEFINITY CONTRAST 1ST ML
|
Facility
|
IP
|
$296.10
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600002
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$192.46 |
| Max. Negotiated Rate |
$296.10 |
| Rate for Payer: Aetna Commercial |
$266.49
|
| Rate for Payer: ASR ASR |
$287.22
|
| Rate for Payer: ASR Commercial |
$287.22
|
| Rate for Payer: BCBS Trust/PPO |
$241.29
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: Cash Price |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$278.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.88
|
| Rate for Payer: Healthscope Commercial |
$296.10
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$266.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.68
|
| Rate for Payer: Nomi Health Commercial |
$242.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.57
|
|
|
HC DEFINITY CONTRAST 2ND ML
|
Facility
|
OP
|
$296.10
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.77 |
| Max. Negotiated Rate |
$296.10 |
| Rate for Payer: Aetna Commercial |
$266.49
|
| Rate for Payer: Aetna Medicare |
$148.05
|
| Rate for Payer: ASR ASR |
$287.22
|
| Rate for Payer: ASR Commercial |
$287.22
|
| Rate for Payer: BCBS Complete |
$118.44
|
| Rate for Payer: BCBS Trust/PPO |
$242.48
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: Cash Price |
$236.88
|
| Rate for Payer: Cash Price |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$278.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.88
|
| Rate for Payer: Healthscope Commercial |
$296.10
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$266.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.68
|
| Rate for Payer: Nomi Health Commercial |
$242.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.46
|
| Rate for Payer: Priority Health Narrow Network |
$34.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.57
|
|
|
HC DEFINITY CONTRAST 2ND ML
|
Facility
|
IP
|
$296.10
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$192.46 |
| Max. Negotiated Rate |
$296.10 |
| Rate for Payer: Aetna Commercial |
$266.49
|
| Rate for Payer: ASR ASR |
$287.22
|
| Rate for Payer: ASR Commercial |
$287.22
|
| Rate for Payer: BCBS Trust/PPO |
$241.29
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: Cash Price |
$236.88
|
| Rate for Payer: Cofinity Commercial |
$278.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.88
|
| Rate for Payer: Healthscope Commercial |
$296.10
|
| Rate for Payer: Healthscope Whirlpool |
$287.22
|
| Rate for Payer: Mclaren Commercial |
$266.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.68
|
| Rate for Payer: Nomi Health Commercial |
$242.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.57
|
|
|
HC DEGARELIX INJECTION PER 1MG
|
Facility
|
IP
|
$6.24
|
|
|
Service Code
|
HCPCS J9155
|
| Hospital Charge Code |
63600146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$6.24 |
| Rate for Payer: Aetna Commercial |
$5.62
|
| Rate for Payer: ASR ASR |
$6.05
|
| Rate for Payer: ASR Commercial |
$6.05
|
| Rate for Payer: BCBS Trust/PPO |
$5.08
|
| Rate for Payer: BCN Commercial |
$4.84
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.99
|
| Rate for Payer: Healthscope Commercial |
$6.24
|
| Rate for Payer: Healthscope Whirlpool |
$6.05
|
| Rate for Payer: Mclaren Commercial |
$5.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.30
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.49
|
|
|
HC DEGARELIX INJECTION PER 1MG
|
Facility
|
OP
|
$6.24
|
|
|
Service Code
|
HCPCS J9155
|
| Hospital Charge Code |
63600146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$6.63 |
| Rate for Payer: Aetna Commercial |
$5.62
|
| Rate for Payer: Aetna Medicare |
$4.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.35
|
| Rate for Payer: ASR ASR |
$6.05
|
| Rate for Payer: ASR Commercial |
$6.05
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.28
|
| Rate for Payer: BCBS Trust/PPO |
$5.11
|
| Rate for Payer: BCN Commercial |
$4.84
|
| Rate for Payer: BCN Medicare Advantage |
$4.28
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.28
|
| Rate for Payer: Healthscope Commercial |
$6.24
|
| Rate for Payer: Healthscope Whirlpool |
$6.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.28
|
| Rate for Payer: Mclaren Commercial |
$5.62
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.49
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.30
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: PACE Medicare |
$4.07
|
| Rate for Payer: PACE SWMI |
$4.28
|
| Rate for Payer: PHP Commercial |
$4.71
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.52
|
| Rate for Payer: Priority Health Medicare |
$4.28
|
| Rate for Payer: Priority Health Narrow Network |
$3.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.28
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$4.28
|
| Rate for Payer: UHCCP DNSP |
$4.28
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: VA VA |
$4.28
|
|
|
HC DEGLYCEROLIZED RED BLOOD CELLS
|
Facility
|
OP
|
$944.06
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
39000049
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$343.32 |
| Max. Negotiated Rate |
$992.81 |
| Rate for Payer: Aetna Commercial |
$849.65
|
| Rate for Payer: Aetna Medicare |
$640.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$800.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$800.65
|
| Rate for Payer: ASR ASR |
$915.74
|
| Rate for Payer: ASR Commercial |
$915.74
|
| Rate for Payer: BCBS Complete |
$360.48
|
| Rate for Payer: BCBS MAPPO |
$640.52
|
| Rate for Payer: BCBS Trust/PPO |
$773.09
|
| Rate for Payer: BCN Commercial |
$731.93
|
| Rate for Payer: BCN Medicare Advantage |
$640.52
|
| Rate for Payer: Cash Price |
$755.25
|
| Rate for Payer: Cash Price |
$755.25
|
| Rate for Payer: Cofinity Commercial |
$887.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.52
|
| Rate for Payer: Healthscope Commercial |
$944.06
|
| Rate for Payer: Healthscope Whirlpool |
$915.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$640.52
|
| Rate for Payer: Mclaren Commercial |
$849.65
|
| Rate for Payer: Mclaren Medicaid |
$343.32
|
| Rate for Payer: Mclaren Medicare |
$640.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.55
|
| Rate for Payer: Meridian Medicaid |
$360.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$736.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.45
|
| Rate for Payer: Nomi Health Commercial |
$774.13
|
| Rate for Payer: PACE Medicare |
$608.49
|
| Rate for Payer: PACE SWMI |
$640.52
|
| Rate for Payer: PHP Commercial |
$704.57
|
| Rate for Payer: PHP Medicaid |
$343.32
|
| Rate for Payer: PHP Medicare Advantage |
$640.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.19
|
| Rate for Payer: Priority Health Medicare |
$640.52
|
| Rate for Payer: Priority Health Narrow Network |
$661.79
|
| Rate for Payer: Railroad Medicare Medicare |
$640.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$830.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.52
|
| Rate for Payer: UHC Exchange |
$992.81
|
| Rate for Payer: UHC Medicare Advantage |
$640.52
|
| Rate for Payer: UHCCP DNSP |
$640.52
|
| Rate for Payer: UHCCP Medicaid |
$343.32
|
| Rate for Payer: VA VA |
$640.52
|
|
