|
HC ENDOFORM 4X4
|
Facility
|
OP
|
$138.43
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$138.43 |
| Rate for Payer: Aetna Commercial |
$124.59
|
| Rate for Payer: Aetna Medicare |
$51.22
|
| Rate for Payer: ASR ASR |
$134.28
|
| Rate for Payer: BCBS Complete |
$55.37
|
| Rate for Payer: BCBS Trust/PPO |
$114.14
|
| Rate for Payer: BCN Commercial |
$114.14
|
| Rate for Payer: Cash Price |
$110.74
|
| Rate for Payer: Cofinity Commercial |
$130.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.74
|
| Rate for Payer: Healthscope Commercial |
$134.28
|
| Rate for Payer: Healthscope Whirlpool |
$138.43
|
| Rate for Payer: Mclaren Commercial |
$124.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.67
|
| Rate for Payer: Nomi Health Commercial |
$113.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$121.29
|
| Rate for Payer: Priority Health Narrow Network |
$97.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.82
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
IP
|
$127.97
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$95.98 |
| Max. Negotiated Rate |
$127.97 |
| Rate for Payer: Aetna Commercial |
$115.17
|
| Rate for Payer: ASR ASR |
$124.13
|
| Rate for Payer: BCBS Trust/PPO |
$105.09
|
| Rate for Payer: BCN Commercial |
$105.09
|
| Rate for Payer: Cash Price |
$102.38
|
| Rate for Payer: Cofinity Commercial |
$120.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.38
|
| Rate for Payer: Healthscope Commercial |
$124.13
|
| Rate for Payer: Healthscope Whirlpool |
$127.97
|
| Rate for Payer: Mclaren Commercial |
$115.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.77
|
| Rate for Payer: Nomi Health Commercial |
$104.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.61
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
OP
|
$127.97
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$47.35 |
| Max. Negotiated Rate |
$127.97 |
| Rate for Payer: Aetna Commercial |
$115.17
|
| Rate for Payer: Aetna Medicare |
$47.35
|
| Rate for Payer: ASR ASR |
$124.13
|
| Rate for Payer: BCBS Complete |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$105.51
|
| Rate for Payer: BCN Commercial |
$105.51
|
| Rate for Payer: Cash Price |
$102.38
|
| Rate for Payer: Cofinity Commercial |
$120.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.38
|
| Rate for Payer: Healthscope Commercial |
$124.13
|
| Rate for Payer: Healthscope Whirlpool |
$127.97
|
| Rate for Payer: Mclaren Commercial |
$115.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.77
|
| Rate for Payer: Nomi Health Commercial |
$104.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$112.13
|
| Rate for Payer: Priority Health Narrow Network |
$89.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.61
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
OP
|
$675.66
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$249.99 |
| Max. Negotiated Rate |
$675.66 |
| Rate for Payer: Aetna Commercial |
$608.09
|
| Rate for Payer: Aetna Medicare |
$249.99
|
| Rate for Payer: ASR ASR |
$655.39
|
| Rate for Payer: BCBS Complete |
$270.26
|
| Rate for Payer: BCBS Trust/PPO |
$557.08
|
| Rate for Payer: BCN Commercial |
$557.08
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Commercial |
$635.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$655.39
|
| Rate for Payer: Healthscope Whirlpool |
$675.66
|
| Rate for Payer: Mclaren Commercial |
$608.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Nomi Health Commercial |
$554.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$592.01
|
| Rate for Payer: Priority Health Narrow Network |
$473.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$594.58
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
IP
|
$675.66
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.75 |
| Max. Negotiated Rate |
$675.66 |
| Rate for Payer: Aetna Commercial |
$608.09
|
| Rate for Payer: ASR ASR |
$655.39
|
| Rate for Payer: BCBS Trust/PPO |
$554.85
|
| Rate for Payer: BCN Commercial |
$554.85
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Commercial |
$635.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$655.39
|
| Rate for Payer: Healthscope Whirlpool |
$675.66
|
| Rate for Payer: Mclaren Commercial |
$608.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Nomi Health Commercial |
$554.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$594.58
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
IP
|
$5,199.92
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,899.94 |
| Max. Negotiated Rate |
$5,199.92 |
| Rate for Payer: Aetna Commercial |
$4,679.93
|
| Rate for Payer: ASR ASR |
$5,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,270.17
|
| Rate for Payer: BCN Commercial |
$4,270.17
|
| Rate for Payer: Cash Price |
$4,159.94
|
| Rate for Payer: Cofinity Commercial |
$4,887.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,159.94
|
| Rate for Payer: Healthscope Commercial |
$5,043.92
|
| Rate for Payer: Healthscope Whirlpool |
$5,199.92
|
| Rate for Payer: Mclaren Commercial |
$4,679.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,419.93
|
| Rate for Payer: Nomi Health Commercial |
$4,263.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,899.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,575.93
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
OP
|
$5,199.92
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,923.97 |
| Max. Negotiated Rate |
$5,199.92 |
| Rate for Payer: Aetna Commercial |
$4,679.93
|
| Rate for Payer: Aetna Medicare |
$1,923.97
|
| Rate for Payer: ASR ASR |
$5,043.92
|
| Rate for Payer: BCBS Complete |
$2,079.97
|
| Rate for Payer: BCBS Trust/PPO |
$4,287.33
|
| Rate for Payer: BCN Commercial |
$4,287.33
|
| Rate for Payer: Cash Price |
$4,159.94
|
| Rate for Payer: Cofinity Commercial |
$4,887.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,159.94
|
| Rate for Payer: Healthscope Commercial |
$5,043.92
|
| Rate for Payer: Healthscope Whirlpool |
$5,199.92
|
| Rate for Payer: Mclaren Commercial |
$4,679.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,159.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,419.93
|
| Rate for Payer: Nomi Health Commercial |
$4,263.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,899.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,556.17
|
| Rate for Payer: Priority Health Narrow Network |
$3,645.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,575.93
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$10,215.45 |
| Max. Negotiated Rate |
$13,620.60 |
| Rate for Payer: Aetna Commercial |
$12,258.54
|
| Rate for Payer: ASR ASR |
$13,211.98
|
| Rate for Payer: BCBS Trust/PPO |
$11,185.24
|
| Rate for Payer: BCN Commercial |
$11,185.24
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$12,803.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$13,211.98
|
| Rate for Payer: Healthscope Whirlpool |
$13,620.60
|
| Rate for Payer: Mclaren Commercial |
$12,258.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,986.13
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$13,620.60 |
| Rate for Payer: Aetna Commercial |
$12,258.54
|
| Rate for Payer: Aetna Medicare |
$4,984.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: ASR ASR |
$13,211.98
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$11,230.18
|
| Rate for Payer: BCN Commercial |
$11,230.18
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$12,803.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Healthscope Commercial |
$13,211.98
|
| Rate for Payer: Healthscope Whirlpool |
$13,620.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$4,984.46
|
| Rate for Payer: Mclaren Commercial |
$12,258.54
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$2,737.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Commercial |
$5,482.91
|
| Rate for Payer: PHP Medicaid |
$2,671.67
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11,934.37
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health Narrow Network |
$9,548.04
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$11,986.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Exchange |
$7,725.91
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP DNSP |
$4,984.46
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: VA VA |
$4,984.46
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
IP
|
$737.54
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$553.15 |
| Max. Negotiated Rate |
$737.54 |
| Rate for Payer: Aetna Commercial |
$663.79
|
| Rate for Payer: ASR ASR |
$715.41
|
| Rate for Payer: BCBS Trust/PPO |
$605.67
|
| Rate for Payer: BCN Commercial |
$605.67
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cofinity Commercial |
$693.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.03
|
| Rate for Payer: Healthscope Commercial |
$715.41
|
| Rate for Payer: Healthscope Whirlpool |
$737.54
|
| Rate for Payer: Mclaren Commercial |
$663.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.91
|
| Rate for Payer: Nomi Health Commercial |
$604.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$649.04
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
OP
|
$737.54
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$737.54 |
| Rate for Payer: Aetna Commercial |
$663.79
|
| Rate for Payer: Aetna Medicare |
$272.89
|
| Rate for Payer: ASR ASR |
$715.41
|
| Rate for Payer: BCBS Complete |
$295.02
|
| Rate for Payer: BCBS Trust/PPO |
$608.10
|
| Rate for Payer: BCCCP Commercial |
$49.12
|
| Rate for Payer: BCN Commercial |
$608.10
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cofinity Commercial |
$693.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.03
|
| Rate for Payer: Healthscope Commercial |
$715.41
|
| Rate for Payer: Healthscope Whirlpool |
$737.54
|
| Rate for Payer: Mclaren Commercial |
$663.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$590.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.91
|
| Rate for Payer: Nomi Health Commercial |
$604.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$646.23
|
| Rate for Payer: Priority Health Narrow Network |
$517.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$649.04
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
OP
|
$223.91
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.15 |
| Max. Negotiated Rate |
$312.23 |
| Rate for Payer: Aetna Commercial |
$201.52
|
| Rate for Payer: Aetna Medicare |
$201.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: ASR ASR |
$217.19
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$184.61
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$184.61
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$217.19
|
| Rate for Payer: Healthscope Whirlpool |
$223.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$201.44
|
| Rate for Payer: Mclaren Commercial |
$201.52
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$110.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$221.58
|
| Rate for Payer: PHP Medicaid |
$107.97
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$196.19
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health Narrow Network |
$156.96
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$312.23
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP DNSP |
$201.44
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: VA VA |
$201.44
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
IP
|
$223.91
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$167.93 |
| Max. Negotiated Rate |
$223.91 |
| Rate for Payer: Aetna Commercial |
$201.52
|
| Rate for Payer: ASR ASR |
$217.19
|
| Rate for Payer: BCBS Trust/PPO |
$183.87
|
| Rate for Payer: BCN Commercial |
$183.87
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Healthscope Commercial |
$217.19
|
| Rate for Payer: Healthscope Whirlpool |
$223.91
|
| Rate for Payer: Mclaren Commercial |
$201.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.04
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
OP
|
$2,923.12
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$2,630.81
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$2,835.43
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,410.11
|
| Rate for Payer: BCN Commercial |
$2,410.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cofinity Commercial |
$2,747.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,338.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,835.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,923.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$2,630.81
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,484.65
|
| Rate for Payer: Nomi Health Commercial |
$2,396.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,561.24
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,049.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,572.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
IP
|
$2,923.12
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,192.34 |
| Max. Negotiated Rate |
$2,923.12 |
| Rate for Payer: Aetna Commercial |
$2,630.81
|
| Rate for Payer: ASR ASR |
$2,835.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.47
|
| Rate for Payer: BCN Commercial |
$2,400.47
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cofinity Commercial |
$2,747.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,338.50
|
| Rate for Payer: Healthscope Commercial |
$2,835.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,923.12
|
| Rate for Payer: Mclaren Commercial |
$2,630.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,484.65
|
| Rate for Payer: Nomi Health Commercial |
$2,396.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,572.35
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
OP
|
$81.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$250.58 |
| Rate for Payer: Aetna Commercial |
$73.54
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$79.26
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$67.37
|
| Rate for Payer: BCN Commercial |
$67.37
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cofinity Commercial |
$76.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$79.26
|
| Rate for Payer: Healthscope Whirlpool |
$81.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$73.54
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.45
|
| Rate for Payer: Nomi Health Commercial |
$67.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.28
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.46
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$200.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP DNSP |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
IP
|
$81.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.28 |
| Max. Negotiated Rate |
$81.71 |
| Rate for Payer: Aetna Commercial |
$73.54
|
| Rate for Payer: ASR ASR |
$79.26
|
| Rate for Payer: BCBS Trust/PPO |
$67.10
|
| Rate for Payer: BCN Commercial |
$67.10
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cofinity Commercial |
$76.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$79.26
|
| Rate for Payer: Healthscope Whirlpool |
$81.71
|
| Rate for Payer: Mclaren Commercial |
$73.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.45
|
| Rate for Payer: Nomi Health Commercial |
$67.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.90
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
OP
|
$163.24
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$163.24 |
| Rate for Payer: Aetna Commercial |
$146.92
|
| Rate for Payer: Aetna Medicare |
$12.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: ASR ASR |
$158.34
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$134.59
|
| Rate for Payer: BCN Commercial |
$134.59
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cofinity Commercial |
$153.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$158.34
|
| Rate for Payer: Healthscope Whirlpool |
$163.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.09
|
| Rate for Payer: Mclaren Commercial |
$146.92
|
| Rate for Payer: Mclaren Medicaid |
$12.09
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.75
|
| Rate for Payer: Nomi Health Commercial |
$133.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.43
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$13.30
|
| Rate for Payer: PHP Medicaid |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.03
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$114.43
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.74
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHCCP DNSP |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$12.09
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
IP
|
$163.24
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$122.43 |
| Max. Negotiated Rate |
$163.24 |
| Rate for Payer: Aetna Commercial |
$146.92
|
| Rate for Payer: ASR ASR |
$158.34
|
| Rate for Payer: BCBS Trust/PPO |
$134.05
|
| Rate for Payer: BCN Commercial |
$134.05
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cofinity Commercial |
$153.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$158.34
|
| Rate for Payer: Healthscope Whirlpool |
$163.24
|
| Rate for Payer: Mclaren Commercial |
$146.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.75
|
| Rate for Payer: Nomi Health Commercial |
$133.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.65
|
|
|
HC ENDOPLEGE
|
Facility
|
OP
|
$5,404.70
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,999.74 |
| Max. Negotiated Rate |
$5,404.70 |
| Rate for Payer: Aetna Commercial |
$4,864.23
|
| Rate for Payer: Aetna Medicare |
$1,999.74
|
| Rate for Payer: ASR ASR |
$5,242.56
|
| Rate for Payer: BCBS Complete |
$2,161.88
|
| Rate for Payer: BCBS Trust/PPO |
$4,456.18
|
| Rate for Payer: BCN Commercial |
$4,456.18
|
| Rate for Payer: Cash Price |
$4,323.76
|
| Rate for Payer: Cofinity Commercial |
$5,080.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,323.76
|
| Rate for Payer: Healthscope Commercial |
$5,242.56
|
| Rate for Payer: Healthscope Whirlpool |
$5,404.70
|
| Rate for Payer: Mclaren Commercial |
$4,864.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,323.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.99
|
| Rate for Payer: Nomi Health Commercial |
$4,431.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,053.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,735.60
|
| Rate for Payer: Priority Health Narrow Network |
$3,788.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,756.14
|
|
|
HC ENDOPLEGE
|
Facility
|
IP
|
$5,404.70
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,053.53 |
| Max. Negotiated Rate |
$5,404.70 |
| Rate for Payer: Aetna Commercial |
$4,864.23
|
| Rate for Payer: ASR ASR |
$5,242.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.34
|
| Rate for Payer: BCN Commercial |
$4,438.34
|
| Rate for Payer: Cash Price |
$4,323.76
|
| Rate for Payer: Cofinity Commercial |
$5,080.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,323.76
|
| Rate for Payer: Healthscope Commercial |
$5,242.56
|
| Rate for Payer: Healthscope Whirlpool |
$5,404.70
|
| Rate for Payer: Mclaren Commercial |
$4,864.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.99
|
| Rate for Payer: Nomi Health Commercial |
$4,431.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,053.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,756.14
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
OP
|
$9,663.48
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$9,663.48 |
| Rate for Payer: Aetna Commercial |
$8,697.13
|
| Rate for Payer: Aetna Medicare |
$3,512.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: ASR ASR |
$9,373.58
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$7,967.54
|
| Rate for Payer: BCN Commercial |
$7,967.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Commercial |
$9,083.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$9,373.58
|
| Rate for Payer: Healthscope Whirlpool |
$9,663.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,512.31
|
| Rate for Payer: Mclaren Commercial |
$8,697.13
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$1,928.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$3,863.54
|
| Rate for Payer: PHP Medicaid |
$1,882.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8,467.14
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Narrow Network |
$6,774.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,503.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$5,444.08
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP DNSP |
$3,512.31
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
IP
|
$9,663.48
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,247.61 |
| Max. Negotiated Rate |
$9,663.48 |
| Rate for Payer: Aetna Commercial |
$8,697.13
|
| Rate for Payer: ASR ASR |
$9,373.58
|
| Rate for Payer: BCBS Trust/PPO |
$7,935.65
|
| Rate for Payer: BCN Commercial |
$7,935.65
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Commercial |
$9,083.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Healthscope Commercial |
$9,373.58
|
| Rate for Payer: Healthscope Whirlpool |
$9,663.48
|
| Rate for Payer: Mclaren Commercial |
$8,697.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,503.86
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
IP
|
$504.90
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.68 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Aetna Commercial |
$454.41
|
| Rate for Payer: ASR ASR |
$489.75
|
| Rate for Payer: BCBS Trust/PPO |
$414.62
|
| Rate for Payer: BCN Commercial |
$414.62
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cofinity Commercial |
$474.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.92
|
| Rate for Payer: Healthscope Commercial |
$489.75
|
| Rate for Payer: Healthscope Whirlpool |
$504.90
|
| Rate for Payer: Mclaren Commercial |
$454.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.17
|
| Rate for Payer: Nomi Health Commercial |
$414.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.31
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
OP
|
$504.90
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$186.81 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Aetna Commercial |
$454.41
|
| Rate for Payer: Aetna Medicare |
$186.81
|
| Rate for Payer: ASR ASR |
$489.75
|
| Rate for Payer: BCBS Complete |
$201.96
|
| Rate for Payer: BCBS Trust/PPO |
$416.29
|
| Rate for Payer: BCN Commercial |
$416.29
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cofinity Commercial |
$474.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.92
|
| Rate for Payer: Healthscope Commercial |
$489.75
|
| Rate for Payer: Healthscope Whirlpool |
$504.90
|
| Rate for Payer: Mclaren Commercial |
$454.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.17
|
| Rate for Payer: Nomi Health Commercial |
$414.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$442.39
|
| Rate for Payer: Priority Health Narrow Network |
$353.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$444.31
|
|
