|
HC EP AFTER DRUGS
|
Facility
|
OP
|
$7,572.41
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,801.79 |
| Max. Negotiated Rate |
$7,572.41 |
| Rate for Payer: Aetna Commercial |
$6,815.17
|
| Rate for Payer: Aetna Medicare |
$2,801.79
|
| Rate for Payer: ASR ASR |
$7,345.24
|
| Rate for Payer: BCBS Complete |
$3,028.96
|
| Rate for Payer: BCBS Trust/PPO |
$6,243.45
|
| Rate for Payer: BCN Commercial |
$6,243.45
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Commercial |
$7,118.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Healthscope Commercial |
$7,345.24
|
| Rate for Payer: Healthscope Whirlpool |
$7,572.41
|
| Rate for Payer: Mclaren Commercial |
$6,815.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,057.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Nomi Health Commercial |
$6,209.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,634.95
|
| Rate for Payer: Priority Health Narrow Network |
$5,308.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,663.72
|
|
|
HC EP AFTER DRUGS
|
Facility
|
IP
|
$7,572.41
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,679.31 |
| Max. Negotiated Rate |
$7,572.41 |
| Rate for Payer: Aetna Commercial |
$6,815.17
|
| Rate for Payer: ASR ASR |
$7,345.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,218.46
|
| Rate for Payer: BCN Commercial |
$6,218.46
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Commercial |
$7,118.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Healthscope Commercial |
$7,345.24
|
| Rate for Payer: Healthscope Whirlpool |
$7,572.41
|
| Rate for Payer: Mclaren Commercial |
$6,815.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Nomi Health Commercial |
$6,209.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,663.72
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
OP
|
$3,409.67
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,261.58 |
| Max. Negotiated Rate |
$3,409.67 |
| Rate for Payer: Aetna Commercial |
$3,068.70
|
| Rate for Payer: Aetna Medicare |
$1,261.58
|
| Rate for Payer: ASR ASR |
$3,307.38
|
| Rate for Payer: BCBS Complete |
$1,363.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,811.27
|
| Rate for Payer: BCN Commercial |
$2,811.27
|
| Rate for Payer: Cash Price |
$2,727.74
|
| Rate for Payer: Cofinity Commercial |
$3,205.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,727.74
|
| Rate for Payer: Healthscope Commercial |
$3,307.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,409.67
|
| Rate for Payer: Mclaren Commercial |
$3,068.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,727.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,898.22
|
| Rate for Payer: Nomi Health Commercial |
$2,795.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,557.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,987.55
|
| Rate for Payer: Priority Health Narrow Network |
$2,390.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,000.51
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
IP
|
$3,409.67
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,557.25 |
| Max. Negotiated Rate |
$3,409.67 |
| Rate for Payer: Aetna Commercial |
$3,068.70
|
| Rate for Payer: ASR ASR |
$3,307.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,800.02
|
| Rate for Payer: BCN Commercial |
$2,800.02
|
| Rate for Payer: Cash Price |
$2,727.74
|
| Rate for Payer: Cofinity Commercial |
$3,205.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,727.74
|
| Rate for Payer: Healthscope Commercial |
$3,307.38
|
| Rate for Payer: Healthscope Whirlpool |
$3,409.67
|
| Rate for Payer: Mclaren Commercial |
$3,068.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,898.22
|
| Rate for Payer: Nomi Health Commercial |
$2,795.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,557.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,000.51
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
IP
|
$2,436.41
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,827.31 |
| Max. Negotiated Rate |
$2,436.41 |
| Rate for Payer: Aetna Commercial |
$2,192.77
|
| Rate for Payer: ASR ASR |
$2,363.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,000.78
|
| Rate for Payer: BCN Commercial |
$2,000.78
|
| Rate for Payer: Cash Price |
$1,949.13
|
| Rate for Payer: Cofinity Commercial |
$2,290.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,949.13
|
| Rate for Payer: Healthscope Commercial |
$2,363.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,436.41
|
| Rate for Payer: Mclaren Commercial |
$2,192.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,070.95
|
| Rate for Payer: Nomi Health Commercial |
$1,997.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,827.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,144.04
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
OP
|
$2,436.41
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$901.47 |
| Max. Negotiated Rate |
$2,436.41 |
| Rate for Payer: Aetna Commercial |
$2,192.77
|
| Rate for Payer: Aetna Medicare |
$901.47
|
| Rate for Payer: ASR ASR |
$2,363.32
|
| Rate for Payer: BCBS Complete |
$974.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,008.82
|
| Rate for Payer: BCN Commercial |
$2,008.82
|
| Rate for Payer: Cash Price |
$1,949.13
|
| Rate for Payer: Cofinity Commercial |
$2,290.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,949.13
|
| Rate for Payer: Healthscope Commercial |
$2,363.32
|
| Rate for Payer: Healthscope Whirlpool |
$2,436.41
|
| Rate for Payer: Mclaren Commercial |
$2,192.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,949.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,070.95
|
| Rate for Payer: Nomi Health Commercial |
$1,997.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,827.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,134.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,707.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,144.04
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
OP
|
$2,233.25
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$826.30 |
| Max. Negotiated Rate |
$2,233.25 |
| Rate for Payer: Aetna Commercial |
$2,009.92
|
| Rate for Payer: Aetna Medicare |
$826.30
|
| Rate for Payer: ASR ASR |
$2,166.25
|
| Rate for Payer: BCBS Complete |
$893.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,841.31
|
| Rate for Payer: BCN Commercial |
$1,841.31
|
| Rate for Payer: Cash Price |
$1,786.60
|
| Rate for Payer: Cofinity Commercial |
$2,099.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,786.60
|
| Rate for Payer: Healthscope Commercial |
$2,166.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,233.25
|
| Rate for Payer: Mclaren Commercial |
$2,009.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,786.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,898.26
|
| Rate for Payer: Nomi Health Commercial |
$1,831.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,674.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,956.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,565.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,965.26
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
IP
|
$2,233.25
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,674.94 |
| Max. Negotiated Rate |
$2,233.25 |
| Rate for Payer: Aetna Commercial |
$2,009.92
|
| Rate for Payer: ASR ASR |
$2,166.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,833.94
|
| Rate for Payer: BCN Commercial |
$1,833.94
|
| Rate for Payer: Cash Price |
$1,786.60
|
| Rate for Payer: Cofinity Commercial |
$2,099.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,786.60
|
| Rate for Payer: Healthscope Commercial |
$2,166.25
|
| Rate for Payer: Healthscope Whirlpool |
$2,233.25
|
| Rate for Payer: Mclaren Commercial |
$2,009.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,898.26
|
| Rate for Payer: Nomi Health Commercial |
$1,831.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,674.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,965.26
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
IP
|
$688.50
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$516.38 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: ASR ASR |
$667.85
|
| Rate for Payer: BCBS Trust/PPO |
$565.40
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$647.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$667.85
|
| Rate for Payer: Healthscope Whirlpool |
$688.50
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC EPIDURAL/LOCAL FLAT
|
Facility
|
OP
|
$688.50
|
|
| Hospital Charge Code |
37000023
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$254.75 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$619.65
|
| Rate for Payer: Aetna Medicare |
$254.75
|
| Rate for Payer: ASR ASR |
$667.85
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS Trust/PPO |
$567.67
|
| Rate for Payer: BCN Commercial |
$567.67
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$647.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$667.85
|
| Rate for Payer: Healthscope Whirlpool |
$688.50
|
| Rate for Payer: Mclaren Commercial |
$619.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$603.26
|
| Rate for Payer: Priority Health Narrow Network |
$482.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.88
|
|
|
HC EPIDURAL PREP (OB)
|
Facility
|
IP
|
$659.01
|
|
| Hospital Charge Code |
37000003
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$494.26 |
| Max. Negotiated Rate |
$659.01 |
| Rate for Payer: Aetna Commercial |
$593.11
|
| Rate for Payer: ASR ASR |
$639.24
|
| Rate for Payer: BCBS Trust/PPO |
$541.18
|
| Rate for Payer: BCN Commercial |
$541.18
|
| Rate for Payer: Cash Price |
$527.21
|
| Rate for Payer: Cofinity Commercial |
$619.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.21
|
| Rate for Payer: Healthscope Commercial |
$639.24
|
| Rate for Payer: Healthscope Whirlpool |
$659.01
|
| Rate for Payer: Mclaren Commercial |
$593.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.16
|
| Rate for Payer: Nomi Health Commercial |
$540.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$494.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$579.93
|
|
|
HC EPIDURAL PREP (OB)
|
Facility
|
OP
|
$659.01
|
|
| Hospital Charge Code |
37000003
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$243.83 |
| Max. Negotiated Rate |
$659.01 |
| Rate for Payer: Aetna Commercial |
$593.11
|
| Rate for Payer: Aetna Medicare |
$243.83
|
| Rate for Payer: ASR ASR |
$639.24
|
| Rate for Payer: BCBS Complete |
$263.60
|
| Rate for Payer: BCBS Trust/PPO |
$543.35
|
| Rate for Payer: BCN Commercial |
$543.35
|
| Rate for Payer: Cash Price |
$527.21
|
| Rate for Payer: Cofinity Commercial |
$619.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$527.21
|
| Rate for Payer: Healthscope Commercial |
$639.24
|
| Rate for Payer: Healthscope Whirlpool |
$659.01
|
| Rate for Payer: Mclaren Commercial |
$593.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$527.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$560.16
|
| Rate for Payer: Nomi Health Commercial |
$540.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$494.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$577.42
|
| Rate for Payer: Priority Health Narrow Network |
$461.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$579.93
|
|
|
HC EPIFIX (14 MM DISC) PER SQ CM
|
Facility
|
IP
|
$498.24
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600135
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$373.68 |
| Max. Negotiated Rate |
$498.24 |
| Rate for Payer: Aetna Commercial |
$448.42
|
| Rate for Payer: ASR ASR |
$483.29
|
| Rate for Payer: BCBS Trust/PPO |
$409.15
|
| Rate for Payer: BCN Commercial |
$409.15
|
| Rate for Payer: Cash Price |
$398.59
|
| Rate for Payer: Cofinity Commercial |
$468.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.59
|
| Rate for Payer: Healthscope Commercial |
$483.29
|
| Rate for Payer: Healthscope Whirlpool |
$498.24
|
| Rate for Payer: Mclaren Commercial |
$448.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.50
|
| Rate for Payer: Nomi Health Commercial |
$408.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$373.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$438.45
|
|
|
HC EPIFIX (14 MM DISC) PER SQ CM
|
Facility
|
OP
|
$498.24
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600135
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$498.24 |
| Rate for Payer: Aetna Commercial |
$448.42
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$483.29
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$410.80
|
| Rate for Payer: BCN Commercial |
$410.80
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$398.59
|
| Rate for Payer: Cash Price |
$398.59
|
| Rate for Payer: Cofinity Commercial |
$468.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$483.29
|
| Rate for Payer: Healthscope Whirlpool |
$498.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$448.42
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.50
|
| Rate for Payer: Nomi Health Commercial |
$408.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$373.68
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$438.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC EPIFIX (18 MM DISC) PER SQ CM
|
Facility
|
OP
|
$723.74
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600136
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$723.74 |
| Rate for Payer: Aetna Commercial |
$651.37
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$702.03
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$596.72
|
| Rate for Payer: BCN Commercial |
$596.72
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$578.99
|
| Rate for Payer: Cash Price |
$578.99
|
| Rate for Payer: Cofinity Commercial |
$680.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$702.03
|
| Rate for Payer: Healthscope Whirlpool |
$723.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$651.37
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.18
|
| Rate for Payer: Nomi Health Commercial |
$593.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.80
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC EPIFIX (18 MM DISC) PER SQ CM
|
Facility
|
IP
|
$723.74
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600136
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$542.80 |
| Max. Negotiated Rate |
$723.74 |
| Rate for Payer: Aetna Commercial |
$651.37
|
| Rate for Payer: ASR ASR |
$702.03
|
| Rate for Payer: BCBS Trust/PPO |
$594.34
|
| Rate for Payer: BCN Commercial |
$594.34
|
| Rate for Payer: Cash Price |
$578.99
|
| Rate for Payer: Cofinity Commercial |
$680.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.99
|
| Rate for Payer: Healthscope Commercial |
$702.03
|
| Rate for Payer: Healthscope Whirlpool |
$723.74
|
| Rate for Payer: Mclaren Commercial |
$651.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.18
|
| Rate for Payer: Nomi Health Commercial |
$593.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.89
|
|
|
HC EPIFIX 2X2 PER SQ CM
|
Facility
|
IP
|
$705.71
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600130
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$529.28 |
| Max. Negotiated Rate |
$705.71 |
| Rate for Payer: Aetna Commercial |
$635.14
|
| Rate for Payer: ASR ASR |
$684.54
|
| Rate for Payer: BCBS Trust/PPO |
$579.53
|
| Rate for Payer: BCN Commercial |
$579.53
|
| Rate for Payer: Cash Price |
$564.57
|
| Rate for Payer: Cofinity Commercial |
$663.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.57
|
| Rate for Payer: Healthscope Commercial |
$684.54
|
| Rate for Payer: Healthscope Whirlpool |
$705.71
|
| Rate for Payer: Mclaren Commercial |
$635.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.85
|
| Rate for Payer: Nomi Health Commercial |
$578.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$621.02
|
|
|
HC EPIFIX 2X2 PER SQ CM
|
Facility
|
OP
|
$705.71
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600130
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$705.71 |
| Rate for Payer: Aetna Commercial |
$635.14
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$684.54
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$581.86
|
| Rate for Payer: BCN Commercial |
$581.86
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$564.57
|
| Rate for Payer: Cash Price |
$564.57
|
| Rate for Payer: Cofinity Commercial |
$663.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$684.54
|
| Rate for Payer: Healthscope Whirlpool |
$705.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$635.14
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.85
|
| Rate for Payer: Nomi Health Commercial |
$578.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.28
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$621.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC EPIFIX 2X3 PER SQ CM
|
Facility
|
IP
|
$505.84
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600131
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$379.38 |
| Max. Negotiated Rate |
$505.84 |
| Rate for Payer: Aetna Commercial |
$455.26
|
| Rate for Payer: ASR ASR |
$490.66
|
| Rate for Payer: BCBS Trust/PPO |
$415.40
|
| Rate for Payer: BCN Commercial |
$415.40
|
| Rate for Payer: Cash Price |
$404.67
|
| Rate for Payer: Cofinity Commercial |
$475.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.67
|
| Rate for Payer: Healthscope Commercial |
$490.66
|
| Rate for Payer: Healthscope Whirlpool |
$505.84
|
| Rate for Payer: Mclaren Commercial |
$455.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.96
|
| Rate for Payer: Nomi Health Commercial |
$414.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$379.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$445.14
|
|
|
HC EPIFIX 2X3 PER SQ CM
|
Facility
|
OP
|
$505.84
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600131
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$505.84 |
| Rate for Payer: Aetna Commercial |
$455.26
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$490.66
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$417.07
|
| Rate for Payer: BCN Commercial |
$417.07
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$404.67
|
| Rate for Payer: Cash Price |
$404.67
|
| Rate for Payer: Cofinity Commercial |
$475.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$490.66
|
| Rate for Payer: Healthscope Whirlpool |
$505.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$455.26
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.96
|
| Rate for Payer: Nomi Health Commercial |
$414.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$379.38
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$445.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC EPIFIX 2X4 PER SQ CM
|
Facility
|
OP
|
$447.71
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$447.71 |
| Rate for Payer: Aetna Commercial |
$402.94
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$434.28
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$369.14
|
| Rate for Payer: BCN Commercial |
$369.14
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$358.17
|
| Rate for Payer: Cash Price |
$358.17
|
| Rate for Payer: Cofinity Commercial |
$420.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$434.28
|
| Rate for Payer: Healthscope Whirlpool |
$447.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$402.94
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.55
|
| Rate for Payer: Nomi Health Commercial |
$367.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.78
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC EPIFIX 2X4 PER SQ CM
|
Facility
|
IP
|
$447.71
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600132
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$335.78 |
| Max. Negotiated Rate |
$447.71 |
| Rate for Payer: Aetna Commercial |
$402.94
|
| Rate for Payer: ASR ASR |
$434.28
|
| Rate for Payer: BCBS Trust/PPO |
$367.66
|
| Rate for Payer: BCN Commercial |
$367.66
|
| Rate for Payer: Cash Price |
$358.17
|
| Rate for Payer: Cofinity Commercial |
$420.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.17
|
| Rate for Payer: Healthscope Commercial |
$434.28
|
| Rate for Payer: Healthscope Whirlpool |
$447.71
|
| Rate for Payer: Mclaren Commercial |
$402.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.55
|
| Rate for Payer: Nomi Health Commercial |
$367.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$393.98
|
|
|
HC EPIFIX 3X4 PER SQ CM
|
Facility
|
OP
|
$420.77
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600133
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$420.77 |
| Rate for Payer: Aetna Commercial |
$378.69
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$408.15
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$346.92
|
| Rate for Payer: BCN Commercial |
$346.92
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$336.62
|
| Rate for Payer: Cash Price |
$336.62
|
| Rate for Payer: Cofinity Commercial |
$395.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$408.15
|
| Rate for Payer: Healthscope Whirlpool |
$420.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$378.69
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.65
|
| Rate for Payer: Nomi Health Commercial |
$345.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.58
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
|
HC EPIFIX 3X4 PER SQ CM
|
Facility
|
IP
|
$420.77
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600133
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$315.58 |
| Max. Negotiated Rate |
$420.77 |
| Rate for Payer: Aetna Commercial |
$378.69
|
| Rate for Payer: ASR ASR |
$408.15
|
| Rate for Payer: BCBS Trust/PPO |
$345.54
|
| Rate for Payer: BCN Commercial |
$345.54
|
| Rate for Payer: Cash Price |
$336.62
|
| Rate for Payer: Cofinity Commercial |
$395.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.62
|
| Rate for Payer: Healthscope Commercial |
$408.15
|
| Rate for Payer: Healthscope Whirlpool |
$420.77
|
| Rate for Payer: Mclaren Commercial |
$378.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.65
|
| Rate for Payer: Nomi Health Commercial |
$345.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.28
|
|
|
HC EPIFIX 4 X 4.5 PER SQ CM
|
Facility
|
OP
|
$216.03
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600227
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$340.68 |
| Rate for Payer: Aetna Commercial |
$194.43
|
| Rate for Payer: Aetna Medicare |
$124.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.00
|
| Rate for Payer: ASR ASR |
$209.55
|
| Rate for Payer: BCBS Complete |
$68.10
|
| Rate for Payer: BCBS MAPPO |
$124.00
|
| Rate for Payer: BCBS Trust/PPO |
$178.12
|
| Rate for Payer: BCN Commercial |
$178.12
|
| Rate for Payer: BCN Medicare Advantage |
$124.00
|
| Rate for Payer: Cash Price |
$172.82
|
| Rate for Payer: Cash Price |
$172.82
|
| Rate for Payer: Cofinity Commercial |
$203.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$209.55
|
| Rate for Payer: Healthscope Whirlpool |
$216.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$124.00
|
| Rate for Payer: Mclaren Commercial |
$194.43
|
| Rate for Payer: Mclaren Medicaid |
$124.00
|
| Rate for Payer: Mclaren Medicare |
$124.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.20
|
| Rate for Payer: Meridian Medicaid |
$68.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.63
|
| Rate for Payer: Nomi Health Commercial |
$177.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.02
|
| Rate for Payer: PACE Medicare |
$117.80
|
| Rate for Payer: PACE SWMI |
$124.00
|
| Rate for Payer: PHP Commercial |
$136.40
|
| Rate for Payer: PHP Medicaid |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$340.68
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow Network |
$272.54
|
| Rate for Payer: Railroad Medicare Medicare |
$124.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.00
|
| Rate for Payer: UHC Exchange |
$192.20
|
| Rate for Payer: UHC Medicaid |
$64.85
|
| Rate for Payer: UHCCP DNSP |
$124.00
|
| Rate for Payer: UHCCP Medicaid |
$64.85
|
| Rate for Payer: VA VA |
$124.00
|
|
