|
HC DGTZ GLS MCRSCP SL SP GRPIII
|
Facility
|
IP
|
$18.72
|
|
|
Service Code
|
CPT 0759T
|
| Hospital Charge Code |
31200017
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$16.85
|
| Rate for Payer: ASR ASR |
$18.16
|
| Rate for Payer: ASR Commercial |
$18.16
|
| Rate for Payer: BCBS Trust/PPO |
$15.25
|
| Rate for Payer: BCN Commercial |
$14.51
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$17.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Healthscope Whirlpool |
$18.16
|
| Rate for Payer: Mclaren Commercial |
$16.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.91
|
| Rate for Payer: Nomi Health Commercial |
$15.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.47
|
|
|
HC DHEA
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
30100187
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$25.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.59
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Complete |
$14.22
|
| Rate for Payer: BCBS MAPPO |
$25.27
|
| Rate for Payer: BCBS Trust/PPO |
$41.75
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: BCN Medicare Advantage |
$25.27
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.27
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.27
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$13.54
|
| Rate for Payer: Mclaren Medicare |
$25.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.53
|
| Rate for Payer: Meridian Medicaid |
$14.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Medicare |
$24.01
|
| Rate for Payer: PACE SWMI |
$25.27
|
| Rate for Payer: PHP Commercial |
$27.80
|
| Rate for Payer: PHP Medicaid |
$13.54
|
| Rate for Payer: PHP Medicare Advantage |
$25.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.67
|
| Rate for Payer: Priority Health Medicare |
$25.27
|
| Rate for Payer: Priority Health Narrow Network |
$35.74
|
| Rate for Payer: Railroad Medicare Medicare |
$25.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.27
|
| Rate for Payer: UHC Exchange |
$39.17
|
| Rate for Payer: UHC Medicare Advantage |
$25.27
|
| Rate for Payer: UHCCP DNSP |
$25.27
|
| Rate for Payer: UHCCP Medicaid |
$13.54
|
| Rate for Payer: VA VA |
$25.27
|
|
|
HC DHEA
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
30100187
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: ASR Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$39.52
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$50.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.45
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC DHEA-SULFATE
|
Facility
|
OP
|
$56.18
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
30100188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$50.56
|
| Rate for Payer: Aetna Medicare |
$22.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.79
|
| Rate for Payer: ASR ASR |
$54.49
|
| Rate for Payer: ASR Commercial |
$54.49
|
| Rate for Payer: BCBS Complete |
$12.51
|
| Rate for Payer: BCBS MAPPO |
$22.23
|
| Rate for Payer: BCBS Trust/PPO |
$46.01
|
| Rate for Payer: BCN Commercial |
$43.56
|
| Rate for Payer: BCN Medicare Advantage |
$22.23
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$52.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.23
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Healthscope Whirlpool |
$54.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$22.23
|
| Rate for Payer: Mclaren Commercial |
$50.56
|
| Rate for Payer: Mclaren Medicaid |
$11.92
|
| Rate for Payer: Mclaren Medicare |
$22.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.34
|
| Rate for Payer: Meridian Medicaid |
$12.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: PACE Medicare |
$21.12
|
| Rate for Payer: PACE SWMI |
$22.23
|
| Rate for Payer: PHP Commercial |
$24.45
|
| Rate for Payer: PHP Medicaid |
$11.92
|
| Rate for Payer: PHP Medicare Advantage |
$22.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.22
|
| Rate for Payer: Priority Health Medicare |
$22.23
|
| Rate for Payer: Priority Health Narrow Network |
$39.38
|
| Rate for Payer: Railroad Medicare Medicare |
$22.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.23
|
| Rate for Payer: UHC Exchange |
$34.46
|
| Rate for Payer: UHC Medicare Advantage |
$22.23
|
| Rate for Payer: UHCCP DNSP |
$22.23
|
| Rate for Payer: UHCCP Medicaid |
$11.92
|
| Rate for Payer: VA VA |
$22.23
|
|
|
HC DHEA-SULFATE
|
Facility
|
IP
|
$56.18
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
30100188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.52 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$50.56
|
| Rate for Payer: ASR ASR |
$54.49
|
| Rate for Payer: ASR Commercial |
$54.49
|
| Rate for Payer: BCBS Trust/PPO |
$45.78
|
| Rate for Payer: BCN Commercial |
$43.56
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$52.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Healthscope Whirlpool |
$54.49
|
| Rate for Payer: Mclaren Commercial |
$50.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.44
|
|
|
HC DIABETES GROUP SESSION PER 30"
|
Facility
|
OP
|
$63.09
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200006
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$25.24 |
| Max. Negotiated Rate |
$63.09 |
| Rate for Payer: Aetna Commercial |
$56.78
|
| Rate for Payer: Aetna Medicare |
$31.55
|
| Rate for Payer: ASR ASR |
$61.20
|
| Rate for Payer: ASR Commercial |
$61.20
|
| Rate for Payer: BCBS Complete |
$25.24
|
| Rate for Payer: BCBS Trust/PPO |
$51.66
|
| Rate for Payer: BCN Commercial |
$48.91
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$59.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$63.09
|
| Rate for Payer: Healthscope Whirlpool |
$61.20
|
| Rate for Payer: Mclaren Commercial |
$56.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.28
|
| Rate for Payer: Priority Health Narrow Network |
$44.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.52
|
|
|
HC DIABETES GROUP SESSION PER 30"
|
Facility
|
IP
|
$63.09
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200006
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$41.01 |
| Max. Negotiated Rate |
$63.09 |
| Rate for Payer: Aetna Commercial |
$56.78
|
| Rate for Payer: ASR ASR |
$61.20
|
| Rate for Payer: ASR Commercial |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$51.41
|
| Rate for Payer: BCN Commercial |
$48.91
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$59.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$63.09
|
| Rate for Payer: Healthscope Whirlpool |
$61.20
|
| Rate for Payer: Mclaren Commercial |
$56.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.52
|
|
|
HC DIABETES MELLITUS TYPE 1 EVAL
|
Facility
|
OP
|
$48.68
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$48.68 |
| Rate for Payer: Aetna Commercial |
$43.81
|
| Rate for Payer: Aetna Medicare |
$21.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.76
|
| Rate for Payer: ASR ASR |
$47.22
|
| Rate for Payer: ASR Commercial |
$47.22
|
| Rate for Payer: BCBS Complete |
$12.05
|
| Rate for Payer: BCBS MAPPO |
$21.41
|
| Rate for Payer: BCBS Trust/PPO |
$39.86
|
| Rate for Payer: BCN Commercial |
$37.74
|
| Rate for Payer: BCN Medicare Advantage |
$21.41
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Commercial |
$45.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$48.68
|
| Rate for Payer: Healthscope Whirlpool |
$47.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.41
|
| Rate for Payer: Mclaren Commercial |
$43.81
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.48
|
| Rate for Payer: Meridian Medicaid |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.38
|
| Rate for Payer: Nomi Health Commercial |
$39.92
|
| Rate for Payer: PACE Medicare |
$20.34
|
| Rate for Payer: PACE SWMI |
$21.41
|
| Rate for Payer: PHP Commercial |
$23.55
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$21.41
|
| Rate for Payer: Priority Health Narrow Network |
$34.12
|
| Rate for Payer: Railroad Medicare Medicare |
$21.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.41
|
| Rate for Payer: UHC Exchange |
$33.19
|
| Rate for Payer: UHC Medicare Advantage |
$21.41
|
| Rate for Payer: UHCCP DNSP |
$21.41
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.41
|
|
|
HC DIABETES MELLITUS TYPE 1 EVAL
|
Facility
|
IP
|
$48.68
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.64 |
| Max. Negotiated Rate |
$48.68 |
| Rate for Payer: Aetna Commercial |
$43.81
|
| Rate for Payer: ASR ASR |
$47.22
|
| Rate for Payer: ASR Commercial |
$47.22
|
| Rate for Payer: BCBS Trust/PPO |
$39.67
|
| Rate for Payer: BCN Commercial |
$37.74
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Commercial |
$45.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$48.68
|
| Rate for Payer: Healthscope Whirlpool |
$47.22
|
| Rate for Payer: Mclaren Commercial |
$43.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.38
|
| Rate for Payer: Nomi Health Commercial |
$39.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.84
|
|
|
HC DIABETES TRAINING PER 30 MIN
|
Facility
|
IP
|
$149.77
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$97.35 |
| Max. Negotiated Rate |
$149.77 |
| Rate for Payer: Aetna Commercial |
$134.79
|
| Rate for Payer: ASR ASR |
$145.28
|
| Rate for Payer: ASR Commercial |
$145.28
|
| Rate for Payer: BCBS Trust/PPO |
$122.05
|
| Rate for Payer: BCN Commercial |
$116.12
|
| Rate for Payer: Cash Price |
$119.82
|
| Rate for Payer: Cofinity Commercial |
$140.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.82
|
| Rate for Payer: Healthscope Commercial |
$149.77
|
| Rate for Payer: Healthscope Whirlpool |
$145.28
|
| Rate for Payer: Mclaren Commercial |
$134.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.30
|
| Rate for Payer: Nomi Health Commercial |
$122.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.80
|
|
|
HC DIABETES TRAINING PER 30 MIN
|
Facility
|
OP
|
$149.77
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$149.77 |
| Rate for Payer: Aetna Commercial |
$134.79
|
| Rate for Payer: Aetna Medicare |
$74.89
|
| Rate for Payer: ASR ASR |
$145.28
|
| Rate for Payer: ASR Commercial |
$145.28
|
| Rate for Payer: BCBS Complete |
$59.91
|
| Rate for Payer: BCBS Trust/PPO |
$122.65
|
| Rate for Payer: BCN Commercial |
$116.12
|
| Rate for Payer: Cash Price |
$119.82
|
| Rate for Payer: Cofinity Commercial |
$140.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.82
|
| Rate for Payer: Healthscope Commercial |
$149.77
|
| Rate for Payer: Healthscope Whirlpool |
$145.28
|
| Rate for Payer: Mclaren Commercial |
$134.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.30
|
| Rate for Payer: Nomi Health Commercial |
$122.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.23
|
| Rate for Payer: Priority Health Narrow Network |
$104.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.80
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W ANGIOPLASTY AND IMAGING
|
Facility
|
OP
|
$11,009.31
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
36100526
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$11,009.31 |
| Rate for Payer: Aetna Commercial |
$9,908.38
|
| Rate for Payer: Aetna Medicare |
$5,560.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: ASR ASR |
$10,679.03
|
| Rate for Payer: ASR Commercial |
$10,679.03
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCBS Trust/PPO |
$9,015.52
|
| Rate for Payer: BCN Commercial |
$8,535.52
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$8,807.45
|
| Rate for Payer: Cash Price |
$8,807.45
|
| Rate for Payer: Cofinity Commercial |
$10,348.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,807.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$11,009.31
|
| Rate for Payer: Healthscope Whirlpool |
$10,679.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,560.58
|
| Rate for Payer: Mclaren Commercial |
$9,908.38
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,357.91
|
| Rate for Payer: Nomi Health Commercial |
$9,027.63
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$6,116.64
|
| Rate for Payer: PHP Medicaid |
$2,980.47
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,156.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,646.36
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health Narrow Network |
$7,717.53
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,688.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$8,618.90
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP DNSP |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W ANGIOPLASTY AND IMAGING
|
Facility
|
IP
|
$11,009.31
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
36100526
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,156.05 |
| Max. Negotiated Rate |
$11,009.31 |
| Rate for Payer: Aetna Commercial |
$9,908.38
|
| Rate for Payer: ASR ASR |
$10,679.03
|
| Rate for Payer: ASR Commercial |
$10,679.03
|
| Rate for Payer: BCBS Trust/PPO |
$8,971.49
|
| Rate for Payer: BCN Commercial |
$8,535.52
|
| Rate for Payer: Cash Price |
$8,807.45
|
| Rate for Payer: Cofinity Commercial |
$10,348.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,807.45
|
| Rate for Payer: Healthscope Commercial |
$11,009.31
|
| Rate for Payer: Healthscope Whirlpool |
$10,679.03
|
| Rate for Payer: Mclaren Commercial |
$9,908.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,357.91
|
| Rate for Payer: Nomi Health Commercial |
$9,027.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,156.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,688.19
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$2,146.12
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
36100525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,394.98 |
| Max. Negotiated Rate |
$2,146.12 |
| Rate for Payer: Aetna Commercial |
$1,931.51
|
| Rate for Payer: ASR ASR |
$2,081.74
|
| Rate for Payer: ASR Commercial |
$2,081.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,748.87
|
| Rate for Payer: BCN Commercial |
$1,663.89
|
| Rate for Payer: Cash Price |
$1,716.90
|
| Rate for Payer: Cofinity Commercial |
$2,017.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,716.90
|
| Rate for Payer: Healthscope Commercial |
$2,146.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,081.74
|
| Rate for Payer: Mclaren Commercial |
$1,931.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.20
|
| Rate for Payer: Nomi Health Commercial |
$1,759.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,888.59
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$2,146.12
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
36100525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$2,348.31 |
| Rate for Payer: Aetna Commercial |
$1,931.51
|
| Rate for Payer: Aetna Medicare |
$1,515.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: ASR ASR |
$2,081.74
|
| Rate for Payer: ASR Commercial |
$2,081.74
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.46
|
| Rate for Payer: BCN Commercial |
$1,663.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,716.90
|
| Rate for Payer: Cash Price |
$1,716.90
|
| Rate for Payer: Cofinity Commercial |
$2,017.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,716.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$2,146.12
|
| Rate for Payer: Healthscope Whirlpool |
$2,081.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,515.04
|
| Rate for Payer: Mclaren Commercial |
$1,931.51
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,824.20
|
| Rate for Payer: Nomi Health Commercial |
$1,759.82
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,666.54
|
| Rate for Payer: PHP Medicaid |
$812.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.43
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,504.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,888.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,348.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP DNSP |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: VA VA |
$1,515.04
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING
|
Facility
|
IP
|
$18,535.04
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
36100527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,047.78 |
| Max. Negotiated Rate |
$18,535.04 |
| Rate for Payer: Aetna Commercial |
$16,681.54
|
| Rate for Payer: ASR ASR |
$17,978.99
|
| Rate for Payer: ASR Commercial |
$17,978.99
|
| Rate for Payer: BCBS Trust/PPO |
$15,104.20
|
| Rate for Payer: BCN Commercial |
$14,370.22
|
| Rate for Payer: Cash Price |
$14,828.03
|
| Rate for Payer: Cofinity Commercial |
$17,422.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,828.03
|
| Rate for Payer: Healthscope Commercial |
$18,535.04
|
| Rate for Payer: Healthscope Whirlpool |
$17,978.99
|
| Rate for Payer: Mclaren Commercial |
$16,681.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,754.78
|
| Rate for Payer: Nomi Health Commercial |
$15,198.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,047.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,310.84
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING
|
Facility
|
OP
|
$18,535.04
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
36100527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$18,535.04 |
| Rate for Payer: Aetna Commercial |
$16,681.54
|
| Rate for Payer: Aetna Medicare |
$11,060.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: ASR ASR |
$17,978.99
|
| Rate for Payer: ASR Commercial |
$17,978.99
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCBS Trust/PPO |
$15,178.34
|
| Rate for Payer: BCN Commercial |
$14,370.22
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$14,828.03
|
| Rate for Payer: Cash Price |
$14,828.03
|
| Rate for Payer: Cofinity Commercial |
$17,422.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,828.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$18,535.04
|
| Rate for Payer: Healthscope Whirlpool |
$17,978.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,060.23
|
| Rate for Payer: Mclaren Commercial |
$16,681.54
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,754.78
|
| Rate for Payer: Nomi Health Commercial |
$15,198.73
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$12,166.25
|
| Rate for Payer: PHP Medicaid |
$5,928.28
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,047.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,240.40
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health Narrow Network |
$12,993.06
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,310.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$17,143.36
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP DNSP |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: VA VA |
$11,060.23
|
|
|
HC DIALYSIS CATH LVL 10 LONG TERM
|
Facility
|
OP
|
$1,047.44
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$418.98 |
| Max. Negotiated Rate |
$1,047.44 |
| Rate for Payer: Aetna Commercial |
$942.70
|
| Rate for Payer: Aetna Medicare |
$523.72
|
| Rate for Payer: ASR ASR |
$1,016.02
|
| Rate for Payer: ASR Commercial |
$1,016.02
|
| Rate for Payer: BCBS Complete |
$418.98
|
| Rate for Payer: BCBS Trust/PPO |
$857.75
|
| Rate for Payer: BCN Commercial |
$812.08
|
| Rate for Payer: Cash Price |
$837.95
|
| Rate for Payer: Cofinity Commercial |
$984.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$837.95
|
| Rate for Payer: Healthscope Commercial |
$1,047.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.02
|
| Rate for Payer: Mclaren Commercial |
$942.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$890.32
|
| Rate for Payer: Nomi Health Commercial |
$858.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$917.77
|
| Rate for Payer: Priority Health Narrow Network |
$734.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$921.75
|
|
|
HC DIALYSIS CATH LVL 10 LONG TERM
|
Facility
|
IP
|
$1,047.44
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$680.84 |
| Max. Negotiated Rate |
$1,047.44 |
| Rate for Payer: Aetna Commercial |
$942.70
|
| Rate for Payer: ASR ASR |
$1,016.02
|
| Rate for Payer: ASR Commercial |
$1,016.02
|
| Rate for Payer: BCBS Trust/PPO |
$853.56
|
| Rate for Payer: BCN Commercial |
$812.08
|
| Rate for Payer: Cash Price |
$837.95
|
| Rate for Payer: Cofinity Commercial |
$984.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$837.95
|
| Rate for Payer: Healthscope Commercial |
$1,047.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,016.02
|
| Rate for Payer: Mclaren Commercial |
$942.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$890.32
|
| Rate for Payer: Nomi Health Commercial |
$858.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$921.75
|
|
|
HC DIALYSIS CATH LVL 11 LONG TERM
|
Facility
|
IP
|
$1,171.97
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$761.78 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$1,054.77
|
| Rate for Payer: ASR ASR |
$1,136.81
|
| Rate for Payer: ASR Commercial |
$1,136.81
|
| Rate for Payer: BCBS Trust/PPO |
$955.04
|
| Rate for Payer: BCN Commercial |
$908.63
|
| Rate for Payer: Cash Price |
$937.58
|
| Rate for Payer: Cofinity Commercial |
$1,101.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$937.58
|
| Rate for Payer: Healthscope Commercial |
$1,171.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,136.81
|
| Rate for Payer: Mclaren Commercial |
$1,054.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$996.17
|
| Rate for Payer: Nomi Health Commercial |
$961.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,031.33
|
|
|
HC DIALYSIS CATH LVL 11 LONG TERM
|
Facility
|
OP
|
$1,171.97
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$468.79 |
| Max. Negotiated Rate |
$1,171.97 |
| Rate for Payer: Aetna Commercial |
$1,054.77
|
| Rate for Payer: Aetna Medicare |
$585.99
|
| Rate for Payer: ASR ASR |
$1,136.81
|
| Rate for Payer: ASR Commercial |
$1,136.81
|
| Rate for Payer: BCBS Complete |
$468.79
|
| Rate for Payer: BCBS Trust/PPO |
$959.73
|
| Rate for Payer: BCN Commercial |
$908.63
|
| Rate for Payer: Cash Price |
$937.58
|
| Rate for Payer: Cofinity Commercial |
$1,101.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$937.58
|
| Rate for Payer: Healthscope Commercial |
$1,171.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,136.81
|
| Rate for Payer: Mclaren Commercial |
$1,054.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$996.17
|
| Rate for Payer: Nomi Health Commercial |
$961.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,026.88
|
| Rate for Payer: Priority Health Narrow Network |
$821.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,031.33
|
|
|
HC DIALYSIS CATH LVL 13 LONG TERM
|
Facility
|
IP
|
$1,380.06
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$897.04 |
| Max. Negotiated Rate |
$1,380.06 |
| Rate for Payer: Aetna Commercial |
$1,242.05
|
| Rate for Payer: ASR ASR |
$1,338.66
|
| Rate for Payer: ASR Commercial |
$1,338.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.61
|
| Rate for Payer: BCN Commercial |
$1,069.96
|
| Rate for Payer: Cash Price |
$1,104.05
|
| Rate for Payer: Cofinity Commercial |
$1,297.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.05
|
| Rate for Payer: Healthscope Commercial |
$1,380.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,338.66
|
| Rate for Payer: Mclaren Commercial |
$1,242.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.05
|
| Rate for Payer: Nomi Health Commercial |
$1,131.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.45
|
|
|
HC DIALYSIS CATH LVL 13 LONG TERM
|
Facility
|
OP
|
$1,380.06
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$552.02 |
| Max. Negotiated Rate |
$1,380.06 |
| Rate for Payer: Aetna Commercial |
$1,242.05
|
| Rate for Payer: Aetna Medicare |
$690.03
|
| Rate for Payer: ASR ASR |
$1,338.66
|
| Rate for Payer: ASR Commercial |
$1,338.66
|
| Rate for Payer: BCBS Complete |
$552.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.13
|
| Rate for Payer: BCN Commercial |
$1,069.96
|
| Rate for Payer: Cash Price |
$1,104.05
|
| Rate for Payer: Cofinity Commercial |
$1,297.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.05
|
| Rate for Payer: Healthscope Commercial |
$1,380.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,338.66
|
| Rate for Payer: Mclaren Commercial |
$1,242.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.05
|
| Rate for Payer: Nomi Health Commercial |
$1,131.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,209.21
|
| Rate for Payer: Priority Health Narrow Network |
$967.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.45
|
|
|
HC DIALYSIS CATH LVL 2 SHORT TERM
|
Facility
|
OP
|
$208.07
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$83.23 |
| Max. Negotiated Rate |
$208.07 |
| Rate for Payer: Aetna Commercial |
$187.26
|
| Rate for Payer: Aetna Medicare |
$104.03
|
| Rate for Payer: ASR ASR |
$201.83
|
| Rate for Payer: ASR Commercial |
$201.83
|
| Rate for Payer: BCBS Complete |
$83.23
|
| Rate for Payer: BCBS Trust/PPO |
$170.39
|
| Rate for Payer: BCN Commercial |
$161.32
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$195.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$208.07
|
| Rate for Payer: Healthscope Whirlpool |
$201.83
|
| Rate for Payer: Mclaren Commercial |
$187.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.86
|
| Rate for Payer: Nomi Health Commercial |
$170.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.31
|
| Rate for Payer: Priority Health Narrow Network |
$145.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.10
|
|
|
HC DIALYSIS CATH LVL 2 SHORT TERM
|
Facility
|
IP
|
$208.07
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$208.07 |
| Rate for Payer: Aetna Commercial |
$187.26
|
| Rate for Payer: ASR ASR |
$201.83
|
| Rate for Payer: ASR Commercial |
$201.83
|
| Rate for Payer: BCBS Trust/PPO |
$169.56
|
| Rate for Payer: BCN Commercial |
$161.32
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$195.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$208.07
|
| Rate for Payer: Healthscope Whirlpool |
$201.83
|
| Rate for Payer: Mclaren Commercial |
$187.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.86
|
| Rate for Payer: Nomi Health Commercial |
$170.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.10
|
|
