|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
OP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$64.26 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: Aetna Commercial |
$144.58
|
| Rate for Payer: Aetna Medicare |
$80.32
|
| Rate for Payer: ASR ASR |
$155.83
|
| Rate for Payer: ASR Commercial |
$155.83
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS Trust/PPO |
$131.56
|
| Rate for Payer: BCN Commercial |
$124.55
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$151.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$160.65
|
| Rate for Payer: Healthscope Whirlpool |
$155.83
|
| Rate for Payer: Mclaren Commercial |
$144.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.76
|
| Rate for Payer: Priority Health Narrow Network |
$112.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$141.37
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.78 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$433.76
|
| Rate for Payer: Aetna Medicare |
$240.98
|
| Rate for Payer: ASR ASR |
$467.49
|
| Rate for Payer: ASR Commercial |
$467.49
|
| Rate for Payer: BCBS Complete |
$192.78
|
| Rate for Payer: BCBS Trust/PPO |
$394.67
|
| Rate for Payer: BCN Commercial |
$373.66
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$453.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Healthscope Whirlpool |
$467.49
|
| Rate for Payer: Mclaren Commercial |
$433.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.28
|
| Rate for Payer: Priority Health Narrow Network |
$337.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$424.12
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.27 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$433.76
|
| Rate for Payer: ASR ASR |
$467.49
|
| Rate for Payer: ASR Commercial |
$467.49
|
| Rate for Payer: BCBS Trust/PPO |
$392.74
|
| Rate for Payer: BCN Commercial |
$373.66
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$453.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Healthscope Whirlpool |
$467.49
|
| Rate for Payer: Mclaren Commercial |
$433.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$424.12
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
IP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,538.49 |
| Max. Negotiated Rate |
$2,366.91 |
| Rate for Payer: Aetna Commercial |
$2,130.22
|
| Rate for Payer: ASR ASR |
$2,295.90
|
| Rate for Payer: ASR Commercial |
$2,295.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,928.79
|
| Rate for Payer: BCN Commercial |
$1,835.07
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,224.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,366.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,295.90
|
| Rate for Payer: Mclaren Commercial |
$2,130.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,082.88
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$946.76 |
| Max. Negotiated Rate |
$2,366.91 |
| Rate for Payer: Aetna Commercial |
$2,130.22
|
| Rate for Payer: Aetna Medicare |
$1,183.46
|
| Rate for Payer: ASR ASR |
$2,295.90
|
| Rate for Payer: ASR Commercial |
$2,295.90
|
| Rate for Payer: BCBS Complete |
$946.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,938.26
|
| Rate for Payer: BCN Commercial |
$1,835.07
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,224.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,366.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,295.90
|
| Rate for Payer: Mclaren Commercial |
$2,130.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,073.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,659.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,082.88
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$17,260.72 |
| Rate for Payer: Aetna Commercial |
$15,534.65
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$16,742.90
|
| Rate for Payer: ASR Commercial |
$16,742.90
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$14,134.80
|
| Rate for Payer: BCN Commercial |
$13,382.24
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$16,225.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$17,260.72
|
| Rate for Payer: Healthscope Whirlpool |
$16,742.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$15,534.65
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: Nomi Health Commercial |
$14,153.79
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,123.97
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$8,099.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,189.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,219.47 |
| Max. Negotiated Rate |
$17,260.72 |
| Rate for Payer: Aetna Commercial |
$15,534.65
|
| Rate for Payer: ASR ASR |
$16,742.90
|
| Rate for Payer: ASR Commercial |
$16,742.90
|
| Rate for Payer: BCBS Trust/PPO |
$14,065.76
|
| Rate for Payer: BCN Commercial |
$13,382.24
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$16,225.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Healthscope Commercial |
$17,260.72
|
| Rate for Payer: Healthscope Whirlpool |
$16,742.90
|
| Rate for Payer: Mclaren Commercial |
$15,534.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: Nomi Health Commercial |
$14,153.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15,189.43
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,415.31 |
| Max. Negotiated Rate |
$17,222.45 |
| Rate for Payer: Aetna Commercial |
$4,728.89
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$5,096.69
|
| Rate for Payer: ASR Commercial |
$5,096.69
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$4,302.76
|
| Rate for Payer: BCN Commercial |
$4,073.67
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,939.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$5,254.32
|
| Rate for Payer: Healthscope Whirlpool |
$5,096.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$4,728.89
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$4,308.54
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,603.84
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$3,683.28
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,415.31 |
| Max. Negotiated Rate |
$5,254.32 |
| Rate for Payer: Aetna Commercial |
$4,728.89
|
| Rate for Payer: ASR ASR |
$5,096.69
|
| Rate for Payer: ASR Commercial |
$5,096.69
|
| Rate for Payer: BCBS Trust/PPO |
$4,281.75
|
| Rate for Payer: BCN Commercial |
$4,073.67
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,939.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Healthscope Commercial |
$5,254.32
|
| Rate for Payer: Healthscope Whirlpool |
$5,096.69
|
| Rate for Payer: Mclaren Commercial |
$4,728.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$4,308.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,623.80
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.69 |
| Max. Negotiated Rate |
$428.76 |
| Rate for Payer: Aetna Commercial |
$385.88
|
| Rate for Payer: ASR ASR |
$415.90
|
| Rate for Payer: ASR Commercial |
$415.90
|
| Rate for Payer: BCBS Trust/PPO |
$349.40
|
| Rate for Payer: BCN Commercial |
$332.42
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$403.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$428.76
|
| Rate for Payer: Healthscope Whirlpool |
$415.90
|
| Rate for Payer: Mclaren Commercial |
$385.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: Nomi Health Commercial |
$351.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.31
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.50 |
| Max. Negotiated Rate |
$428.76 |
| Rate for Payer: Aetna Commercial |
$385.88
|
| Rate for Payer: Aetna Medicare |
$214.38
|
| Rate for Payer: ASR ASR |
$415.90
|
| Rate for Payer: ASR Commercial |
$415.90
|
| Rate for Payer: BCBS Complete |
$171.50
|
| Rate for Payer: BCBS Trust/PPO |
$351.11
|
| Rate for Payer: BCN Commercial |
$332.42
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$403.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$428.76
|
| Rate for Payer: Healthscope Whirlpool |
$415.90
|
| Rate for Payer: Mclaren Commercial |
$385.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: Nomi Health Commercial |
$351.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$375.68
|
| Rate for Payer: Priority Health Narrow Network |
$300.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$377.31
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$21,556.74 |
| Rate for Payer: Aetna Commercial |
$19,401.07
|
| Rate for Payer: Aetna Medicare |
$11,111.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: ASR ASR |
$20,910.04
|
| Rate for Payer: ASR Commercial |
$20,910.04
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$17,652.81
|
| Rate for Payer: BCN Commercial |
$16,712.94
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$20,263.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$21,556.74
|
| Rate for Payer: Healthscope Whirlpool |
$20,910.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$11,111.26
|
| Rate for Payer: Mclaren Commercial |
$19,401.07
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$17,676.53
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,222.39
|
| Rate for Payer: PHP Medicaid |
$5,955.64
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,123.97
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$8,099.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,969.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$17,222.45
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP DNSP |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: VA VA |
$11,111.26
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,011.88 |
| Max. Negotiated Rate |
$21,556.74 |
| Rate for Payer: Aetna Commercial |
$19,401.07
|
| Rate for Payer: ASR ASR |
$20,910.04
|
| Rate for Payer: ASR Commercial |
$20,910.04
|
| Rate for Payer: BCBS Trust/PPO |
$17,566.59
|
| Rate for Payer: BCN Commercial |
$16,712.94
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$20,263.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Healthscope Commercial |
$21,556.74
|
| Rate for Payer: Healthscope Whirlpool |
$20,910.04
|
| Rate for Payer: Mclaren Commercial |
$19,401.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$17,676.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18,969.93
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,836.57 |
| Max. Negotiated Rate |
$5,902.41 |
| Rate for Payer: Aetna Commercial |
$5,312.17
|
| Rate for Payer: ASR ASR |
$5,725.34
|
| Rate for Payer: ASR Commercial |
$5,725.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,809.87
|
| Rate for Payer: BCN Commercial |
$4,576.14
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$5,548.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,902.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,725.34
|
| Rate for Payer: Mclaren Commercial |
$5,312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: Nomi Health Commercial |
$4,839.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,194.12
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,360.96 |
| Max. Negotiated Rate |
$5,902.41 |
| Rate for Payer: Aetna Commercial |
$5,312.17
|
| Rate for Payer: Aetna Medicare |
$2,951.20
|
| Rate for Payer: ASR ASR |
$5,725.34
|
| Rate for Payer: ASR Commercial |
$5,725.34
|
| Rate for Payer: BCBS Complete |
$2,360.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,833.48
|
| Rate for Payer: BCN Commercial |
$4,576.14
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$5,548.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,902.41
|
| Rate for Payer: Healthscope Whirlpool |
$5,725.34
|
| Rate for Payer: Mclaren Commercial |
$5,312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: Nomi Health Commercial |
$4,839.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,171.69
|
| Rate for Payer: Priority Health Narrow Network |
$4,137.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,194.12
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.63 |
| Max. Negotiated Rate |
$140.97 |
| Rate for Payer: Aetna Commercial |
$126.87
|
| Rate for Payer: ASR ASR |
$136.74
|
| Rate for Payer: ASR Commercial |
$136.74
|
| Rate for Payer: BCBS Trust/PPO |
$114.88
|
| Rate for Payer: BCN Commercial |
$109.29
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$140.97
|
| Rate for Payer: Healthscope Whirlpool |
$136.74
|
| Rate for Payer: Mclaren Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: Nomi Health Commercial |
$115.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.05
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$140.97 |
| Rate for Payer: Aetna Commercial |
$126.87
|
| Rate for Payer: Aetna Medicare |
$70.48
|
| Rate for Payer: ASR ASR |
$136.74
|
| Rate for Payer: ASR Commercial |
$136.74
|
| Rate for Payer: BCBS Complete |
$56.39
|
| Rate for Payer: BCBS Trust/PPO |
$115.44
|
| Rate for Payer: BCN Commercial |
$109.29
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$140.97
|
| Rate for Payer: Healthscope Whirlpool |
$136.74
|
| Rate for Payer: Mclaren Commercial |
$126.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: Nomi Health Commercial |
$115.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$49.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.05
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$369.35 |
| Rate for Payer: Aetna Commercial |
$315.94
|
| Rate for Payer: Aetna Medicare |
$238.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: ASR ASR |
$340.51
|
| Rate for Payer: ASR Commercial |
$340.51
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$287.47
|
| Rate for Payer: BCN Commercial |
$272.16
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$329.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.29
|
| Rate for Payer: Healthscope Commercial |
$351.04
|
| Rate for Payer: Healthscope Whirlpool |
$340.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$238.29
|
| Rate for Payer: Mclaren Commercial |
$315.94
|
| Rate for Payer: Mclaren Medicaid |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$287.85
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$262.12
|
| Rate for Payer: PHP Medicaid |
$127.72
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.58
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$369.35
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP DNSP |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: VA VA |
$238.29
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$228.18 |
| Max. Negotiated Rate |
$351.04 |
| Rate for Payer: Aetna Commercial |
$315.94
|
| Rate for Payer: ASR ASR |
$340.51
|
| Rate for Payer: ASR Commercial |
$340.51
|
| Rate for Payer: BCBS Trust/PPO |
$286.06
|
| Rate for Payer: BCN Commercial |
$272.16
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$329.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Healthscope Commercial |
$351.04
|
| Rate for Payer: Healthscope Whirlpool |
$340.51
|
| Rate for Payer: Mclaren Commercial |
$315.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$287.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.92
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$237.33 |
| Max. Negotiated Rate |
$365.12 |
| Rate for Payer: Aetna Commercial |
$328.61
|
| Rate for Payer: ASR ASR |
$354.17
|
| Rate for Payer: ASR Commercial |
$354.17
|
| Rate for Payer: BCBS Trust/PPO |
$297.54
|
| Rate for Payer: BCN Commercial |
$283.08
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$343.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Healthscope Commercial |
$365.12
|
| Rate for Payer: Healthscope Whirlpool |
$354.17
|
| Rate for Payer: Mclaren Commercial |
$328.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$299.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.31
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$365.12 |
| Rate for Payer: Aetna Commercial |
$328.61
|
| Rate for Payer: Aetna Medicare |
$153.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: ASR ASR |
$354.17
|
| Rate for Payer: ASR Commercial |
$354.17
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$299.00
|
| Rate for Payer: BCN Commercial |
$283.08
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$343.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$365.12
|
| Rate for Payer: Healthscope Whirlpool |
$354.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$153.30
|
| Rate for Payer: Mclaren Commercial |
$328.61
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$299.40
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicaid |
$82.17
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.92
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$255.95
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$237.62
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP DNSP |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$153.30
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$246.37 |
| Rate for Payer: Aetna Commercial |
$221.73
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: ASR ASR |
$238.98
|
| Rate for Payer: ASR Commercial |
$238.98
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$201.75
|
| Rate for Payer: BCN Commercial |
$191.01
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$231.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$246.37
|
| Rate for Payer: Healthscope Whirlpool |
$238.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$58.20
|
| Rate for Payer: Mclaren Commercial |
$221.73
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$202.02
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicaid |
$31.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.87
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$172.71
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$90.21
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP DNSP |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$160.14 |
| Max. Negotiated Rate |
$246.37 |
| Rate for Payer: Aetna Commercial |
$221.73
|
| Rate for Payer: ASR ASR |
$238.98
|
| Rate for Payer: ASR Commercial |
$238.98
|
| Rate for Payer: BCBS Trust/PPO |
$200.77
|
| Rate for Payer: BCN Commercial |
$191.01
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$231.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$246.37
|
| Rate for Payer: Healthscope Whirlpool |
$238.98
|
| Rate for Payer: Mclaren Commercial |
$221.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$202.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.81
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$397.83 |
| Max. Negotiated Rate |
$612.05 |
| Rate for Payer: Aetna Commercial |
$550.84
|
| Rate for Payer: ASR ASR |
$593.69
|
| Rate for Payer: ASR Commercial |
$593.69
|
| Rate for Payer: BCBS Trust/PPO |
$498.76
|
| Rate for Payer: BCN Commercial |
$474.52
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$575.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$612.05
|
| Rate for Payer: Healthscope Whirlpool |
$593.69
|
| Rate for Payer: Mclaren Commercial |
$550.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: Nomi Health Commercial |
$501.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.60
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$244.82 |
| Max. Negotiated Rate |
$612.05 |
| Rate for Payer: Aetna Commercial |
$550.84
|
| Rate for Payer: Aetna Medicare |
$306.02
|
| Rate for Payer: ASR ASR |
$593.69
|
| Rate for Payer: ASR Commercial |
$593.69
|
| Rate for Payer: BCBS Complete |
$244.82
|
| Rate for Payer: BCBS Trust/PPO |
$501.21
|
| Rate for Payer: BCN Commercial |
$474.52
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$575.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$612.05
|
| Rate for Payer: Healthscope Whirlpool |
$593.69
|
| Rate for Payer: Mclaren Commercial |
$550.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: Nomi Health Commercial |
$501.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.28
|
| Rate for Payer: Priority Health Narrow Network |
$429.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.60
|
|
