|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$51.40
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$19.19
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: ASR ASR |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$39.54
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$47.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$51.00
|
| Rate for Payer: Healthscope Whirlpool |
$49.47
|
| Rate for Payer: Mclaren Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.88
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,538.29
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,076.80 |
| Max. Negotiated Rate |
$1,538.29 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: ASR ASR |
$1,492.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,192.64
|
| Rate for Payer: BCN Commercial |
$1,192.64
|
| Rate for Payer: Cash Price |
$1,230.63
|
| Rate for Payer: Cofinity Commercial |
$1,445.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.63
|
| Rate for Payer: Healthscope Commercial |
$1,538.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.14
|
| Rate for Payer: Mclaren Commercial |
$1,384.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,307.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,353.70
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,538.29
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$304.70 |
| Max. Negotiated Rate |
$3,776.34 |
| Rate for Payer: Aetna Commercial |
$1,384.46
|
| Rate for Payer: Aetna Medicare |
$557.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.29
|
| Rate for Payer: ASR ASR |
$1,492.14
|
| Rate for Payer: BCBS Complete |
$319.96
|
| Rate for Payer: BCBS MAPPO |
$557.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,192.64
|
| Rate for Payer: BCN Commercial |
$1,192.64
|
| Rate for Payer: BCN Medicare Advantage |
$557.03
|
| Rate for Payer: Cash Price |
$1,230.63
|
| Rate for Payer: Cash Price |
$1,230.63
|
| Rate for Payer: Cofinity Commercial |
$1,445.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.03
|
| Rate for Payer: Healthscope Commercial |
$1,538.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,492.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$557.03
|
| Rate for Payer: Mclaren Commercial |
$1,384.46
|
| Rate for Payer: Mclaren Medicaid |
$304.70
|
| Rate for Payer: Mclaren Medicare |
$557.03
|
| Rate for Payer: Meridian Medicaid |
$319.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,307.55
|
| Rate for Payer: PACE Medicare |
$529.18
|
| Rate for Payer: PACE SWMI |
$557.03
|
| Rate for Payer: PHP Commercial |
$612.73
|
| Rate for Payer: PHP Medicaid |
$304.70
|
| Rate for Payer: PHP Medicare Advantage |
$557.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,776.34
|
| Rate for Payer: Priority Health Medicare |
$557.03
|
| Rate for Payer: Priority Health Narrow Network |
$3,021.07
|
| Rate for Payer: Railroad Medicare Medicare |
$557.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,353.70
|
| Rate for Payer: UHC Medicare Advantage |
$573.74
|
| Rate for Payer: VA VA |
$557.03
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,173.97
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$821.78 |
| Max. Negotiated Rate |
$1,173.97 |
| Rate for Payer: Aetna Commercial |
$1,056.57
|
| Rate for Payer: ASR ASR |
$1,138.75
|
| Rate for Payer: BCBS Trust/PPO |
$910.18
|
| Rate for Payer: BCN Commercial |
$910.18
|
| Rate for Payer: Cash Price |
$939.18
|
| Rate for Payer: Cofinity Commercial |
$1,103.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.18
|
| Rate for Payer: Healthscope Commercial |
$1,173.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,138.75
|
| Rate for Payer: Mclaren Commercial |
$1,056.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.09
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,173.97
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$304.70 |
| Max. Negotiated Rate |
$3,304.30 |
| Rate for Payer: Aetna Commercial |
$1,056.57
|
| Rate for Payer: Aetna Medicare |
$557.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.29
|
| Rate for Payer: ASR ASR |
$1,138.75
|
| Rate for Payer: BCBS Complete |
$319.96
|
| Rate for Payer: BCBS MAPPO |
$557.03
|
| Rate for Payer: BCBS Trust/PPO |
$910.18
|
| Rate for Payer: BCN Commercial |
$910.18
|
| Rate for Payer: BCN Medicare Advantage |
$557.03
|
| Rate for Payer: Cash Price |
$939.18
|
| Rate for Payer: Cash Price |
$939.18
|
| Rate for Payer: Cofinity Commercial |
$1,103.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.03
|
| Rate for Payer: Healthscope Commercial |
$1,173.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,138.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$557.03
|
| Rate for Payer: Mclaren Commercial |
$1,056.57
|
| Rate for Payer: Mclaren Medicaid |
$304.70
|
| Rate for Payer: Mclaren Medicare |
$557.03
|
| Rate for Payer: Meridian Medicaid |
$319.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.87
|
| Rate for Payer: PACE Medicare |
$529.18
|
| Rate for Payer: PACE SWMI |
$557.03
|
| Rate for Payer: PHP Commercial |
$612.73
|
| Rate for Payer: PHP Medicaid |
$304.70
|
| Rate for Payer: PHP Medicare Advantage |
$557.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,304.30
|
| Rate for Payer: Priority Health Medicare |
$557.03
|
| Rate for Payer: Priority Health Narrow Network |
$2,643.44
|
| Rate for Payer: Railroad Medicare Medicare |
$557.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,033.09
|
| Rate for Payer: UHC Medicare Advantage |
$573.74
|
| Rate for Payer: VA VA |
$557.03
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,180.78
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.14 |
| Max. Negotiated Rate |
$1,180.78 |
| Rate for Payer: Aetna Commercial |
$1,062.70
|
| Rate for Payer: Aetna Medicare |
$607.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: ASR ASR |
$1,145.36
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$915.46
|
| Rate for Payer: BCN Commercial |
$915.46
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,109.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$1,180.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$607.20
|
| Rate for Payer: Mclaren Commercial |
$1,062.70
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$667.92
|
| Rate for Payer: PHP Medicaid |
$332.14
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.51
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$838.35
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,039.09
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: VA VA |
$607.20
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,180.78
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$826.55 |
| Max. Negotiated Rate |
$1,180.78 |
| Rate for Payer: Aetna Commercial |
$1,062.70
|
| Rate for Payer: ASR ASR |
$1,145.36
|
| Rate for Payer: BCBS Trust/PPO |
$915.46
|
| Rate for Payer: BCN Commercial |
$915.46
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,109.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Healthscope Commercial |
$1,180.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.36
|
| Rate for Payer: Mclaren Commercial |
$1,062.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,039.09
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,180.78
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.14 |
| Max. Negotiated Rate |
$1,180.78 |
| Rate for Payer: Aetna Commercial |
$1,062.70
|
| Rate for Payer: Aetna Medicare |
$607.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: ASR ASR |
$1,145.36
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$915.46
|
| Rate for Payer: BCN Commercial |
$915.46
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,109.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$1,180.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$607.20
|
| Rate for Payer: Mclaren Commercial |
$1,062.70
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$667.92
|
| Rate for Payer: PHP Medicaid |
$332.14
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.51
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$838.35
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,039.09
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: VA VA |
$607.20
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,180.78
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$826.55 |
| Max. Negotiated Rate |
$1,180.78 |
| Rate for Payer: Aetna Commercial |
$1,062.70
|
| Rate for Payer: ASR ASR |
$1,145.36
|
| Rate for Payer: BCBS Trust/PPO |
$915.46
|
| Rate for Payer: BCN Commercial |
$915.46
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,109.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Healthscope Commercial |
$1,180.78
|
| Rate for Payer: Healthscope Whirlpool |
$1,145.36
|
| Rate for Payer: Mclaren Commercial |
$1,062.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,039.09
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL MULT REG
|
Facility
|
OP
|
$1,462.17
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,462.17 |
| Rate for Payer: Aetna Commercial |
$1,315.95
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,418.30
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.62
|
| Rate for Payer: BCN Commercial |
$1,133.62
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,169.74
|
| Rate for Payer: Cash Price |
$1,169.74
|
| Rate for Payer: Cofinity Commercial |
$1,374.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,462.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,418.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,315.95
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,242.84
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,023.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.35
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$857.88
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,286.71
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL MULT REG
|
Facility
|
IP
|
$1,462.17
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,023.52 |
| Max. Negotiated Rate |
$1,462.17 |
| Rate for Payer: Aetna Commercial |
$1,315.95
|
| Rate for Payer: ASR ASR |
$1,418.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.62
|
| Rate for Payer: BCN Commercial |
$1,133.62
|
| Rate for Payer: Cash Price |
$1,169.74
|
| Rate for Payer: Cofinity Commercial |
$1,374.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.74
|
| Rate for Payer: Healthscope Commercial |
$1,462.17
|
| Rate for Payer: Healthscope Whirlpool |
$1,418.30
|
| Rate for Payer: Mclaren Commercial |
$1,315.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,242.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,023.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,286.71
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$743.82
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.24 |
| Max. Negotiated Rate |
$768.38 |
| Rate for Payer: Aetna Commercial |
$669.44
|
| Rate for Payer: Aetna Medicare |
$614.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: ASR ASR |
$721.51
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$576.68
|
| Rate for Payer: BCN Commercial |
$576.68
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$595.06
|
| Rate for Payer: Cash Price |
$595.06
|
| Rate for Payer: Cofinity Commercial |
$699.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$595.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$743.82
|
| Rate for Payer: Healthscope Whirlpool |
$721.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$614.70
|
| Rate for Payer: Mclaren Commercial |
$669.44
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$632.25
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicaid |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$520.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$549.01
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$439.21
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$654.56
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: VA VA |
$614.70
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$743.82
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.67 |
| Max. Negotiated Rate |
$743.82 |
| Rate for Payer: Aetna Commercial |
$669.44
|
| Rate for Payer: ASR ASR |
$721.51
|
| Rate for Payer: BCBS Trust/PPO |
$576.68
|
| Rate for Payer: BCN Commercial |
$576.68
|
| Rate for Payer: Cash Price |
$595.06
|
| Rate for Payer: Cofinity Commercial |
$699.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$595.06
|
| Rate for Payer: Healthscope Commercial |
$743.82
|
| Rate for Payer: Healthscope Whirlpool |
$721.51
|
| Rate for Payer: Mclaren Commercial |
$669.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$632.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$520.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$654.56
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC NETTLE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$132.60
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$119.34
|
| Rate for Payer: ASR ASR |
$128.62
|
| Rate for Payer: BCBS Complete |
$53.04
|
| Rate for Payer: BCBS Trust/PPO |
$102.80
|
| Rate for Payer: BCN Commercial |
$102.80
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$124.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Healthscope Commercial |
$132.60
|
| Rate for Payer: Healthscope Whirlpool |
$128.62
|
| Rate for Payer: Mclaren Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.67
|
| Rate for Payer: Priority Health Narrow Network |
$94.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.69
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$132.60
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$92.82 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$119.34
|
| Rate for Payer: ASR ASR |
$128.62
|
| Rate for Payer: BCBS Trust/PPO |
$102.80
|
| Rate for Payer: BCN Commercial |
$102.80
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$124.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Healthscope Commercial |
$132.60
|
| Rate for Payer: Healthscope Whirlpool |
$128.62
|
| Rate for Payer: Mclaren Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.69
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
OP
|
$269.71
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$348.75 |
| Rate for Payer: Aetna Commercial |
$242.74
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: ASR ASR |
$261.62
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$209.11
|
| Rate for Payer: BCN Commercial |
$209.11
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$215.77
|
| Rate for Payer: Cash Price |
$215.77
|
| Rate for Payer: Cofinity Commercial |
$253.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$269.71
|
| Rate for Payer: Healthscope Whirlpool |
$261.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$242.74
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.25
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$306.90
|
| Rate for Payer: PHP Medicaid |
$152.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.44
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$191.49
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.34
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$269.71
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$269.71 |
| Rate for Payer: Aetna Commercial |
$242.74
|
| Rate for Payer: ASR ASR |
$261.62
|
| Rate for Payer: BCBS Trust/PPO |
$209.11
|
| Rate for Payer: BCN Commercial |
$209.11
|
| Rate for Payer: Cash Price |
$215.77
|
| Rate for Payer: Cofinity Commercial |
$253.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.77
|
| Rate for Payer: Healthscope Commercial |
$269.71
|
| Rate for Payer: Healthscope Whirlpool |
$261.62
|
| Rate for Payer: Mclaren Commercial |
$242.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.34
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
OP
|
$11,647.13
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,658.85 |
| Max. Negotiated Rate |
$11,647.13 |
| Rate for Payer: Aetna Commercial |
$10,482.42
|
| Rate for Payer: ASR ASR |
$11,297.72
|
| Rate for Payer: BCBS Complete |
$4,658.85
|
| Rate for Payer: BCBS Trust/PPO |
$9,030.02
|
| Rate for Payer: BCN Commercial |
$9,030.02
|
| Rate for Payer: Cash Price |
$9,317.70
|
| Rate for Payer: Cofinity Commercial |
$10,948.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,317.70
|
| Rate for Payer: Healthscope Commercial |
$11,647.13
|
| Rate for Payer: Healthscope Whirlpool |
$11,297.72
|
| Rate for Payer: Mclaren Commercial |
$10,482.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,900.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,152.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,598.89
|
| Rate for Payer: Priority Health Narrow Network |
$8,269.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,249.47
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
IP
|
$11,647.13
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,152.99 |
| Max. Negotiated Rate |
$11,647.13 |
| Rate for Payer: Aetna Commercial |
$10,482.42
|
| Rate for Payer: ASR ASR |
$11,297.72
|
| Rate for Payer: BCBS Trust/PPO |
$9,030.02
|
| Rate for Payer: BCN Commercial |
$9,030.02
|
| Rate for Payer: Cash Price |
$9,317.70
|
| Rate for Payer: Cofinity Commercial |
$10,948.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,317.70
|
| Rate for Payer: Healthscope Commercial |
$11,647.13
|
| Rate for Payer: Healthscope Whirlpool |
$11,297.72
|
| Rate for Payer: Mclaren Commercial |
$10,482.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,900.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,152.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,249.47
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
IP
|
$1,892.10
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,324.47 |
| Max. Negotiated Rate |
$1,892.10 |
| Rate for Payer: Aetna Commercial |
$1,702.89
|
| Rate for Payer: ASR ASR |
$1,835.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.95
|
| Rate for Payer: BCN Commercial |
$1,466.95
|
| Rate for Payer: Cash Price |
$1,513.68
|
| Rate for Payer: Cofinity Commercial |
$1,778.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.68
|
| Rate for Payer: Healthscope Commercial |
$1,892.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,835.34
|
| Rate for Payer: Mclaren Commercial |
$1,702.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,608.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.05
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
OP
|
$1,892.10
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.17 |
| Max. Negotiated Rate |
$1,892.10 |
| Rate for Payer: Aetna Commercial |
$1,702.89
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$1,835.34
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.95
|
| Rate for Payer: BCN Commercial |
$1,466.95
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,513.68
|
| Rate for Payer: Cash Price |
$1,513.68
|
| Rate for Payer: Cofinity Commercial |
$1,778.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,892.10
|
| Rate for Payer: Healthscope Whirlpool |
$1,835.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$1,702.89
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,608.28
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,324.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,721.81
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,343.39
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,665.05
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
