|
HC ILEOSCOPY
|
Facility
|
OP
|
$2,308.81
|
|
| Hospital Charge Code |
36000055
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$923.52 |
| Max. Negotiated Rate |
$2,308.81 |
| Rate for Payer: Aetna Commercial |
$2,077.93
|
| Rate for Payer: Aetna Medicare |
$1,154.40
|
| Rate for Payer: ASR ASR |
$2,239.55
|
| Rate for Payer: ASR Commercial |
$2,239.55
|
| Rate for Payer: BCBS Complete |
$923.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,890.68
|
| Rate for Payer: BCN Commercial |
$1,790.02
|
| Rate for Payer: Cash Price |
$1,847.05
|
| Rate for Payer: Cofinity Commercial |
$2,170.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,847.05
|
| Rate for Payer: Healthscope Commercial |
$2,308.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,239.55
|
| Rate for Payer: Mclaren Commercial |
$2,077.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,962.49
|
| Rate for Payer: Nomi Health Commercial |
$1,893.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,500.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,022.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,618.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,031.75
|
|
|
HC ILEOSCOPY
|
Facility
|
IP
|
$2,308.81
|
|
| Hospital Charge Code |
36000055
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,500.73 |
| Max. Negotiated Rate |
$2,308.81 |
| Rate for Payer: Aetna Commercial |
$2,077.93
|
| Rate for Payer: ASR ASR |
$2,239.55
|
| Rate for Payer: ASR Commercial |
$2,239.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,881.45
|
| Rate for Payer: BCN Commercial |
$1,790.02
|
| Rate for Payer: Cash Price |
$1,847.05
|
| Rate for Payer: Cofinity Commercial |
$2,170.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,847.05
|
| Rate for Payer: Healthscope Commercial |
$2,308.81
|
| Rate for Payer: Healthscope Whirlpool |
$2,239.55
|
| Rate for Payer: Mclaren Commercial |
$2,077.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,962.49
|
| Rate for Payer: Nomi Health Commercial |
$1,893.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,500.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,031.75
|
|
|
HC ILIAC ANGIOGRAPHY W/HEART CATH
|
Facility
|
IP
|
$2,755.73
|
|
|
Service Code
|
HCPCS G0278
|
| Hospital Charge Code |
48100053
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,791.22 |
| Max. Negotiated Rate |
$2,755.73 |
| Rate for Payer: Aetna Commercial |
$2,480.16
|
| Rate for Payer: ASR ASR |
$2,673.06
|
| Rate for Payer: ASR Commercial |
$2,673.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.64
|
| Rate for Payer: BCN Commercial |
$2,136.52
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,590.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Healthscope Commercial |
$2,755.73
|
| Rate for Payer: Healthscope Whirlpool |
$2,673.06
|
| Rate for Payer: Mclaren Commercial |
$2,480.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$2,259.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,425.04
|
|
|
HC ILIAC ANGIOGRAPHY W/HEART CATH
|
Facility
|
OP
|
$2,755.73
|
|
|
Service Code
|
HCPCS G0278
|
| Hospital Charge Code |
48100053
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,102.29 |
| Max. Negotiated Rate |
$2,755.73 |
| Rate for Payer: Aetna Commercial |
$2,480.16
|
| Rate for Payer: Aetna Medicare |
$1,377.86
|
| Rate for Payer: ASR ASR |
$2,673.06
|
| Rate for Payer: ASR Commercial |
$2,673.06
|
| Rate for Payer: BCBS Complete |
$1,102.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,256.67
|
| Rate for Payer: BCN Commercial |
$2,136.52
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,590.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Healthscope Commercial |
$2,755.73
|
| Rate for Payer: Healthscope Whirlpool |
$2,673.06
|
| Rate for Payer: Mclaren Commercial |
$2,480.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$2,259.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,414.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,931.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,425.04
|
|
|
HC IMFLUOR 1ST AB STAIN (BILL ONLY)
|
Facility
|
OP
|
$139.38
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
31000086
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.99 |
| Max. Negotiated Rate |
$260.24 |
| Rate for Payer: Aetna Commercial |
$125.44
|
| Rate for Payer: Aetna Medicare |
$167.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: ASR ASR |
$135.20
|
| Rate for Payer: ASR Commercial |
$135.20
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$114.14
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$111.50
|
| Rate for Payer: Cash Price |
$111.50
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$139.38
|
| Rate for Payer: Healthscope Whirlpool |
$135.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$167.90
|
| Rate for Payer: Mclaren Commercial |
$125.44
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.47
|
| Rate for Payer: Nomi Health Commercial |
$114.29
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$184.69
|
| Rate for Payer: PHP Medicaid |
$89.99
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.12
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$97.71
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$260.24
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP DNSP |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: VA VA |
$167.90
|
|
|
HC IMFLUOR 1ST AB STAIN (BILL ONLY)
|
Facility
|
IP
|
$139.38
|
|
|
Service Code
|
CPT 88346
|
| Hospital Charge Code |
31000086
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$90.60 |
| Max. Negotiated Rate |
$139.38 |
| Rate for Payer: Aetna Commercial |
$125.44
|
| Rate for Payer: ASR ASR |
$135.20
|
| Rate for Payer: ASR Commercial |
$135.20
|
| Rate for Payer: BCBS Trust/PPO |
$113.58
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: Cash Price |
$111.50
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.50
|
| Rate for Payer: Healthscope Commercial |
$139.38
|
| Rate for Payer: Healthscope Whirlpool |
$135.20
|
| Rate for Payer: Mclaren Commercial |
$125.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.47
|
| Rate for Payer: Nomi Health Commercial |
$114.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$122.65
|
|
|
HC IMFLUOR EACH ADDL AB STAIN (BILL ONLY)
|
Facility
|
IP
|
$105.99
|
|
|
Service Code
|
CPT 88350
|
| Hospital Charge Code |
31000085
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.89 |
| Max. Negotiated Rate |
$105.99 |
| Rate for Payer: Aetna Commercial |
$95.39
|
| Rate for Payer: ASR ASR |
$102.81
|
| Rate for Payer: ASR Commercial |
$102.81
|
| Rate for Payer: BCBS Trust/PPO |
$86.37
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: Cash Price |
$84.79
|
| Rate for Payer: Cofinity Commercial |
$99.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.79
|
| Rate for Payer: Healthscope Commercial |
$105.99
|
| Rate for Payer: Healthscope Whirlpool |
$102.81
|
| Rate for Payer: Mclaren Commercial |
$95.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.09
|
| Rate for Payer: Nomi Health Commercial |
$86.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.27
|
|
|
HC IMFLUOR EACH ADDL AB STAIN (BILL ONLY)
|
Facility
|
OP
|
$105.99
|
|
|
Service Code
|
CPT 88350
|
| Hospital Charge Code |
31000085
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.40 |
| Max. Negotiated Rate |
$105.99 |
| Rate for Payer: Aetna Commercial |
$95.39
|
| Rate for Payer: Aetna Medicare |
$53.00
|
| Rate for Payer: ASR ASR |
$102.81
|
| Rate for Payer: ASR Commercial |
$102.81
|
| Rate for Payer: BCBS Complete |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$86.80
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: Cash Price |
$84.79
|
| Rate for Payer: Cofinity Commercial |
$99.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.79
|
| Rate for Payer: Healthscope Commercial |
$105.99
|
| Rate for Payer: Healthscope Whirlpool |
$102.81
|
| Rate for Payer: Mclaren Commercial |
$95.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.09
|
| Rate for Payer: Nomi Health Commercial |
$86.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.87
|
| Rate for Payer: Priority Health Narrow Network |
$74.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.27
|
|
|
HC IMMATURE PLATELET FRACTION
|
Facility
|
OP
|
$61.07
|
|
|
Service Code
|
CPT 85055
|
| Hospital Charge Code |
30500013
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$61.07 |
| Rate for Payer: Aetna Commercial |
$54.96
|
| Rate for Payer: Aetna Medicare |
$35.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.68
|
| Rate for Payer: ASR ASR |
$59.24
|
| Rate for Payer: ASR Commercial |
$59.24
|
| Rate for Payer: BCBS Complete |
$20.11
|
| Rate for Payer: BCBS MAPPO |
$35.74
|
| Rate for Payer: BCBS Trust/PPO |
$50.01
|
| Rate for Payer: BCN Commercial |
$47.35
|
| Rate for Payer: BCN Medicare Advantage |
$35.74
|
| Rate for Payer: Cash Price |
$48.86
|
| Rate for Payer: Cash Price |
$48.86
|
| Rate for Payer: Cofinity Commercial |
$57.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.74
|
| Rate for Payer: Healthscope Commercial |
$61.07
|
| Rate for Payer: Healthscope Whirlpool |
$59.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.74
|
| Rate for Payer: Mclaren Commercial |
$54.96
|
| Rate for Payer: Mclaren Medicaid |
$19.16
|
| Rate for Payer: Mclaren Medicare |
$35.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.53
|
| Rate for Payer: Meridian Medicaid |
$20.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.91
|
| Rate for Payer: Nomi Health Commercial |
$50.08
|
| Rate for Payer: PACE Medicare |
$33.95
|
| Rate for Payer: PACE SWMI |
$35.74
|
| Rate for Payer: PHP Commercial |
$39.31
|
| Rate for Payer: PHP Medicaid |
$19.16
|
| Rate for Payer: PHP Medicare Advantage |
$35.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.51
|
| Rate for Payer: Priority Health Medicare |
$35.74
|
| Rate for Payer: Priority Health Narrow Network |
$42.81
|
| Rate for Payer: Railroad Medicare Medicare |
$35.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.74
|
| Rate for Payer: UHC Exchange |
$55.40
|
| Rate for Payer: UHC Medicare Advantage |
$35.74
|
| Rate for Payer: UHCCP DNSP |
$35.74
|
| Rate for Payer: UHCCP Medicaid |
$19.16
|
| Rate for Payer: VA VA |
$35.74
|
|
|
HC IMMATURE PLATELET FRACTION
|
Facility
|
IP
|
$61.07
|
|
|
Service Code
|
CPT 85055
|
| Hospital Charge Code |
30500013
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$61.07 |
| Rate for Payer: Aetna Commercial |
$54.96
|
| Rate for Payer: ASR ASR |
$59.24
|
| Rate for Payer: ASR Commercial |
$59.24
|
| Rate for Payer: BCBS Trust/PPO |
$49.77
|
| Rate for Payer: BCN Commercial |
$47.35
|
| Rate for Payer: Cash Price |
$48.86
|
| Rate for Payer: Cofinity Commercial |
$57.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.86
|
| Rate for Payer: Healthscope Commercial |
$61.07
|
| Rate for Payer: Healthscope Whirlpool |
$59.24
|
| Rate for Payer: Mclaren Commercial |
$54.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.91
|
| Rate for Payer: Nomi Health Commercial |
$50.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.74
|
|
|
HC IMMUNIZATION 18YEARS OR YOUNGER
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 90460
|
| Hospital Charge Code |
77100001
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Trust/PPO |
$24.94
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC IMMUNIZATION 18YEARS OR YOUNGER
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 90460
|
| Hospital Charge Code |
77100001
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$28.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.81
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
|
|
HC IMMUNIZATION 1ST VACCINE
|
Facility
|
OP
|
$33.66
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
77100003
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$108.08 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: Aetna Medicare |
$69.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.16
|
| Rate for Payer: ASR ASR |
$32.65
|
| Rate for Payer: ASR Commercial |
$32.65
|
| Rate for Payer: BCBS Complete |
$39.24
|
| Rate for Payer: BCBS MAPPO |
$69.73
|
| Rate for Payer: BCBS Trust/PPO |
$27.56
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: BCN Medicare Advantage |
$69.73
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$31.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.73
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.73
|
| Rate for Payer: Mclaren Commercial |
$30.29
|
| Rate for Payer: Mclaren Medicaid |
$37.38
|
| Rate for Payer: Mclaren Medicare |
$69.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.22
|
| Rate for Payer: Meridian Medicaid |
$39.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.61
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: PACE Medicare |
$66.24
|
| Rate for Payer: PACE SWMI |
$69.73
|
| Rate for Payer: PHP Commercial |
$76.70
|
| Rate for Payer: PHP Medicaid |
$37.38
|
| Rate for Payer: PHP Medicare Advantage |
$69.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.38
|
| Rate for Payer: Priority Health Medicare |
$69.73
|
| Rate for Payer: Priority Health Narrow Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$69.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.73
|
| Rate for Payer: UHC Exchange |
$108.08
|
| Rate for Payer: UHC Medicare Advantage |
$69.73
|
| Rate for Payer: UHCCP DNSP |
$69.73
|
| Rate for Payer: UHCCP Medicaid |
$37.38
|
| Rate for Payer: VA VA |
$69.73
|
|
|
HC IMMUNIZATION 1ST VACCINE
|
Facility
|
IP
|
$33.66
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
77100003
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.88 |
| Max. Negotiated Rate |
$33.66 |
| Rate for Payer: Aetna Commercial |
$30.29
|
| Rate for Payer: ASR ASR |
$32.65
|
| Rate for Payer: ASR Commercial |
$32.65
|
| Rate for Payer: BCBS Trust/PPO |
$27.43
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Commercial |
$31.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Healthscope Commercial |
$33.66
|
| Rate for Payer: Healthscope Whirlpool |
$32.65
|
| Rate for Payer: Mclaren Commercial |
$30.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.61
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.62
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE
|
Facility
|
IP
|
$34.12
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
77100004
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$22.18 |
| Max. Negotiated Rate |
$34.12 |
| Rate for Payer: Aetna Commercial |
$30.71
|
| Rate for Payer: ASR ASR |
$33.10
|
| Rate for Payer: ASR Commercial |
$33.10
|
| Rate for Payer: BCBS Trust/PPO |
$27.80
|
| Rate for Payer: BCN Commercial |
$26.45
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$32.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$34.12
|
| Rate for Payer: Healthscope Whirlpool |
$33.10
|
| Rate for Payer: Mclaren Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.03
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE
|
Facility
|
OP
|
$34.12
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
77100004
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$34.12 |
| Rate for Payer: Aetna Commercial |
$30.71
|
| Rate for Payer: Aetna Medicare |
$17.06
|
| Rate for Payer: ASR ASR |
$33.10
|
| Rate for Payer: ASR Commercial |
$33.10
|
| Rate for Payer: BCBS Complete |
$13.65
|
| Rate for Payer: BCBS Trust/PPO |
$27.94
|
| Rate for Payer: BCN Commercial |
$26.45
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cash Price |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$32.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$34.12
|
| Rate for Payer: Healthscope Whirlpool |
$33.10
|
| Rate for Payer: Mclaren Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.00
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.38
|
| Rate for Payer: Priority Health Narrow Network |
$14.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.03
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: ASR Commercial |
$24.74
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$20.88
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.34
|
| Rate for Payer: Priority Health Narrow Network |
$17.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC IMMUNIZATION EACH ADDL VACCINE 18 YEARS OR YOUNGER
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 90461
|
| Hospital Charge Code |
77100002
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$22.95
|
| Rate for Payer: ASR ASR |
$24.74
|
| Rate for Payer: ASR Commercial |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$20.78
|
| Rate for Payer: BCN Commercial |
$19.77
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$23.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$25.50
|
| Rate for Payer: Healthscope Whirlpool |
$24.74
|
| Rate for Payer: Mclaren Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.44
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
OP
|
$37.54
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$108.08 |
| Rate for Payer: Aetna Commercial |
$33.79
|
| Rate for Payer: Aetna Medicare |
$69.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.16
|
| Rate for Payer: ASR ASR |
$36.41
|
| Rate for Payer: ASR Commercial |
$36.41
|
| Rate for Payer: BCBS Complete |
$39.24
|
| Rate for Payer: BCBS MAPPO |
$69.73
|
| Rate for Payer: BCBS Trust/PPO |
$30.74
|
| Rate for Payer: BCN Commercial |
$29.10
|
| Rate for Payer: BCN Medicare Advantage |
$69.73
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cofinity Commercial |
$35.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.73
|
| Rate for Payer: Healthscope Commercial |
$37.54
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$69.73
|
| Rate for Payer: Mclaren Commercial |
$33.79
|
| Rate for Payer: Mclaren Medicaid |
$37.38
|
| Rate for Payer: Mclaren Medicare |
$69.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.22
|
| Rate for Payer: Meridian Medicaid |
$39.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.91
|
| Rate for Payer: Nomi Health Commercial |
$30.78
|
| Rate for Payer: PACE Medicare |
$66.24
|
| Rate for Payer: PACE SWMI |
$69.73
|
| Rate for Payer: PHP Commercial |
$76.70
|
| Rate for Payer: PHP Medicaid |
$37.38
|
| Rate for Payer: PHP Medicare Advantage |
$69.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.89
|
| Rate for Payer: Priority Health Medicare |
$69.73
|
| Rate for Payer: Priority Health Narrow Network |
$26.32
|
| Rate for Payer: Railroad Medicare Medicare |
$69.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.73
|
| Rate for Payer: UHC Exchange |
$108.08
|
| Rate for Payer: UHC Medicare Advantage |
$69.73
|
| Rate for Payer: UHCCP DNSP |
$69.73
|
| Rate for Payer: UHCCP Medicaid |
$37.38
|
| Rate for Payer: VA VA |
$69.73
|
|
|
HC IMMUNIZATION NASAL ORAL 1ST
|
Facility
|
IP
|
$37.54
|
|
|
Service Code
|
CPT 90473
|
| Hospital Charge Code |
77100005
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$37.54 |
| Rate for Payer: Aetna Commercial |
$33.79
|
| Rate for Payer: ASR ASR |
$36.41
|
| Rate for Payer: ASR Commercial |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$30.59
|
| Rate for Payer: BCN Commercial |
$29.10
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cofinity Commercial |
$35.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.03
|
| Rate for Payer: Healthscope Commercial |
$37.54
|
| Rate for Payer: Healthscope Whirlpool |
$36.41
|
| Rate for Payer: Mclaren Commercial |
$33.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.91
|
| Rate for Payer: Nomi Health Commercial |
$30.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.04
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
OP
|
$27.54
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: ASR ASR |
$26.71
|
| Rate for Payer: ASR Commercial |
$26.71
|
| Rate for Payer: BCBS Complete |
$11.02
|
| Rate for Payer: BCBS Trust/PPO |
$22.55
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Healthscope Whirlpool |
$26.71
|
| Rate for Payer: Mclaren Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.41
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.13
|
| Rate for Payer: Priority Health Narrow Network |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.24
|
|
|
HC IMMUNIZATION ORAL/NASL EA ADD
|
Facility
|
IP
|
$27.54
|
|
|
Service Code
|
CPT 90474
|
| Hospital Charge Code |
77100006
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.90 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$24.79
|
| Rate for Payer: ASR ASR |
$26.71
|
| Rate for Payer: ASR Commercial |
$26.71
|
| Rate for Payer: BCBS Trust/PPO |
$22.44
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Healthscope Whirlpool |
$26.71
|
| Rate for Payer: Mclaren Commercial |
$24.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.41
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.24
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$210.82 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: ASR Commercial |
$24.22
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$20.45
|
| Rate for Payer: BCN Commercial |
$19.36
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$24.97
|
| Rate for Payer: Healthscope Whirlpool |
$24.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
|
HC IMMUNOASSAY MULTI STEP
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$24.97 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: ASR ASR |
$24.22
|
| Rate for Payer: ASR Commercial |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.35
|
| Rate for Payer: BCN Commercial |
$19.36
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$23.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$24.97
|
| Rate for Payer: Healthscope Whirlpool |
$24.22
|
| Rate for Payer: Mclaren Commercial |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.97
|
|
|
HC IMMUNOASSAY MULTI STEP ADDITIONAL
|
Facility
|
OP
|
$39.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100658
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$210.82 |
| Rate for Payer: Aetna Commercial |
$35.12
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: ASR ASR |
$37.85
|
| Rate for Payer: ASR Commercial |
$37.85
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$31.95
|
| Rate for Payer: BCN Commercial |
$30.25
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$36.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$39.02
|
| Rate for Payer: Healthscope Whirlpool |
$37.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.53
|
| Rate for Payer: Mclaren Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$12.68
|
| Rate for Payer: PHP Medicaid |
$6.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.87
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP DNSP |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: VA VA |
$11.53
|
|
