|
HC ISOVUE 200 PER ML
|
Facility
|
OP
|
$4.46
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Aetna Commercial |
$4.01
|
| Rate for Payer: Aetna Medicare |
$2.23
|
| Rate for Payer: ASR ASR |
$4.33
|
| Rate for Payer: ASR Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: BCBS Trust/PPO |
$3.65
|
| Rate for Payer: BCN Commercial |
$3.46
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: Cofinity Commercial |
$4.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.57
|
| Rate for Payer: Healthscope Commercial |
$4.46
|
| Rate for Payer: Healthscope Whirlpool |
$4.33
|
| Rate for Payer: Mclaren Commercial |
$4.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.79
|
| Rate for Payer: Nomi Health Commercial |
$3.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.42
|
| Rate for Payer: Priority Health Narrow Network |
$0.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.92
|
|
|
HC ISOVUE 300M PER ML
|
Facility
|
OP
|
$1.94
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600034
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$2.19 |
| Rate for Payer: Aetna Commercial |
$1.75
|
| Rate for Payer: Aetna Medicare |
$0.97
|
| Rate for Payer: ASR ASR |
$1.88
|
| Rate for Payer: ASR Commercial |
$1.88
|
| Rate for Payer: BCBS Complete |
$0.78
|
| Rate for Payer: BCBS Trust/PPO |
$1.59
|
| Rate for Payer: BCN Commercial |
$1.50
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cofinity Commercial |
$1.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.55
|
| Rate for Payer: Healthscope Commercial |
$1.94
|
| Rate for Payer: Healthscope Whirlpool |
$1.88
|
| Rate for Payer: Mclaren Commercial |
$1.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.65
|
| Rate for Payer: Nomi Health Commercial |
$1.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.19
|
| Rate for Payer: Priority Health Narrow Network |
$1.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.71
|
|
|
HC ISOVUE 300M PER ML
|
Facility
|
IP
|
$1.94
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600034
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Aetna Commercial |
$1.75
|
| Rate for Payer: ASR ASR |
$1.88
|
| Rate for Payer: ASR Commercial |
$1.88
|
| Rate for Payer: BCBS Trust/PPO |
$1.58
|
| Rate for Payer: BCN Commercial |
$1.50
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cofinity Commercial |
$1.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.55
|
| Rate for Payer: Healthscope Commercial |
$1.94
|
| Rate for Payer: Healthscope Whirlpool |
$1.88
|
| Rate for Payer: Mclaren Commercial |
$1.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.65
|
| Rate for Payer: Nomi Health Commercial |
$1.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.71
|
|
|
HC ISOVUE 300 PER ML
|
Facility
|
OP
|
$1.67
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600012
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$2.19 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare |
$0.84
|
| Rate for Payer: ASR ASR |
$1.62
|
| Rate for Payer: ASR Commercial |
$1.62
|
| Rate for Payer: BCBS Complete |
$0.67
|
| Rate for Payer: BCBS Trust/PPO |
$1.37
|
| Rate for Payer: BCN Commercial |
$1.29
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.34
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Healthscope Whirlpool |
$1.62
|
| Rate for Payer: Mclaren Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.42
|
| Rate for Payer: Nomi Health Commercial |
$1.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.19
|
| Rate for Payer: Priority Health Narrow Network |
$1.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.47
|
|
|
HC ISOVUE 300 PER ML
|
Facility
|
IP
|
$1.67
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600012
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: ASR ASR |
$1.62
|
| Rate for Payer: ASR Commercial |
$1.62
|
| Rate for Payer: BCBS Trust/PPO |
$1.36
|
| Rate for Payer: BCN Commercial |
$1.29
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.34
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Healthscope Whirlpool |
$1.62
|
| Rate for Payer: Mclaren Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.42
|
| Rate for Payer: Nomi Health Commercial |
$1.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.47
|
|
|
HC ISOVUE 370 PER ML
|
Facility
|
OP
|
$1.90
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600013
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.76 |
| Max. Negotiated Rate |
$2.19 |
| Rate for Payer: Aetna Commercial |
$1.71
|
| Rate for Payer: Aetna Medicare |
$0.95
|
| Rate for Payer: ASR ASR |
$1.84
|
| Rate for Payer: ASR Commercial |
$1.84
|
| Rate for Payer: BCBS Complete |
$0.76
|
| Rate for Payer: BCBS Trust/PPO |
$1.56
|
| Rate for Payer: BCN Commercial |
$1.47
|
| Rate for Payer: Cash Price |
$1.52
|
| Rate for Payer: Cash Price |
$1.52
|
| Rate for Payer: Cofinity Commercial |
$1.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.52
|
| Rate for Payer: Healthscope Commercial |
$1.90
|
| Rate for Payer: Healthscope Whirlpool |
$1.84
|
| Rate for Payer: Mclaren Commercial |
$1.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.62
|
| Rate for Payer: Nomi Health Commercial |
$1.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.19
|
| Rate for Payer: Priority Health Narrow Network |
$1.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.67
|
|
|
HC ISOVUE 370 PER ML
|
Facility
|
IP
|
$1.90
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600013
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$1.90 |
| Rate for Payer: Aetna Commercial |
$1.71
|
| Rate for Payer: ASR ASR |
$1.84
|
| Rate for Payer: ASR Commercial |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.55
|
| Rate for Payer: BCN Commercial |
$1.47
|
| Rate for Payer: Cash Price |
$1.52
|
| Rate for Payer: Cofinity Commercial |
$1.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.52
|
| Rate for Payer: Healthscope Commercial |
$1.90
|
| Rate for Payer: Healthscope Whirlpool |
$1.84
|
| Rate for Payer: Mclaren Commercial |
$1.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.62
|
| Rate for Payer: Nomi Health Commercial |
$1.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.67
|
|
|
HC IUD REMOVAL
|
Facility
|
IP
|
$321.69
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
45000086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.10 |
| Max. Negotiated Rate |
$321.69 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: ASR ASR |
$312.04
|
| Rate for Payer: ASR Commercial |
$312.04
|
| Rate for Payer: BCBS Trust/PPO |
$262.15
|
| Rate for Payer: BCN Commercial |
$249.41
|
| Rate for Payer: Cash Price |
$257.35
|
| Rate for Payer: Cofinity Commercial |
$302.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.35
|
| Rate for Payer: Healthscope Commercial |
$321.69
|
| Rate for Payer: Healthscope Whirlpool |
$312.04
|
| Rate for Payer: Mclaren Commercial |
$289.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.44
|
| Rate for Payer: Nomi Health Commercial |
$263.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.09
|
|
|
HC IUD REMOVAL
|
Facility
|
OP
|
$321.69
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
45000086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$312.04
|
| Rate for Payer: ASR Commercial |
$312.04
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$263.43
|
| Rate for Payer: BCN Commercial |
$249.41
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$257.35
|
| Rate for Payer: Cash Price |
$257.35
|
| Rate for Payer: Cofinity Commercial |
$302.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$321.69
|
| Rate for Payer: Healthscope Whirlpool |
$312.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$289.52
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.44
|
| Rate for Payer: Nomi Health Commercial |
$263.79
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.06
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$197.65
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
HC IUPC ASSIST
|
Facility
|
IP
|
$119.72
|
|
| Hospital Charge Code |
27000120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.82 |
| Max. Negotiated Rate |
$119.72 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: ASR ASR |
$116.13
|
| Rate for Payer: ASR Commercial |
$116.13
|
| Rate for Payer: BCBS Trust/PPO |
$97.56
|
| Rate for Payer: BCN Commercial |
$92.82
|
| Rate for Payer: Cash Price |
$95.78
|
| Rate for Payer: Cofinity Commercial |
$112.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.78
|
| Rate for Payer: Healthscope Commercial |
$119.72
|
| Rate for Payer: Healthscope Whirlpool |
$116.13
|
| Rate for Payer: Mclaren Commercial |
$107.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.76
|
| Rate for Payer: Nomi Health Commercial |
$98.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.35
|
|
|
HC IUPC ASSIST
|
Facility
|
OP
|
$119.72
|
|
| Hospital Charge Code |
27000120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.89 |
| Max. Negotiated Rate |
$119.72 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$59.86
|
| Rate for Payer: ASR ASR |
$116.13
|
| Rate for Payer: ASR Commercial |
$116.13
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: BCBS Trust/PPO |
$98.04
|
| Rate for Payer: BCN Commercial |
$92.82
|
| Rate for Payer: Cash Price |
$95.78
|
| Rate for Payer: Cofinity Commercial |
$112.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.78
|
| Rate for Payer: Healthscope Commercial |
$119.72
|
| Rate for Payer: Healthscope Whirlpool |
$116.13
|
| Rate for Payer: Mclaren Commercial |
$107.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.76
|
| Rate for Payer: Nomi Health Commercial |
$98.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.90
|
| Rate for Payer: Priority Health Narrow Network |
$83.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.35
|
|
|
HC IV 0.45% NS 1000
|
Facility
|
OP
|
$85.41
|
|
| Hospital Charge Code |
25000010
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$34.16 |
| Max. Negotiated Rate |
$85.41 |
| Rate for Payer: Aetna Commercial |
$76.87
|
| Rate for Payer: Aetna Medicare |
$42.70
|
| Rate for Payer: ASR ASR |
$82.85
|
| Rate for Payer: ASR Commercial |
$82.85
|
| Rate for Payer: BCBS Complete |
$34.16
|
| Rate for Payer: BCBS Trust/PPO |
$69.94
|
| Rate for Payer: BCN Commercial |
$66.22
|
| Rate for Payer: Cash Price |
$68.33
|
| Rate for Payer: Cofinity Commercial |
$80.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.33
|
| Rate for Payer: Healthscope Commercial |
$85.41
|
| Rate for Payer: Healthscope Whirlpool |
$82.85
|
| Rate for Payer: Mclaren Commercial |
$76.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.60
|
| Rate for Payer: Nomi Health Commercial |
$70.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.84
|
| Rate for Payer: Priority Health Narrow Network |
$59.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.16
|
|
|
HC IV 0.45% NS 1000
|
Facility
|
IP
|
$85.41
|
|
| Hospital Charge Code |
25000010
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$55.52 |
| Max. Negotiated Rate |
$85.41 |
| Rate for Payer: Aetna Commercial |
$76.87
|
| Rate for Payer: ASR ASR |
$82.85
|
| Rate for Payer: ASR Commercial |
$82.85
|
| Rate for Payer: BCBS Trust/PPO |
$69.60
|
| Rate for Payer: BCN Commercial |
$66.22
|
| Rate for Payer: Cash Price |
$68.33
|
| Rate for Payer: Cofinity Commercial |
$80.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.33
|
| Rate for Payer: Healthscope Commercial |
$85.41
|
| Rate for Payer: Healthscope Whirlpool |
$82.85
|
| Rate for Payer: Mclaren Commercial |
$76.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.60
|
| Rate for Payer: Nomi Health Commercial |
$70.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.16
|
|
|
HC IV HYDRATION ONLY, EACH ADDL HR
|
Facility
|
IP
|
$203.57
|
|
|
Service Code
|
CPT 96361
|
| Hospital Charge Code |
26000002
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$132.32 |
| Max. Negotiated Rate |
$203.57 |
| Rate for Payer: Aetna Commercial |
$183.21
|
| Rate for Payer: ASR ASR |
$197.46
|
| Rate for Payer: ASR Commercial |
$197.46
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$157.83
|
| Rate for Payer: Cash Price |
$162.86
|
| Rate for Payer: Cofinity Commercial |
$191.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.86
|
| Rate for Payer: Healthscope Commercial |
$203.57
|
| Rate for Payer: Healthscope Whirlpool |
$197.46
|
| Rate for Payer: Mclaren Commercial |
$183.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.03
|
| Rate for Payer: Nomi Health Commercial |
$166.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.14
|
|
|
HC IV HYDRATION ONLY, EACH ADDL HR
|
Facility
|
OP
|
$203.57
|
|
|
Service Code
|
CPT 96361
|
| Hospital Charge Code |
26000002
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$24.23 |
| Max. Negotiated Rate |
$203.57 |
| Rate for Payer: Aetna Commercial |
$183.21
|
| Rate for Payer: Aetna Medicare |
$45.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.51
|
| Rate for Payer: ASR ASR |
$197.46
|
| Rate for Payer: ASR Commercial |
$197.46
|
| Rate for Payer: BCBS Complete |
$25.44
|
| Rate for Payer: BCBS MAPPO |
$45.21
|
| Rate for Payer: BCBS Trust/PPO |
$166.70
|
| Rate for Payer: BCN Commercial |
$157.83
|
| Rate for Payer: BCN Medicare Advantage |
$45.21
|
| Rate for Payer: Cash Price |
$162.86
|
| Rate for Payer: Cash Price |
$162.86
|
| Rate for Payer: Cofinity Commercial |
$191.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.21
|
| Rate for Payer: Healthscope Commercial |
$203.57
|
| Rate for Payer: Healthscope Whirlpool |
$197.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$45.21
|
| Rate for Payer: Mclaren Commercial |
$183.21
|
| Rate for Payer: Mclaren Medicaid |
$24.23
|
| Rate for Payer: Mclaren Medicare |
$45.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.47
|
| Rate for Payer: Meridian Medicaid |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.03
|
| Rate for Payer: Nomi Health Commercial |
$166.93
|
| Rate for Payer: PACE Medicare |
$42.95
|
| Rate for Payer: PACE SWMI |
$45.21
|
| Rate for Payer: PHP Commercial |
$49.73
|
| Rate for Payer: PHP Medicaid |
$24.23
|
| Rate for Payer: PHP Medicare Advantage |
$45.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.98
|
| Rate for Payer: Priority Health Medicare |
$45.21
|
| Rate for Payer: Priority Health Narrow Network |
$53.58
|
| Rate for Payer: Railroad Medicare Medicare |
$45.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.21
|
| Rate for Payer: UHC Exchange |
$70.08
|
| Rate for Payer: UHC Medicare Advantage |
$45.21
|
| Rate for Payer: UHCCP DNSP |
$45.21
|
| Rate for Payer: UHCCP Medicaid |
$24.23
|
| Rate for Payer: VA VA |
$45.21
|
|
|
HC IV HYDRATION ONLY,INITIAL HR
|
Facility
|
IP
|
$510.24
|
|
|
Service Code
|
CPT 96360
|
| Hospital Charge Code |
26000001
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$331.66 |
| Max. Negotiated Rate |
$510.24 |
| Rate for Payer: Aetna Commercial |
$459.22
|
| Rate for Payer: ASR ASR |
$494.93
|
| Rate for Payer: ASR Commercial |
$494.93
|
| Rate for Payer: BCBS Trust/PPO |
$415.79
|
| Rate for Payer: BCN Commercial |
$395.59
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cofinity Commercial |
$479.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Healthscope Commercial |
$510.24
|
| Rate for Payer: Healthscope Whirlpool |
$494.93
|
| Rate for Payer: Mclaren Commercial |
$459.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Nomi Health Commercial |
$418.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.01
|
|
|
HC IV HYDRATION ONLY,INITIAL HR
|
Facility
|
OP
|
$510.24
|
|
|
Service Code
|
CPT 96360
|
| Hospital Charge Code |
26000001
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$110.65 |
| Max. Negotiated Rate |
$510.24 |
| Rate for Payer: Aetna Commercial |
$459.22
|
| Rate for Payer: Aetna Medicare |
$206.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: ASR ASR |
$494.93
|
| Rate for Payer: ASR Commercial |
$494.93
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$417.84
|
| Rate for Payer: BCN Commercial |
$395.59
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cash Price |
$408.19
|
| Rate for Payer: Cofinity Commercial |
$479.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$510.24
|
| Rate for Payer: Healthscope Whirlpool |
$494.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$206.43
|
| Rate for Payer: Mclaren Commercial |
$459.22
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.70
|
| Rate for Payer: Nomi Health Commercial |
$418.40
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$227.07
|
| Rate for Payer: PHP Medicaid |
$110.65
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.81
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$132.65
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$319.97
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP DNSP |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: VA VA |
$206.43
|
|
|
HC IV HYDRATION W/OBS, EACH ADDL HR
|
Facility
|
IP
|
$129.02
|
|
|
Service Code
|
CPT 96361
|
| Hospital Charge Code |
26000011
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$83.86 |
| Max. Negotiated Rate |
$129.02 |
| Rate for Payer: Aetna Commercial |
$116.12
|
| Rate for Payer: ASR ASR |
$125.15
|
| Rate for Payer: ASR Commercial |
$125.15
|
| Rate for Payer: BCBS Trust/PPO |
$105.14
|
| Rate for Payer: BCN Commercial |
$100.03
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$121.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Healthscope Commercial |
$129.02
|
| Rate for Payer: Healthscope Whirlpool |
$125.15
|
| Rate for Payer: Mclaren Commercial |
$116.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.67
|
| Rate for Payer: Nomi Health Commercial |
$105.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.54
|
|
|
HC IV HYDRATION W/OBS, EACH ADDL HR
|
Facility
|
OP
|
$129.02
|
|
|
Service Code
|
CPT 96361
|
| Hospital Charge Code |
26000011
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$24.23 |
| Max. Negotiated Rate |
$129.02 |
| Rate for Payer: Aetna Commercial |
$116.12
|
| Rate for Payer: Aetna Medicare |
$45.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.51
|
| Rate for Payer: ASR ASR |
$125.15
|
| Rate for Payer: ASR Commercial |
$125.15
|
| Rate for Payer: BCBS Complete |
$25.44
|
| Rate for Payer: BCBS MAPPO |
$45.21
|
| Rate for Payer: BCBS Trust/PPO |
$105.65
|
| Rate for Payer: BCN Commercial |
$100.03
|
| Rate for Payer: BCN Medicare Advantage |
$45.21
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$121.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.21
|
| Rate for Payer: Healthscope Commercial |
$129.02
|
| Rate for Payer: Healthscope Whirlpool |
$125.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$45.21
|
| Rate for Payer: Mclaren Commercial |
$116.12
|
| Rate for Payer: Mclaren Medicaid |
$24.23
|
| Rate for Payer: Mclaren Medicare |
$45.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.47
|
| Rate for Payer: Meridian Medicaid |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.67
|
| Rate for Payer: Nomi Health Commercial |
$105.80
|
| Rate for Payer: PACE Medicare |
$42.95
|
| Rate for Payer: PACE SWMI |
$45.21
|
| Rate for Payer: PHP Commercial |
$49.73
|
| Rate for Payer: PHP Medicaid |
$24.23
|
| Rate for Payer: PHP Medicare Advantage |
$45.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.98
|
| Rate for Payer: Priority Health Medicare |
$45.21
|
| Rate for Payer: Priority Health Narrow Network |
$53.58
|
| Rate for Payer: Railroad Medicare Medicare |
$45.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.21
|
| Rate for Payer: UHC Exchange |
$70.08
|
| Rate for Payer: UHC Medicare Advantage |
$45.21
|
| Rate for Payer: UHCCP DNSP |
$45.21
|
| Rate for Payer: UHCCP Medicaid |
$24.23
|
| Rate for Payer: VA VA |
$45.21
|
|
|
HC IV HYDRATION W/OBS, INITIAL HR
|
Facility
|
IP
|
$270.93
|
|
|
Service Code
|
CPT 96360
|
| Hospital Charge Code |
26000010
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$176.10 |
| Max. Negotiated Rate |
$270.93 |
| Rate for Payer: Aetna Commercial |
$243.84
|
| Rate for Payer: ASR ASR |
$262.80
|
| Rate for Payer: ASR Commercial |
$262.80
|
| Rate for Payer: BCBS Trust/PPO |
$220.78
|
| Rate for Payer: BCN Commercial |
$210.05
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$254.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Healthscope Commercial |
$270.93
|
| Rate for Payer: Healthscope Whirlpool |
$262.80
|
| Rate for Payer: Mclaren Commercial |
$243.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.29
|
| Rate for Payer: Nomi Health Commercial |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.42
|
|
|
HC IV HYDRATION W/OBS, INITIAL HR
|
Facility
|
OP
|
$270.93
|
|
|
Service Code
|
CPT 96360
|
| Hospital Charge Code |
26000010
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$110.65 |
| Max. Negotiated Rate |
$319.97 |
| Rate for Payer: Aetna Commercial |
$243.84
|
| Rate for Payer: Aetna Medicare |
$206.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: ASR ASR |
$262.80
|
| Rate for Payer: ASR Commercial |
$262.80
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$221.86
|
| Rate for Payer: BCN Commercial |
$210.05
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cash Price |
$216.74
|
| Rate for Payer: Cofinity Commercial |
$254.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$270.93
|
| Rate for Payer: Healthscope Whirlpool |
$262.80
|
| Rate for Payer: Humana Choice PPO Medicare |
$206.43
|
| Rate for Payer: Mclaren Commercial |
$243.84
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.29
|
| Rate for Payer: Nomi Health Commercial |
$222.16
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$227.07
|
| Rate for Payer: PHP Medicaid |
$110.65
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.81
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$132.65
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$319.97
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP DNSP |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: VA VA |
$206.43
|
|
|
HC IVIG INFUSION FIRST HOUR
|
Facility
|
IP
|
$688.17
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
26000004
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$447.31 |
| Max. Negotiated Rate |
$688.17 |
| Rate for Payer: Aetna Commercial |
$619.35
|
| Rate for Payer: ASR ASR |
$667.52
|
| Rate for Payer: ASR Commercial |
$667.52
|
| Rate for Payer: BCBS Trust/PPO |
$560.79
|
| Rate for Payer: BCN Commercial |
$533.54
|
| Rate for Payer: Cash Price |
$550.54
|
| Rate for Payer: Cofinity Commercial |
$646.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.54
|
| Rate for Payer: Healthscope Commercial |
$688.17
|
| Rate for Payer: Healthscope Whirlpool |
$667.52
|
| Rate for Payer: Mclaren Commercial |
$619.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.94
|
| Rate for Payer: Nomi Health Commercial |
$564.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.59
|
|
|
HC IVIG INFUSION FIRST HOUR
|
Facility
|
OP
|
$688.17
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
26000004
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$110.65 |
| Max. Negotiated Rate |
$688.17 |
| Rate for Payer: Aetna Commercial |
$619.35
|
| Rate for Payer: Aetna Medicare |
$206.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: ASR ASR |
$667.52
|
| Rate for Payer: ASR Commercial |
$667.52
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$563.54
|
| Rate for Payer: BCN Commercial |
$533.54
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$550.54
|
| Rate for Payer: Cash Price |
$550.54
|
| Rate for Payer: Cofinity Commercial |
$646.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$688.17
|
| Rate for Payer: Healthscope Whirlpool |
$667.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$206.43
|
| Rate for Payer: Mclaren Commercial |
$619.35
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$584.94
|
| Rate for Payer: Nomi Health Commercial |
$564.30
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$227.07
|
| Rate for Payer: PHP Medicaid |
$110.65
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.18
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$225.74
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$605.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$319.97
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP DNSP |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: VA VA |
$206.43
|
|
|
HC IV INF BAMLANIVIMAB/ETESEVIMAB
|
Facility
|
IP
|
$534.77
|
|
|
Service Code
|
CPT M0245
|
| Hospital Charge Code |
77100031
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$534.77 |
| Rate for Payer: Aetna Commercial |
$481.29
|
| Rate for Payer: ASR ASR |
$518.73
|
| Rate for Payer: ASR Commercial |
$518.73
|
| Rate for Payer: BCBS Trust/PPO |
$435.78
|
| Rate for Payer: BCN Commercial |
$414.61
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$502.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Healthscope Commercial |
$534.77
|
| Rate for Payer: Healthscope Whirlpool |
$518.73
|
| Rate for Payer: Mclaren Commercial |
$481.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.60
|
|
|
HC IV INF BAMLANIVIMAB/ETESEVIMAB
|
Facility
|
OP
|
$534.77
|
|
|
Service Code
|
CPT M0245
|
| Hospital Charge Code |
77100031
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$236.59 |
| Max. Negotiated Rate |
$684.15 |
| Rate for Payer: Aetna Commercial |
$481.29
|
| Rate for Payer: Aetna Medicare |
$441.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$551.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$551.74
|
| Rate for Payer: ASR ASR |
$518.73
|
| Rate for Payer: ASR Commercial |
$518.73
|
| Rate for Payer: BCBS Complete |
$248.41
|
| Rate for Payer: BCBS MAPPO |
$441.39
|
| Rate for Payer: BCBS Trust/PPO |
$437.92
|
| Rate for Payer: BCN Commercial |
$414.61
|
| Rate for Payer: BCN Medicare Advantage |
$441.39
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$502.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.39
|
| Rate for Payer: Healthscope Commercial |
$534.77
|
| Rate for Payer: Healthscope Whirlpool |
$518.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$441.39
|
| Rate for Payer: Mclaren Commercial |
$481.29
|
| Rate for Payer: Mclaren Medicaid |
$236.59
|
| Rate for Payer: Mclaren Medicare |
$441.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.46
|
| Rate for Payer: Meridian Medicaid |
$248.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$507.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: PACE Medicare |
$419.32
|
| Rate for Payer: PACE SWMI |
$441.39
|
| Rate for Payer: PHP Commercial |
$485.53
|
| Rate for Payer: PHP Medicaid |
$236.59
|
| Rate for Payer: PHP Medicare Advantage |
$441.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$468.57
|
| Rate for Payer: Priority Health Medicare |
$441.39
|
| Rate for Payer: Priority Health Narrow Network |
$374.87
|
| Rate for Payer: Railroad Medicare Medicare |
$441.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$470.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.39
|
| Rate for Payer: UHC Exchange |
$684.15
|
| Rate for Payer: UHC Medicare Advantage |
$441.39
|
| Rate for Payer: UHCCP DNSP |
$441.39
|
| Rate for Payer: UHCCP Medicaid |
$236.59
|
| Rate for Payer: VA VA |
$441.39
|
|
