|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$30.00
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$30.00
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.30
|
| Rate for Payer: Priority Health Narrow Network |
$21.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$30.00
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
OP
|
$30.00
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$23.26
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.30
|
| Rate for Payer: Priority Health Narrow Network |
$21.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
OP
|
$825.00
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: Aetna Commercial |
$742.50
|
| Rate for Payer: ASR ASR |
$800.25
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS Trust/PPO |
$639.62
|
| Rate for Payer: BCN Commercial |
$639.62
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$775.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Healthscope Commercial |
$825.00
|
| Rate for Payer: Healthscope Whirlpool |
$800.25
|
| Rate for Payer: Mclaren Commercial |
$742.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$701.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$750.75
|
| Rate for Payer: Priority Health Narrow Network |
$585.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.00
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
IP
|
$825.00
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$577.50 |
| Max. Negotiated Rate |
$825.00 |
| Rate for Payer: Aetna Commercial |
$742.50
|
| Rate for Payer: ASR ASR |
$800.25
|
| Rate for Payer: BCBS Trust/PPO |
$639.62
|
| Rate for Payer: BCN Commercial |
$639.62
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$775.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Healthscope Commercial |
$825.00
|
| Rate for Payer: Healthscope Whirlpool |
$800.25
|
| Rate for Payer: Mclaren Commercial |
$742.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$701.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$726.00
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
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 RESPIRATORY ALLERGEN PROFILE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
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 RESPIRATORY FLOW VOLUME
|
Facility
|
OP
|
$174.91
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$122.44 |
| Max. Negotiated Rate |
$348.75 |
| Rate for Payer: Aetna Commercial |
$157.42
|
| 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 |
$169.66
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$135.61
|
| Rate for Payer: BCN Commercial |
$135.61
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$139.93
|
| Rate for Payer: Cash Price |
$139.93
|
| Rate for Payer: Cofinity Commercial |
$164.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$174.91
|
| Rate for Payer: Healthscope Whirlpool |
$169.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$279.00
|
| Rate for Payer: Mclaren Commercial |
$157.42
|
| 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 |
$148.67
|
| 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 |
$122.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.17
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$124.19
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.92
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: VA VA |
$279.00
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
IP
|
$174.91
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$122.44 |
| Max. Negotiated Rate |
$174.91 |
| Rate for Payer: Aetna Commercial |
$157.42
|
| Rate for Payer: ASR ASR |
$169.66
|
| Rate for Payer: BCBS Trust/PPO |
$135.61
|
| Rate for Payer: BCN Commercial |
$135.61
|
| Rate for Payer: Cash Price |
$139.93
|
| Rate for Payer: Cofinity Commercial |
$164.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.93
|
| Rate for Payer: Healthscope Commercial |
$174.91
|
| Rate for Payer: Healthscope Whirlpool |
$169.66
|
| Rate for Payer: Mclaren Commercial |
$157.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$148.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.92
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$2,541.00
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$337.26 |
| Max. Negotiated Rate |
$2,541.00 |
| Rate for Payer: Aetna Commercial |
$2,286.90
|
| Rate for Payer: Aetna Commercial |
$930.54
|
| Rate for Payer: ASR ASR |
$1,002.91
|
| Rate for Payer: ASR ASR |
$2,464.77
|
| Rate for Payer: BCBS Complete |
$1,016.40
|
| Rate for Payer: BCBS Complete |
$413.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,970.04
|
| Rate for Payer: BCBS Trust/PPO |
$801.61
|
| Rate for Payer: BCN Commercial |
$801.61
|
| Rate for Payer: BCN Commercial |
$1,970.04
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cofinity Commercial |
$971.89
|
| Rate for Payer: Cofinity Commercial |
$2,388.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,032.80
|
| Rate for Payer: Healthscope Commercial |
$1,033.93
|
| Rate for Payer: Healthscope Commercial |
$2,541.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,464.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.91
|
| Rate for Payer: Mclaren Commercial |
$930.54
|
| Rate for Payer: Mclaren Commercial |
$2,286.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,159.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,778.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.58
|
| Rate for Payer: Priority Health Narrow Network |
$337.26
|
| Rate for Payer: Priority Health Narrow Network |
$337.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,236.08
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$2,541.00
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,778.70 |
| Max. Negotiated Rate |
$2,541.00 |
| Rate for Payer: Aetna Commercial |
$2,286.90
|
| Rate for Payer: Aetna Commercial |
$930.54
|
| Rate for Payer: ASR ASR |
$1,002.91
|
| Rate for Payer: ASR ASR |
$2,464.77
|
| Rate for Payer: BCBS Trust/PPO |
$801.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,970.04
|
| Rate for Payer: BCN Commercial |
$801.61
|
| Rate for Payer: BCN Commercial |
$1,970.04
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cofinity Commercial |
$2,388.54
|
| Rate for Payer: Cofinity Commercial |
$971.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,032.80
|
| Rate for Payer: Healthscope Commercial |
$1,033.93
|
| Rate for Payer: Healthscope Commercial |
$2,541.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,464.77
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.91
|
| Rate for Payer: Mclaren Commercial |
$2,286.90
|
| Rate for Payer: Mclaren Commercial |
$930.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,159.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,778.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$909.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,236.08
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$99.60
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$99.60 |
| Rate for Payer: Aetna Commercial |
$89.64
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: ASR ASR |
$96.61
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$77.22
|
| Rate for Payer: BCN Commercial |
$77.22
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cofinity Commercial |
$93.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$99.60
|
| Rate for Payer: Healthscope Whirlpool |
$96.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.10
|
| Rate for Payer: Mclaren Commercial |
$89.64
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.66
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$14.41
|
| Rate for Payer: PHP Medicaid |
$7.17
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.64
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$70.72
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.65
|
| Rate for Payer: UHC Medicare Advantage |
$13.49
|
| Rate for Payer: VA VA |
$13.10
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$99.60
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$69.72 |
| Max. Negotiated Rate |
$99.60 |
| Rate for Payer: Aetna Commercial |
$89.64
|
| Rate for Payer: ASR ASR |
$96.61
|
| Rate for Payer: BCBS Trust/PPO |
$77.22
|
| Rate for Payer: BCN Commercial |
$77.22
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cofinity Commercial |
$93.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.68
|
| Rate for Payer: Healthscope Commercial |
$99.60
|
| Rate for Payer: Healthscope Whirlpool |
$96.61
|
| Rate for Payer: Mclaren Commercial |
$89.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.65
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$71.80
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$71.80 |
| Rate for Payer: Aetna Commercial |
$64.62
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.78
|
| Rate for Payer: ASR ASR |
$69.65
|
| Rate for Payer: BCBS Complete |
$7.71
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$55.67
|
| Rate for Payer: BCN Commercial |
$55.67
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$57.44
|
| Rate for Payer: Cash Price |
$57.44
|
| Rate for Payer: Cofinity Commercial |
$67.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$71.80
|
| Rate for Payer: Healthscope Whirlpool |
$69.65
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.42
|
| Rate for Payer: Mclaren Commercial |
$64.62
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$7.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.03
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$14.76
|
| Rate for Payer: PHP Medicaid |
$7.34
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.34
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$50.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
| Rate for Payer: UHC Medicare Advantage |
$13.82
|
| Rate for Payer: VA VA |
$13.42
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$71.80
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.26 |
| Max. Negotiated Rate |
$71.80 |
| Rate for Payer: Aetna Commercial |
$64.62
|
| Rate for Payer: ASR ASR |
$69.65
|
| Rate for Payer: BCBS Trust/PPO |
$55.67
|
| Rate for Payer: BCN Commercial |
$55.67
|
| Rate for Payer: Cash Price |
$57.44
|
| Rate for Payer: Cofinity Commercial |
$67.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.44
|
| Rate for Payer: Healthscope Commercial |
$71.80
|
| Rate for Payer: Healthscope Whirlpool |
$69.65
|
| Rate for Payer: Mclaren Commercial |
$64.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.18
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: ASR ASR |
$66.93
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$53.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Healthscope Whirlpool |
$66.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.98
|
| Rate for Payer: Mclaren Commercial |
$62.10
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$13.18
|
| Rate for Payer: PHP Medicaid |
$6.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.79
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$48.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: ASR ASR |
$66.93
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$53.50
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Healthscope Whirlpool |
$66.93
|
| Rate for Payer: Mclaren Commercial |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$4,931.74
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,452.22 |
| Max. Negotiated Rate |
$4,931.74 |
| Rate for Payer: Aetna Commercial |
$4,438.57
|
| Rate for Payer: ASR ASR |
$4,783.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,823.58
|
| Rate for Payer: BCN Commercial |
$3,823.58
|
| Rate for Payer: Cash Price |
$3,945.39
|
| Rate for Payer: Cofinity Commercial |
$4,635.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,945.39
|
| Rate for Payer: Healthscope Commercial |
$4,931.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,783.79
|
| Rate for Payer: Mclaren Commercial |
$4,438.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,191.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,452.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,339.93
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$4,931.74
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$185.80 |
| Max. Negotiated Rate |
$4,931.74 |
| Rate for Payer: Aetna Commercial |
$4,438.57
|
| Rate for Payer: Aetna Medicare |
$339.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$424.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$424.60
|
| Rate for Payer: ASR ASR |
$4,783.79
|
| Rate for Payer: BCBS Complete |
$195.11
|
| Rate for Payer: BCBS MAPPO |
$339.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,823.58
|
| Rate for Payer: BCN Commercial |
$3,823.58
|
| Rate for Payer: BCN Medicare Advantage |
$339.68
|
| Rate for Payer: Cash Price |
$3,945.39
|
| Rate for Payer: Cash Price |
$3,945.39
|
| Rate for Payer: Cofinity Commercial |
$4,635.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,945.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.68
|
| Rate for Payer: Healthscope Commercial |
$4,931.74
|
| Rate for Payer: Healthscope Whirlpool |
$4,783.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$339.68
|
| Rate for Payer: Mclaren Commercial |
$4,438.57
|
| Rate for Payer: Mclaren Medicaid |
$185.80
|
| Rate for Payer: Mclaren Medicare |
$339.68
|
| Rate for Payer: Meridian Medicaid |
$195.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$356.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$390.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,191.98
|
| Rate for Payer: PACE Medicare |
$322.70
|
| Rate for Payer: PACE SWMI |
$339.68
|
| Rate for Payer: PHP Commercial |
$373.65
|
| Rate for Payer: PHP Medicaid |
$185.80
|
| Rate for Payer: PHP Medicare Advantage |
$339.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,452.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,487.88
|
| Rate for Payer: Priority Health Medicare |
$339.68
|
| Rate for Payer: Priority Health Narrow Network |
$3,501.54
|
| Rate for Payer: Railroad Medicare Medicare |
$339.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,339.93
|
| Rate for Payer: UHC Medicare Advantage |
$349.87
|
| Rate for Payer: VA VA |
$339.68
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$22.00 |
| Rate for Payer: Aetna Commercial |
$19.80
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: ASR ASR |
$21.34
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$17.06
|
| Rate for Payer: BCN Commercial |
$17.06
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$20.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$22.00
|
| Rate for Payer: Healthscope Whirlpool |
$21.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.10
|
| Rate for Payer: Mclaren Commercial |
$19.80
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.70
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$14.41
|
| Rate for Payer: PHP Medicaid |
$7.17
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.02
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$15.62
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.36
|
| Rate for Payer: UHC Medicare Advantage |
$13.49
|
| Rate for Payer: VA VA |
$13.10
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$22.00 |
| Rate for Payer: Aetna Commercial |
$19.80
|
| Rate for Payer: ASR ASR |
$21.34
|
| Rate for Payer: BCBS Trust/PPO |
$17.06
|
| Rate for Payer: BCN Commercial |
$17.06
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$20.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.60
|
| Rate for Payer: Healthscope Commercial |
$22.00
|
| Rate for Payer: Healthscope Whirlpool |
$21.34
|
| Rate for Payer: Mclaren Commercial |
$19.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.36
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| 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 |
$59.36
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| 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 |
$52.02
|
| 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 |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$43.45
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: BCBS Trust/PPO |
$47.45
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
|
