|
HC MICROSPORIDIA DETECTION
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$22.89 |
| Rate for Payer: Aetna Commercial |
$20.60
|
| Rate for Payer: ASR ASR |
$22.20
|
| Rate for Payer: ASR Commercial |
$22.20
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCN Commercial |
$17.75
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$21.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$22.89
|
| Rate for Payer: Healthscope Whirlpool |
$22.20
|
| Rate for Payer: Mclaren Commercial |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.14
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$32.64 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.49
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: ASR Commercial |
$31.66
|
| Rate for Payer: BCBS Complete |
$3.37
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Healthscope Whirlpool |
$31.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.99
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Mclaren Medicaid |
$3.21
|
| Rate for Payer: Mclaren Medicare |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.29
|
| Rate for Payer: Meridian Medicaid |
$3.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: PACE Medicare |
$5.69
|
| Rate for Payer: PACE SWMI |
$5.99
|
| Rate for Payer: PHP Commercial |
$6.59
|
| Rate for Payer: PHP Medicaid |
$3.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow Network |
$22.88
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.99
|
| Rate for Payer: UHC Exchange |
$9.28
|
| Rate for Payer: UHC Medicare Advantage |
$5.99
|
| Rate for Payer: UHCCP DNSP |
$5.99
|
| Rate for Payer: UHCCP Medicaid |
$3.21
|
| Rate for Payer: VA VA |
$5.99
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$32.64 |
| Rate for Payer: Aetna Commercial |
$29.38
|
| Rate for Payer: ASR ASR |
$31.66
|
| Rate for Payer: ASR Commercial |
$31.66
|
| Rate for Payer: BCBS Trust/PPO |
$26.60
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$32.64
|
| Rate for Payer: Healthscope Whirlpool |
$31.66
|
| Rate for Payer: Mclaren Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.72
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$375.36 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| 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 |
$364.10
|
| Rate for Payer: ASR Commercial |
$364.10
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$307.38
|
| Rate for Payer: BCN Commercial |
$291.02
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$352.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$375.36
|
| Rate for Payer: Healthscope Whirlpool |
$364.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$337.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| 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 |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.89
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$263.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$243.98 |
| Max. Negotiated Rate |
$375.36 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: ASR ASR |
$364.10
|
| Rate for Payer: ASR Commercial |
$364.10
|
| Rate for Payer: BCBS Trust/PPO |
$305.88
|
| Rate for Payer: BCN Commercial |
$291.02
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$352.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$375.36
|
| Rate for Payer: Healthscope Whirlpool |
$364.10
|
| Rate for Payer: Mclaren Commercial |
$337.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.32
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$80.38 |
| Max. Negotiated Rate |
$200.94 |
| Rate for Payer: Aetna Commercial |
$180.85
|
| Rate for Payer: Aetna Medicare |
$100.47
|
| Rate for Payer: ASR ASR |
$194.91
|
| Rate for Payer: ASR Commercial |
$194.91
|
| Rate for Payer: BCBS Complete |
$80.38
|
| Rate for Payer: BCBS Trust/PPO |
$164.55
|
| Rate for Payer: BCN Commercial |
$155.79
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$188.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$200.94
|
| Rate for Payer: Healthscope Whirlpool |
$194.91
|
| Rate for Payer: Mclaren Commercial |
$180.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: Nomi Health Commercial |
$164.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.06
|
| Rate for Payer: Priority Health Narrow Network |
$140.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.83
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$130.61 |
| Max. Negotiated Rate |
$200.94 |
| Rate for Payer: Aetna Commercial |
$180.85
|
| Rate for Payer: ASR ASR |
$194.91
|
| Rate for Payer: ASR Commercial |
$194.91
|
| Rate for Payer: BCBS Trust/PPO |
$163.75
|
| Rate for Payer: BCN Commercial |
$155.79
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$188.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$200.94
|
| Rate for Payer: Healthscope Whirlpool |
$194.91
|
| Rate for Payer: Mclaren Commercial |
$180.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: Nomi Health Commercial |
$164.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.83
|
|
|
HC MILK IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| 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 |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.25
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC MILK IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$25.39 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: ASR ASR |
$24.63
|
| Rate for Payer: ASR Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$23.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$25.39
|
| Rate for Payer: Healthscope Whirlpool |
$24.63
|
| Rate for Payer: Mclaren Commercial |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.34
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$309.26
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$201.02 |
| Max. Negotiated Rate |
$309.26 |
| Rate for Payer: Aetna Commercial |
$278.33
|
| Rate for Payer: ASR ASR |
$299.98
|
| Rate for Payer: ASR Commercial |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$252.02
|
| Rate for Payer: BCN Commercial |
$239.77
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cofinity Commercial |
$290.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.41
|
| Rate for Payer: Healthscope Commercial |
$309.26
|
| Rate for Payer: Healthscope Whirlpool |
$299.98
|
| Rate for Payer: Mclaren Commercial |
$278.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.87
|
| Rate for Payer: Nomi Health Commercial |
$253.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.15
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
OP
|
$309.26
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$309.26 |
| Rate for Payer: Aetna Commercial |
$278.33
|
| Rate for Payer: Aetna Medicare |
$152.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: ASR ASR |
$299.98
|
| Rate for Payer: ASR Commercial |
$299.98
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCBS Trust/PPO |
$253.25
|
| Rate for Payer: BCN Commercial |
$239.77
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cofinity Commercial |
$290.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$309.26
|
| Rate for Payer: Healthscope Whirlpool |
$299.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$152.59
|
| Rate for Payer: Mclaren Commercial |
$278.33
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.87
|
| Rate for Payer: Nomi Health Commercial |
$253.59
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$167.85
|
| Rate for Payer: PHP Medicaid |
$81.79
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.97
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health Narrow Network |
$216.79
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$236.51
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP DNSP |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: VA VA |
$152.59
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| 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 MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$27.54
|
| Rate for Payer: Aetna Medicare |
$6.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.30
|
| Rate for Payer: ASR ASR |
$29.68
|
| Rate for Payer: ASR Commercial |
$29.68
|
| Rate for Payer: BCBS Complete |
$3.74
|
| Rate for Payer: BCBS MAPPO |
$6.64
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: BCN Medicare Advantage |
$6.64
|
| Rate for Payer: Cash Price |
$24.48
|
| 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: Health Alliance Plan Medicare Advantage |
$6.64
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Healthscope Whirlpool |
$29.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$6.64
|
| Rate for Payer: Mclaren Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Mclaren Medicare |
$6.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.97
|
| Rate for Payer: Meridian Medicaid |
$3.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Medicare |
$6.31
|
| Rate for Payer: PACE SWMI |
$6.64
|
| Rate for Payer: PHP Commercial |
$7.30
|
| Rate for Payer: PHP Medicaid |
$3.56
|
| Rate for Payer: PHP Medicare Advantage |
$6.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| 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 Medicare |
$6.64
|
| Rate for Payer: Priority Health Narrow Network |
$21.45
|
| Rate for Payer: Railroad Medicare Medicare |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.64
|
| Rate for Payer: UHC Exchange |
$10.29
|
| Rate for Payer: UHC Medicare Advantage |
$6.64
|
| Rate for Payer: UHCCP DNSP |
$6.64
|
| Rate for Payer: UHCCP Medicaid |
$3.56
|
| Rate for Payer: VA VA |
$6.64
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$38.15
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.53 |
| Max. Negotiated Rate |
$62.26 |
| Rate for Payer: Aetna Commercial |
$42.14
|
| Rate for Payer: Aetna Medicare |
$40.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.21
|
| Rate for Payer: ASR ASR |
$45.42
|
| Rate for Payer: ASR Commercial |
$45.42
|
| Rate for Payer: BCBS Complete |
$22.61
|
| Rate for Payer: BCBS MAPPO |
$40.17
|
| Rate for Payer: BCBS Trust/PPO |
$38.34
|
| Rate for Payer: BCN Commercial |
$36.30
|
| Rate for Payer: BCN Medicare Advantage |
$40.17
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.17
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Healthscope Whirlpool |
$45.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$40.17
|
| Rate for Payer: Mclaren Commercial |
$42.14
|
| Rate for Payer: Mclaren Medicaid |
$21.53
|
| Rate for Payer: Mclaren Medicare |
$40.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.18
|
| Rate for Payer: Meridian Medicaid |
$22.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Medicare |
$38.16
|
| Rate for Payer: PACE SWMI |
$40.17
|
| Rate for Payer: PHP Commercial |
$44.19
|
| Rate for Payer: PHP Medicaid |
$21.53
|
| Rate for Payer: PHP Medicare Advantage |
$40.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.02
|
| Rate for Payer: Priority Health Medicare |
$40.17
|
| Rate for Payer: Priority Health Narrow Network |
$32.82
|
| Rate for Payer: Railroad Medicare Medicare |
$40.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.17
|
| Rate for Payer: UHC Exchange |
$62.26
|
| Rate for Payer: UHC Medicare Advantage |
$40.17
|
| Rate for Payer: UHCCP DNSP |
$40.17
|
| Rate for Payer: UHCCP Medicaid |
$21.53
|
| Rate for Payer: VA VA |
$40.17
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
OP
|
$531.54
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$212.62 |
| Max. Negotiated Rate |
$531.54 |
| Rate for Payer: Aetna Commercial |
$478.39
|
| Rate for Payer: Aetna Medicare |
$265.77
|
| Rate for Payer: ASR ASR |
$515.59
|
| Rate for Payer: ASR Commercial |
$515.59
|
| Rate for Payer: BCBS Complete |
$212.62
|
| Rate for Payer: BCBS Trust/PPO |
$435.28
|
| Rate for Payer: BCN Commercial |
$412.10
|
| Rate for Payer: Cash Price |
$425.23
|
| Rate for Payer: Cofinity Commercial |
$499.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.23
|
| Rate for Payer: Healthscope Commercial |
$531.54
|
| Rate for Payer: Healthscope Whirlpool |
$515.59
|
| Rate for Payer: Mclaren Commercial |
$478.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.81
|
| Rate for Payer: Nomi Health Commercial |
$435.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$465.74
|
| Rate for Payer: Priority Health Narrow Network |
$372.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$467.76
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
IP
|
$531.54
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$345.50 |
| Max. Negotiated Rate |
$531.54 |
| Rate for Payer: Aetna Commercial |
$478.39
|
| Rate for Payer: ASR ASR |
$515.59
|
| Rate for Payer: ASR Commercial |
$515.59
|
| Rate for Payer: BCBS Trust/PPO |
$433.15
|
| Rate for Payer: BCN Commercial |
$412.10
|
| Rate for Payer: Cash Price |
$425.23
|
| Rate for Payer: Cofinity Commercial |
$499.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.23
|
| Rate for Payer: Healthscope Commercial |
$531.54
|
| Rate for Payer: Healthscope Whirlpool |
$515.59
|
| Rate for Payer: Mclaren Commercial |
$478.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.81
|
| Rate for Payer: Nomi Health Commercial |
$435.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$467.76
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
IP
|
$615.92
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$400.35 |
| Max. Negotiated Rate |
$615.92 |
| Rate for Payer: Aetna Commercial |
$554.33
|
| Rate for Payer: ASR ASR |
$597.44
|
| Rate for Payer: ASR Commercial |
$597.44
|
| Rate for Payer: BCBS Trust/PPO |
$501.91
|
| Rate for Payer: BCN Commercial |
$477.52
|
| Rate for Payer: Cash Price |
$492.74
|
| Rate for Payer: Cofinity Commercial |
$578.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.74
|
| Rate for Payer: Healthscope Commercial |
$615.92
|
| Rate for Payer: Healthscope Whirlpool |
$597.44
|
| Rate for Payer: Mclaren Commercial |
$554.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.53
|
| Rate for Payer: Nomi Health Commercial |
$505.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$542.01
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
OP
|
$615.92
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$246.37 |
| Max. Negotiated Rate |
$615.92 |
| Rate for Payer: Aetna Commercial |
$554.33
|
| Rate for Payer: Aetna Medicare |
$307.96
|
| Rate for Payer: ASR ASR |
$597.44
|
| Rate for Payer: ASR Commercial |
$597.44
|
| Rate for Payer: BCBS Complete |
$246.37
|
| Rate for Payer: BCBS Trust/PPO |
$504.38
|
| Rate for Payer: BCN Commercial |
$477.52
|
| Rate for Payer: Cash Price |
$492.74
|
| Rate for Payer: Cofinity Commercial |
$578.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.74
|
| Rate for Payer: Healthscope Commercial |
$615.92
|
| Rate for Payer: Healthscope Whirlpool |
$597.44
|
| Rate for Payer: Mclaren Commercial |
$554.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.53
|
| Rate for Payer: Nomi Health Commercial |
$505.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.67
|
| Rate for Payer: Priority Health Narrow Network |
$431.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$542.01
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
OP
|
$117.52
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$117.52 |
| Rate for Payer: Aetna Commercial |
$105.77
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: ASR ASR |
$113.99
|
| Rate for Payer: ASR Commercial |
$113.99
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$96.24
|
| Rate for Payer: BCN Commercial |
$91.11
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$94.02
|
| Rate for Payer: Cash Price |
$94.02
|
| Rate for Payer: Cofinity Commercial |
$110.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$117.52
|
| Rate for Payer: Healthscope Whirlpool |
$113.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.64
|
| Rate for Payer: Mclaren Commercial |
$105.77
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.89
|
| Rate for Payer: Nomi Health Commercial |
$96.37
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.50
|
| Rate for Payer: PHP Medicaid |
$9.99
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.97
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$82.38
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP DNSP |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: VA VA |
$18.64
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
IP
|
$117.52
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.39 |
| Max. Negotiated Rate |
$117.52 |
| Rate for Payer: Aetna Commercial |
$105.77
|
| Rate for Payer: ASR ASR |
$113.99
|
| Rate for Payer: ASR Commercial |
$113.99
|
| Rate for Payer: BCBS Trust/PPO |
$95.77
|
| Rate for Payer: BCN Commercial |
$91.11
|
| Rate for Payer: Cash Price |
$94.02
|
| Rate for Payer: Cofinity Commercial |
$110.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.02
|
| Rate for Payer: Healthscope Commercial |
$117.52
|
| Rate for Payer: Healthscope Whirlpool |
$113.99
|
| Rate for Payer: Mclaren Commercial |
$105.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.89
|
| Rate for Payer: Nomi Health Commercial |
$96.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.42
|
|
|
HC MMR VACCINE
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
63600027
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: ASR Commercial |
$105.96
|
| Rate for Payer: BCBS Trust/PPO |
$89.02
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Healthscope Whirlpool |
$105.96
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
|
|
HC MMR VACCINE
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
63600027
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$43.70 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna Medicare |
$54.62
|
| Rate for Payer: ASR ASR |
$105.96
|
| Rate for Payer: ASR Commercial |
$105.96
|
| Rate for Payer: BCBS Complete |
$43.70
|
| Rate for Payer: BCBS Trust/PPO |
$89.46
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Healthscope Whirlpool |
$105.96
|
| Rate for Payer: Mclaren Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.72
|
| Rate for Payer: Priority Health Narrow Network |
$76.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.13
|
|
|
HC MNT GROUP 2ND REFERRAL 30 MIN
|
Facility
|
IP
|
$51.60
|
|
|
Service Code
|
HCPCS G0271
|
| Hospital Charge Code |
94200009
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$33.54 |
| Max. Negotiated Rate |
$51.60 |
| Rate for Payer: Aetna Commercial |
$46.44
|
| Rate for Payer: ASR ASR |
$50.05
|
| Rate for Payer: ASR Commercial |
$50.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.05
|
| Rate for Payer: BCN Commercial |
$40.01
|
| Rate for Payer: Cash Price |
$41.28
|
| Rate for Payer: Cofinity Commercial |
$48.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.28
|
| Rate for Payer: Healthscope Commercial |
$51.60
|
| Rate for Payer: Healthscope Whirlpool |
$50.05
|
| Rate for Payer: Mclaren Commercial |
$46.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.86
|
| Rate for Payer: Nomi Health Commercial |
$42.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.41
|
|
|
HC MNT GROUP 2ND REFERRAL 30 MIN
|
Facility
|
OP
|
$51.60
|
|
|
Service Code
|
HCPCS G0271
|
| Hospital Charge Code |
94200009
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$51.60 |
| Rate for Payer: Aetna Commercial |
$46.44
|
| Rate for Payer: Aetna Medicare |
$25.80
|
| Rate for Payer: ASR ASR |
$50.05
|
| Rate for Payer: ASR Commercial |
$50.05
|
| Rate for Payer: BCBS Complete |
$20.64
|
| Rate for Payer: BCBS Trust/PPO |
$42.26
|
| Rate for Payer: BCN Commercial |
$40.01
|
| Rate for Payer: Cash Price |
$41.28
|
| Rate for Payer: Cofinity Commercial |
$48.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.28
|
| Rate for Payer: Healthscope Commercial |
$51.60
|
| Rate for Payer: Healthscope Whirlpool |
$50.05
|
| Rate for Payer: Mclaren Commercial |
$46.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.86
|
| Rate for Payer: Nomi Health Commercial |
$42.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.21
|
| Rate for Payer: Priority Health Narrow Network |
$36.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.41
|
|
