|
HC SIROLIMUS
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 80195
|
| Hospital Charge Code |
30100045
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$74.46 |
| Rate for Payer: Aetna Commercial |
$67.01
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: ASR ASR |
$72.23
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$57.73
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$74.46
|
| Rate for Payer: Healthscope Whirlpool |
$72.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$13.73
|
| Rate for Payer: Mclaren Commercial |
$67.01
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$15.10
|
| Rate for Payer: PHP Medicaid |
$7.51
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.76
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$52.87
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.52
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: VA VA |
$13.73
|
|
|
HC SIROLIMUS
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 80195
|
| Hospital Charge Code |
30100045
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.12 |
| Max. Negotiated Rate |
$74.46 |
| Rate for Payer: Aetna Commercial |
$67.01
|
| Rate for Payer: ASR ASR |
$72.23
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$57.73
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$74.46
|
| Rate for Payer: Healthscope Whirlpool |
$72.23
|
| Rate for Payer: Mclaren Commercial |
$67.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.52
|
|
|
HC SKIN FULL GRFT FACE/GENIT/HF 20 SQ CM OR <
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
76100445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,500.00 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$4,500.00
|
| Rate for Payer: ASR ASR |
$4,850.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.50
|
| Rate for Payer: BCN Commercial |
$3,876.50
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,700.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Healthscope Commercial |
$5,000.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,850.00
|
| Rate for Payer: Mclaren Commercial |
$4,500.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,400.00
|
|
|
HC SKIN FULL GRFT FACE/GENIT/HF 20 SQ CM OR <
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
76100445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$886.68 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$4,500.00
|
| Rate for Payer: Aetna Medicare |
$1,620.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: ASR ASR |
$4,850.00
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.50
|
| Rate for Payer: BCN Commercial |
$3,876.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,700.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$5,000.00
|
| Rate for Payer: Healthscope Whirlpool |
$4,850.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,620.98
|
| Rate for Payer: Mclaren Commercial |
$4,500.00
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,783.08
|
| Rate for Payer: PHP Medicaid |
$886.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,550.00
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$3,550.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,400.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
HC SKIN TAG REMOVAL UP TO 15
|
Facility
|
OP
|
$267.34
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
45000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$267.34 |
| Rate for Payer: Aetna Commercial |
$240.61
|
| Rate for Payer: Aetna Medicare |
$177.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: ASR ASR |
$259.32
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$207.27
|
| Rate for Payer: BCN Commercial |
$207.27
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$213.87
|
| Rate for Payer: Cash Price |
$213.87
|
| Rate for Payer: Cofinity Commercial |
$251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$267.34
|
| Rate for Payer: Healthscope Whirlpool |
$259.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$177.95
|
| Rate for Payer: Mclaren Commercial |
$240.61
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.24
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$195.74
|
| Rate for Payer: PHP Medicaid |
$97.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.27
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$132.22
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.26
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: VA VA |
$177.95
|
|
|
HC SKIN TAG REMOVAL UP TO 15
|
Facility
|
IP
|
$267.34
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
45000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.14 |
| Max. Negotiated Rate |
$267.34 |
| Rate for Payer: Aetna Commercial |
$240.61
|
| Rate for Payer: ASR ASR |
$259.32
|
| Rate for Payer: BCBS Trust/PPO |
$207.27
|
| Rate for Payer: BCN Commercial |
$207.27
|
| Rate for Payer: Cash Price |
$213.87
|
| Rate for Payer: Cofinity Commercial |
$251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.87
|
| Rate for Payer: Healthscope Commercial |
$267.34
|
| Rate for Payer: Healthscope Whirlpool |
$259.32
|
| Rate for Payer: Mclaren Commercial |
$240.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.26
|
|
|
HC SKIN TAGS REMOVAL EA ADDL 10 LESIONS
|
Facility
|
OP
|
$18.36
|
|
|
Service Code
|
CPT 11201
|
| Hospital Charge Code |
76100079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$246.20 |
| Rate for Payer: Aetna Commercial |
$16.52
|
| Rate for Payer: ASR ASR |
$17.81
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS Trust/PPO |
$14.23
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Healthscope Whirlpool |
$17.81
|
| Rate for Payer: Mclaren Commercial |
$16.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.20
|
| Rate for Payer: Priority Health Narrow Network |
$196.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.16
|
|
|
HC SKIN TAGS REMOVAL EA ADDL 10 LESIONS
|
Facility
|
IP
|
$18.36
|
|
|
Service Code
|
CPT 11201
|
| Hospital Charge Code |
76100079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$16.52
|
| Rate for Payer: ASR ASR |
$17.81
|
| Rate for Payer: BCBS Trust/PPO |
$14.23
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$17.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Healthscope Whirlpool |
$17.81
|
| Rate for Payer: Mclaren Commercial |
$16.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.16
|
|
|
HC SLITTING OF PREPUCE, DORSAL/LAT, EXCEPT NEWBORN
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 54001
|
| Hospital Charge Code |
76100250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,710.48 |
| Rate for Payer: Aetna Commercial |
$2,439.43
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: ASR ASR |
$2,629.17
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.44
|
| Rate for Payer: BCN Commercial |
$2,101.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,547.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,710.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,629.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,439.43
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,466.54
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,924.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,385.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC SLITTING OF PREPUCE, DORSAL/LAT, EXCEPT NEWBORN
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 54001
|
| Hospital Charge Code |
76100250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,897.34 |
| Max. Negotiated Rate |
$2,710.48 |
| Rate for Payer: Aetna Commercial |
$2,439.43
|
| Rate for Payer: ASR ASR |
$2,629.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.44
|
| Rate for Payer: BCN Commercial |
$2,101.44
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,547.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,710.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,629.17
|
| Rate for Payer: Mclaren Commercial |
$2,439.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,385.22
|
|
|
HC SMART NEEDLE
|
Facility
|
IP
|
$490.51
|
|
| Hospital Charge Code |
62200011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$343.36 |
| Max. Negotiated Rate |
$490.51 |
| Rate for Payer: Aetna Commercial |
$441.46
|
| Rate for Payer: ASR ASR |
$475.79
|
| Rate for Payer: BCBS Trust/PPO |
$380.29
|
| Rate for Payer: BCN Commercial |
$380.29
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$461.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Healthscope Commercial |
$490.51
|
| Rate for Payer: Healthscope Whirlpool |
$475.79
|
| Rate for Payer: Mclaren Commercial |
$441.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.65
|
|
|
HC SMART NEEDLE
|
Facility
|
OP
|
$490.51
|
|
| Hospital Charge Code |
62200011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$196.20 |
| Max. Negotiated Rate |
$490.51 |
| Rate for Payer: Aetna Commercial |
$441.46
|
| Rate for Payer: ASR ASR |
$475.79
|
| Rate for Payer: BCBS Complete |
$196.20
|
| Rate for Payer: BCBS Trust/PPO |
$380.29
|
| Rate for Payer: BCN Commercial |
$380.29
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$461.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Healthscope Commercial |
$490.51
|
| Rate for Payer: Healthscope Whirlpool |
$475.79
|
| Rate for Payer: Mclaren Commercial |
$441.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.36
|
| Rate for Payer: Priority Health Narrow Network |
$348.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$431.65
|
|
|
HC SMITH SM ANTIBODY
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200165
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$143.67 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.67
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$114.94
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC SMITH SM ANTIBODY
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200165
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
|
|
HC SMOKE CESSATION > 10 MIN
|
Facility
|
OP
|
$120.35
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
94200033
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$120.35 |
| Rate for Payer: Aetna Commercial |
$108.32
|
| Rate for Payer: Aetna Medicare |
$25.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.89
|
| Rate for Payer: ASR ASR |
$116.74
|
| Rate for Payer: BCBS Complete |
$14.65
|
| Rate for Payer: BCBS MAPPO |
$25.51
|
| Rate for Payer: BCBS Trust/PPO |
$93.31
|
| Rate for Payer: BCN Commercial |
$93.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.51
|
| Rate for Payer: Cash Price |
$96.28
|
| Rate for Payer: Cash Price |
$96.28
|
| Rate for Payer: Cofinity Commercial |
$113.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.51
|
| Rate for Payer: Healthscope Commercial |
$120.35
|
| Rate for Payer: Healthscope Whirlpool |
$116.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.51
|
| Rate for Payer: Mclaren Commercial |
$108.32
|
| Rate for Payer: Mclaren Medicaid |
$13.95
|
| Rate for Payer: Mclaren Medicare |
$25.51
|
| Rate for Payer: Meridian Medicaid |
$14.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.30
|
| Rate for Payer: PACE Medicare |
$24.23
|
| Rate for Payer: PACE SWMI |
$25.51
|
| Rate for Payer: PHP Commercial |
$28.06
|
| Rate for Payer: PHP Medicaid |
$13.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.57
|
| Rate for Payer: Priority Health Medicare |
$25.51
|
| Rate for Payer: Priority Health Narrow Network |
$49.26
|
| Rate for Payer: Railroad Medicare Medicare |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.91
|
| Rate for Payer: UHC Medicare Advantage |
$26.28
|
| Rate for Payer: VA VA |
$25.51
|
|
|
HC SMOKE CESSATION > 10 MIN
|
Facility
|
IP
|
$120.35
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
94200033
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$120.35 |
| Rate for Payer: Aetna Commercial |
$108.32
|
| Rate for Payer: ASR ASR |
$116.74
|
| Rate for Payer: BCBS Trust/PPO |
$93.31
|
| Rate for Payer: BCN Commercial |
$93.31
|
| Rate for Payer: Cash Price |
$96.28
|
| Rate for Payer: Cofinity Commercial |
$113.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.28
|
| Rate for Payer: Healthscope Commercial |
$120.35
|
| Rate for Payer: Healthscope Whirlpool |
$116.74
|
| Rate for Payer: Mclaren Commercial |
$108.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.91
|
|
|
HC SMOKING CESSATION 3-10 MIN
|
Facility
|
IP
|
$120.35
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
94200034
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$120.35 |
| Rate for Payer: Aetna Commercial |
$108.32
|
| Rate for Payer: ASR ASR |
$116.74
|
| Rate for Payer: BCBS Trust/PPO |
$93.31
|
| Rate for Payer: BCN Commercial |
$93.31
|
| Rate for Payer: Cash Price |
$96.28
|
| Rate for Payer: Cofinity Commercial |
$113.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.28
|
| Rate for Payer: Healthscope Commercial |
$120.35
|
| Rate for Payer: Healthscope Whirlpool |
$116.74
|
| Rate for Payer: Mclaren Commercial |
$108.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.91
|
|
|
HC SMOKING CESSATION 3-10 MIN
|
Facility
|
OP
|
$120.35
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
94200034
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$120.35 |
| Rate for Payer: Aetna Commercial |
$108.32
|
| Rate for Payer: Aetna Medicare |
$25.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.89
|
| Rate for Payer: ASR ASR |
$116.74
|
| Rate for Payer: BCBS Complete |
$14.65
|
| Rate for Payer: BCBS MAPPO |
$25.51
|
| Rate for Payer: BCBS Trust/PPO |
$93.31
|
| Rate for Payer: BCN Commercial |
$93.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.51
|
| Rate for Payer: Cash Price |
$96.28
|
| Rate for Payer: Cash Price |
$96.28
|
| Rate for Payer: Cofinity Commercial |
$113.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.51
|
| Rate for Payer: Healthscope Commercial |
$120.35
|
| Rate for Payer: Healthscope Whirlpool |
$116.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$25.51
|
| Rate for Payer: Mclaren Commercial |
$108.32
|
| Rate for Payer: Mclaren Medicaid |
$13.95
|
| Rate for Payer: Mclaren Medicare |
$25.51
|
| Rate for Payer: Meridian Medicaid |
$14.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.30
|
| Rate for Payer: PACE Medicare |
$24.23
|
| Rate for Payer: PACE SWMI |
$25.51
|
| Rate for Payer: PHP Commercial |
$28.06
|
| Rate for Payer: PHP Medicaid |
$13.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.36
|
| Rate for Payer: Priority Health Medicare |
$25.51
|
| Rate for Payer: Priority Health Narrow Network |
$42.69
|
| Rate for Payer: Railroad Medicare Medicare |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$105.91
|
| Rate for Payer: UHC Medicare Advantage |
$26.28
|
| Rate for Payer: VA VA |
$25.51
|
|
|
HC SMOOTH MUSCLE AB TITER
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200487
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
|
|
HC SMOOTH MUSCLE AB TITER
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200487
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Aetna Commercial |
$18.36
|
| Rate for Payer: Aetna Medicare |
$12.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: ASR ASR |
$19.79
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$15.82
|
| Rate for Payer: BCN Commercial |
$15.82
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$20.40
|
| Rate for Payer: Healthscope Whirlpool |
$19.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$12.05
|
| Rate for Payer: Mclaren Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$13.26
|
| Rate for Payer: PHP Medicaid |
$6.59
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.56
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$14.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: VA VA |
$12.05
|
|
|
HC SMRNP
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200435
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
|
|
HC SMRNP
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200435
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$143.67 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$33.45
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$26.73
|
| Rate for Payer: BCN Commercial |
$26.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Healthscope Whirlpool |
$33.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.03
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.67
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$114.94
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.34
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC SNARE
|
Facility
|
OP
|
$1,263.96
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200071
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$505.58 |
| Max. Negotiated Rate |
$1,263.96 |
| Rate for Payer: Aetna Commercial |
$1,137.56
|
| Rate for Payer: ASR ASR |
$1,226.04
|
| Rate for Payer: BCBS Complete |
$505.58
|
| Rate for Payer: BCBS Trust/PPO |
$979.95
|
| Rate for Payer: BCN Commercial |
$979.95
|
| Rate for Payer: Cash Price |
$1,011.17
|
| Rate for Payer: Cofinity Commercial |
$1,188.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.17
|
| Rate for Payer: Healthscope Commercial |
$1,263.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,226.04
|
| Rate for Payer: Mclaren Commercial |
$1,137.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,074.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.20
|
| Rate for Payer: Priority Health Narrow Network |
$897.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,112.28
|
|
|
HC SNARE
|
Facility
|
IP
|
$1,263.96
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200071
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$884.77 |
| Max. Negotiated Rate |
$1,263.96 |
| Rate for Payer: Aetna Commercial |
$1,137.56
|
| Rate for Payer: ASR ASR |
$1,226.04
|
| Rate for Payer: BCBS Trust/PPO |
$979.95
|
| Rate for Payer: BCN Commercial |
$979.95
|
| Rate for Payer: Cash Price |
$1,011.17
|
| Rate for Payer: Cofinity Commercial |
$1,188.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.17
|
| Rate for Payer: Healthscope Commercial |
$1,263.96
|
| Rate for Payer: Healthscope Whirlpool |
$1,226.04
|
| Rate for Payer: Mclaren Commercial |
$1,137.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,074.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,112.28
|
|
|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$18.90
|
| Rate for Payer: ASR ASR |
$20.37
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Trust/PPO |
$16.28
|
| Rate for Payer: BCN Commercial |
$16.28
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$19.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$21.00
|
| Rate for Payer: Healthscope Whirlpool |
$20.37
|
| Rate for Payer: Mclaren Commercial |
$18.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.11
|
| Rate for Payer: Priority Health Narrow Network |
$14.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$18.48
|
|
