|
HC TUBING 1/4
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$21.60
|
| Rate for Payer: ASR ASR |
$23.28
|
| Rate for Payer: BCBS Trust/PPO |
$18.61
|
| Rate for Payer: BCN Commercial |
$18.61
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$22.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$24.00
|
| Rate for Payer: Healthscope Whirlpool |
$23.28
|
| Rate for Payer: Mclaren Commercial |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.12
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$21.60
|
| Rate for Payer: ASR ASR |
$23.28
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Trust/PPO |
$18.61
|
| Rate for Payer: BCN Commercial |
$18.61
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$22.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$24.00
|
| Rate for Payer: Healthscope Whirlpool |
$23.28
|
| Rate for Payer: Mclaren Commercial |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.84
|
| Rate for Payer: Priority Health Narrow Network |
$17.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.12
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$28.50
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.95 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Aetna Commercial |
$25.65
|
| Rate for Payer: ASR ASR |
$27.64
|
| Rate for Payer: BCBS Trust/PPO |
$22.10
|
| Rate for Payer: BCN Commercial |
$22.10
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cofinity Commercial |
$26.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.80
|
| Rate for Payer: Healthscope Commercial |
$28.50
|
| Rate for Payer: Healthscope Whirlpool |
$27.64
|
| Rate for Payer: Mclaren Commercial |
$25.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.08
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$28.50
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Aetna Commercial |
$25.65
|
| Rate for Payer: ASR ASR |
$27.64
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS Trust/PPO |
$22.10
|
| Rate for Payer: BCN Commercial |
$22.10
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cofinity Commercial |
$26.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.80
|
| Rate for Payer: Healthscope Commercial |
$28.50
|
| Rate for Payer: Healthscope Whirlpool |
$27.64
|
| Rate for Payer: Mclaren Commercial |
$25.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.94
|
| Rate for Payer: Priority Health Narrow Network |
$20.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.08
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$198.39
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$83.05 |
| Max. Negotiated Rate |
$198.39 |
| Rate for Payer: Aetna Commercial |
$178.55
|
| Rate for Payer: Aetna Medicare |
$151.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: ASR ASR |
$192.44
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$153.81
|
| Rate for Payer: BCCCP Commercial |
$119.02
|
| Rate for Payer: BCN Commercial |
$153.81
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cofinity Commercial |
$186.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$198.39
|
| Rate for Payer: Healthscope Whirlpool |
$192.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$151.82
|
| Rate for Payer: Mclaren Commercial |
$178.55
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.63
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$167.00
|
| Rate for Payer: PHP Medicaid |
$83.05
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.53
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$140.86
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.58
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: VA VA |
$151.82
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$198.39
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$138.87 |
| Max. Negotiated Rate |
$198.39 |
| Rate for Payer: Aetna Commercial |
$178.55
|
| Rate for Payer: ASR ASR |
$192.44
|
| Rate for Payer: BCBS Trust/PPO |
$153.81
|
| Rate for Payer: BCN Commercial |
$153.81
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cofinity Commercial |
$186.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.71
|
| Rate for Payer: Healthscope Commercial |
$198.39
|
| Rate for Payer: Healthscope Whirlpool |
$192.44
|
| Rate for Payer: Mclaren Commercial |
$178.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.58
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
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 TUNA IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
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 TVT DEVICE KIT
|
Facility
|
OP
|
$4,086.47
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,634.59 |
| Max. Negotiated Rate |
$4,086.47 |
| Rate for Payer: Aetna Commercial |
$3,677.82
|
| Rate for Payer: ASR ASR |
$3,963.88
|
| Rate for Payer: BCBS Complete |
$1,634.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,168.24
|
| Rate for Payer: BCN Commercial |
$3,168.24
|
| Rate for Payer: Cash Price |
$3,269.18
|
| Rate for Payer: Cofinity Commercial |
$3,841.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,269.18
|
| Rate for Payer: Healthscope Commercial |
$4,086.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,963.88
|
| Rate for Payer: Mclaren Commercial |
$3,677.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,718.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,901.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,596.09
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,086.47
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,860.53 |
| Max. Negotiated Rate |
$4,086.47 |
| Rate for Payer: Aetna Commercial |
$3,677.82
|
| Rate for Payer: ASR ASR |
$3,963.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,168.24
|
| Rate for Payer: BCN Commercial |
$3,168.24
|
| Rate for Payer: Cash Price |
$3,269.18
|
| Rate for Payer: Cofinity Commercial |
$3,841.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,269.18
|
| Rate for Payer: Healthscope Commercial |
$4,086.47
|
| Rate for Payer: Healthscope Whirlpool |
$3,963.88
|
| Rate for Payer: Mclaren Commercial |
$3,677.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,596.09
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,600.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,520.00 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna Commercial |
$3,240.00
|
| Rate for Payer: ASR ASR |
$3,492.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,791.08
|
| Rate for Payer: BCN Commercial |
$2,791.08
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cofinity Commercial |
$3,384.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,880.00
|
| Rate for Payer: Healthscope Commercial |
$3,600.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,492.00
|
| Rate for Payer: Mclaren Commercial |
$3,240.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,060.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,520.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,168.00
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,600.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,440.00 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna Commercial |
$3,240.00
|
| Rate for Payer: ASR ASR |
$3,492.00
|
| Rate for Payer: BCBS Complete |
$1,440.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,791.08
|
| Rate for Payer: BCN Commercial |
$2,791.08
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cofinity Commercial |
$3,384.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,880.00
|
| Rate for Payer: Healthscope Commercial |
$3,600.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,492.00
|
| Rate for Payer: Mclaren Commercial |
$3,240.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,060.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,520.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,276.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,556.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,168.00
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.09 |
| Max. Negotiated Rate |
$7,789.74 |
| Rate for Payer: Aetna Commercial |
$7,010.77
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$7,556.05
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$6,039.39
|
| Rate for Payer: BCN Commercial |
$6,039.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$7,322.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,789.74
|
| Rate for Payer: Healthscope Whirlpool |
$7,556.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$7,010.77
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,088.66
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$5,530.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,854.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,452.82 |
| Max. Negotiated Rate |
$7,789.74 |
| Rate for Payer: Aetna Commercial |
$7,010.77
|
| Rate for Payer: ASR ASR |
$7,556.05
|
| Rate for Payer: BCBS Trust/PPO |
$6,039.39
|
| Rate for Payer: BCN Commercial |
$6,039.39
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$7,322.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,789.74
|
| Rate for Payer: Healthscope Whirlpool |
$7,556.05
|
| Rate for Payer: Mclaren Commercial |
$7,010.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,854.97
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,452.82 |
| Max. Negotiated Rate |
$7,789.74 |
| Rate for Payer: Aetna Commercial |
$7,010.77
|
| Rate for Payer: ASR ASR |
$7,556.05
|
| Rate for Payer: BCBS Trust/PPO |
$6,039.39
|
| Rate for Payer: BCN Commercial |
$6,039.39
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$7,322.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,789.74
|
| Rate for Payer: Healthscope Whirlpool |
$7,556.05
|
| Rate for Payer: Mclaren Commercial |
$7,010.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,854.97
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.09 |
| Max. Negotiated Rate |
$7,789.74 |
| Rate for Payer: Aetna Commercial |
$7,010.77
|
| Rate for Payer: Aetna Medicare |
$2,778.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: ASR ASR |
$7,556.05
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$6,039.39
|
| Rate for Payer: BCN Commercial |
$6,039.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$7,322.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,789.74
|
| Rate for Payer: Healthscope Whirlpool |
$7,556.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,778.95
|
| Rate for Payer: Mclaren Commercial |
$7,010.77
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,056.84
|
| Rate for Payer: PHP Medicaid |
$1,520.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,088.66
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$5,530.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,854.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
OP
|
$760.44
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$760.44 |
| Rate for Payer: Aetna Commercial |
$684.40
|
| Rate for Payer: Aetna Medicare |
$558.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: ASR ASR |
$737.63
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$589.57
|
| Rate for Payer: BCN Commercial |
$589.57
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cofinity Commercial |
$714.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$760.44
|
| Rate for Payer: Healthscope Whirlpool |
$737.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$558.26
|
| Rate for Payer: Mclaren Commercial |
$684.40
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$646.37
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$614.09
|
| Rate for Payer: PHP Medicaid |
$305.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$655.73
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$524.58
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$669.19
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: VA VA |
$558.26
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
IP
|
$760.44
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$532.31 |
| Max. Negotiated Rate |
$760.44 |
| Rate for Payer: Aetna Commercial |
$684.40
|
| Rate for Payer: ASR ASR |
$737.63
|
| Rate for Payer: BCBS Trust/PPO |
$589.57
|
| Rate for Payer: BCN Commercial |
$589.57
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cofinity Commercial |
$714.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.35
|
| Rate for Payer: Healthscope Commercial |
$760.44
|
| Rate for Payer: Healthscope Whirlpool |
$737.63
|
| Rate for Payer: Mclaren Commercial |
$684.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$646.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$669.19
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
IP
|
$329.46
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.62 |
| Max. Negotiated Rate |
$329.46 |
| Rate for Payer: Aetna Commercial |
$296.51
|
| Rate for Payer: ASR ASR |
$319.58
|
| Rate for Payer: BCBS Trust/PPO |
$255.43
|
| Rate for Payer: BCN Commercial |
$255.43
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cofinity Commercial |
$309.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.57
|
| Rate for Payer: Healthscope Commercial |
$329.46
|
| Rate for Payer: Healthscope Whirlpool |
$319.58
|
| Rate for Payer: Mclaren Commercial |
$296.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.92
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
OP
|
$329.46
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$329.46 |
| Rate for Payer: Aetna Commercial |
$296.51
|
| Rate for Payer: Aetna Medicare |
$209.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: ASR ASR |
$319.58
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$255.43
|
| Rate for Payer: BCN Commercial |
$255.43
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cofinity Commercial |
$309.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$329.46
|
| Rate for Payer: Healthscope Whirlpool |
$319.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$209.62
|
| Rate for Payer: Mclaren Commercial |
$296.51
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.04
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$230.58
|
| Rate for Payer: PHP Medicaid |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.84
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$183.07
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.92
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: VA VA |
$209.62
|
|
|
HC TYMPANOMETRY
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$44.56 |
| Rate for Payer: Aetna Commercial |
$25.70
|
| Rate for Payer: Aetna Medicare |
$35.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: ASR ASR |
$27.70
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$22.14
|
| Rate for Payer: BCN Commercial |
$22.14
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$28.56
|
| Rate for Payer: Healthscope Whirlpool |
$27.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.65
|
| Rate for Payer: Mclaren Commercial |
$25.70
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$39.22
|
| Rate for Payer: PHP Medicaid |
$19.50
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.99
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$20.28
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.13
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: VA VA |
$35.65
|
|
|
HC TYMPANOMETRY
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$19.99 |
| Max. Negotiated Rate |
$28.56 |
| Rate for Payer: Aetna Commercial |
$25.70
|
| Rate for Payer: ASR ASR |
$27.70
|
| Rate for Payer: BCBS Trust/PPO |
$22.14
|
| Rate for Payer: BCN Commercial |
$22.14
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$28.56
|
| Rate for Payer: Healthscope Whirlpool |
$27.70
|
| Rate for Payer: Mclaren Commercial |
$25.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25.13
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$102.20 |
| Max. Negotiated Rate |
$146.00 |
| Rate for Payer: Aetna Commercial |
$131.40
|
| Rate for Payer: ASR ASR |
$141.62
|
| Rate for Payer: BCBS Trust/PPO |
$113.19
|
| Rate for Payer: BCN Commercial |
$113.19
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$137.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Healthscope Commercial |
$146.00
|
| Rate for Payer: Healthscope Whirlpool |
$141.62
|
| Rate for Payer: Mclaren Commercial |
$131.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.48
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$173.56 |
| Rate for Payer: Aetna Commercial |
$131.40
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$141.62
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$113.19
|
| Rate for Payer: BCN Commercial |
$113.19
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$137.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$146.00
|
| Rate for Payer: Healthscope Whirlpool |
$141.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$131.40
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.86
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$103.66
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$128.48
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.52 |
| Max. Negotiated Rate |
$1,316.00 |
| Rate for Payer: Aetna Commercial |
$1,184.40
|
| Rate for Payer: Aetna Medicare |
$489.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: ASR ASR |
$1,276.52
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.29
|
| Rate for Payer: BCN Commercial |
$1,020.29
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,237.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,316.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.52
|
| Rate for Payer: Humana Choice PPO Medicare |
$489.06
|
| Rate for Payer: Mclaren Commercial |
$1,184.40
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$537.97
|
| Rate for Payer: PHP Medicaid |
$267.52
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,197.56
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$934.36
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,158.08
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
