|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
OP
|
$12,179.11
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,506.27 |
| Max. Negotiated Rate |
$12,179.11 |
| Rate for Payer: Aetna Commercial |
$10,961.20
|
| Rate for Payer: Aetna Medicare |
$4,506.27
|
| Rate for Payer: ASR ASR |
$11,813.74
|
| Rate for Payer: BCBS Complete |
$4,871.64
|
| Rate for Payer: BCBS Trust/PPO |
$10,041.68
|
| Rate for Payer: BCN Commercial |
$10,041.68
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cofinity Commercial |
$11,448.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,743.29
|
| Rate for Payer: Healthscope Commercial |
$11,813.74
|
| Rate for Payer: Healthscope Whirlpool |
$12,179.11
|
| Rate for Payer: Mclaren Commercial |
$10,961.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,743.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,352.24
|
| Rate for Payer: Nomi Health Commercial |
$9,986.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,134.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10,671.34
|
| Rate for Payer: Priority Health Narrow Network |
$8,537.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,717.62
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
IP
|
$12,179.11
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,134.33 |
| Max. Negotiated Rate |
$12,179.11 |
| Rate for Payer: Aetna Commercial |
$10,961.20
|
| Rate for Payer: ASR ASR |
$11,813.74
|
| Rate for Payer: BCBS Trust/PPO |
$10,001.49
|
| Rate for Payer: BCN Commercial |
$10,001.49
|
| Rate for Payer: Cash Price |
$9,743.29
|
| Rate for Payer: Cofinity Commercial |
$11,448.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,743.29
|
| Rate for Payer: Healthscope Commercial |
$11,813.74
|
| Rate for Payer: Healthscope Whirlpool |
$12,179.11
|
| Rate for Payer: Mclaren Commercial |
$10,961.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,352.24
|
| Rate for Payer: Nomi Health Commercial |
$9,986.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,134.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,717.62
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,612.95 |
| Max. Negotiated Rate |
$19,483.94 |
| Rate for Payer: Aetna Commercial |
$17,535.55
|
| Rate for Payer: ASR ASR |
$18,899.42
|
| Rate for Payer: BCBS Trust/PPO |
$16,000.21
|
| Rate for Payer: BCN Commercial |
$16,000.21
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$18,314.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$18,899.42
|
| Rate for Payer: Healthscope Whirlpool |
$19,483.94
|
| Rate for Payer: Mclaren Commercial |
$17,535.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,145.87
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,209.06 |
| Max. Negotiated Rate |
$19,483.94 |
| Rate for Payer: Aetna Commercial |
$17,535.55
|
| Rate for Payer: Aetna Medicare |
$7,209.06
|
| Rate for Payer: ASR ASR |
$18,899.42
|
| Rate for Payer: BCBS Complete |
$7,793.58
|
| Rate for Payer: BCBS Trust/PPO |
$16,064.51
|
| Rate for Payer: BCN Commercial |
$16,064.51
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$18,314.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$18,899.42
|
| Rate for Payer: Healthscope Whirlpool |
$19,483.94
|
| Rate for Payer: Mclaren Commercial |
$17,535.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,587.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17,071.83
|
| Rate for Payer: Priority Health Narrow Network |
$13,658.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17,145.87
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,306.33 |
| Max. Negotiated Rate |
$29,741.77 |
| Rate for Payer: Aetna Commercial |
$26,767.59
|
| Rate for Payer: ASR ASR |
$28,849.52
|
| Rate for Payer: BCBS Trust/PPO |
$24,423.94
|
| Rate for Payer: BCN Commercial |
$24,423.94
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$27,957.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$28,849.52
|
| Rate for Payer: Healthscope Whirlpool |
$29,741.77
|
| Rate for Payer: Mclaren Commercial |
$26,767.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,172.76
|
|
|
HC PTCRAWSTENT VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
48100077
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,170.33 |
| Max. Negotiated Rate |
$29,741.77 |
| Rate for Payer: Aetna Commercial |
$26,767.59
|
| Rate for Payer: Aetna Medicare |
$18,265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: ASR ASR |
$28,849.52
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$24,522.09
|
| Rate for Payer: BCN Commercial |
$24,522.09
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$27,957.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$28,849.52
|
| Rate for Payer: Healthscope Whirlpool |
$29,741.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$18,265.72
|
| Rate for Payer: Mclaren Commercial |
$26,767.59
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$10,031.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$20,092.29
|
| Rate for Payer: PHP Medicaid |
$9,790.43
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7,712.91
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health Narrow Network |
$6,170.33
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26,172.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Exchange |
$28,311.87
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP DNSP |
$18,265.72
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: VA VA |
$18,265.72
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
OP
|
$321.01
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$118.77 |
| Max. Negotiated Rate |
$321.01 |
| Rate for Payer: Aetna Commercial |
$288.91
|
| Rate for Payer: Aetna Medicare |
$118.77
|
| Rate for Payer: ASR ASR |
$311.38
|
| Rate for Payer: BCBS Complete |
$128.40
|
| Rate for Payer: BCBS Trust/PPO |
$264.67
|
| Rate for Payer: BCN Commercial |
$264.67
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cofinity Commercial |
$301.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.81
|
| Rate for Payer: Healthscope Commercial |
$311.38
|
| Rate for Payer: Healthscope Whirlpool |
$321.01
|
| Rate for Payer: Mclaren Commercial |
$288.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.86
|
| Rate for Payer: Nomi Health Commercial |
$263.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$281.27
|
| Rate for Payer: Priority Health Narrow Network |
$225.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.49
|
|
|
HC PT EVAL HIGH COMPLEXITY
|
Facility
|
IP
|
$321.01
|
|
|
Service Code
|
CPT 97163
|
| Hospital Charge Code |
42400008
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$240.76 |
| Max. Negotiated Rate |
$321.01 |
| Rate for Payer: Aetna Commercial |
$288.91
|
| Rate for Payer: ASR ASR |
$311.38
|
| Rate for Payer: BCBS Trust/PPO |
$263.61
|
| Rate for Payer: BCN Commercial |
$263.61
|
| Rate for Payer: Cash Price |
$256.81
|
| Rate for Payer: Cofinity Commercial |
$301.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.81
|
| Rate for Payer: Healthscope Commercial |
$311.38
|
| Rate for Payer: Healthscope Whirlpool |
$321.01
|
| Rate for Payer: Mclaren Commercial |
$288.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.86
|
| Rate for Payer: Nomi Health Commercial |
$263.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$240.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.49
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
IP
|
$262.65
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$196.99 |
| Max. Negotiated Rate |
$262.65 |
| Rate for Payer: Aetna Commercial |
$236.38
|
| Rate for Payer: ASR ASR |
$254.77
|
| Rate for Payer: BCBS Trust/PPO |
$215.69
|
| Rate for Payer: BCN Commercial |
$215.69
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cofinity Commercial |
$246.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.12
|
| Rate for Payer: Healthscope Commercial |
$254.77
|
| Rate for Payer: Healthscope Whirlpool |
$262.65
|
| Rate for Payer: Mclaren Commercial |
$236.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.25
|
| Rate for Payer: Nomi Health Commercial |
$215.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.13
|
|
|
HC PT EVAL LOW COMPLEXITY
|
Facility
|
OP
|
$262.65
|
|
|
Service Code
|
CPT 97161
|
| Hospital Charge Code |
42400006
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$97.18 |
| Max. Negotiated Rate |
$262.65 |
| Rate for Payer: Aetna Commercial |
$236.38
|
| Rate for Payer: Aetna Medicare |
$97.18
|
| Rate for Payer: ASR ASR |
$254.77
|
| Rate for Payer: BCBS Complete |
$105.06
|
| Rate for Payer: BCBS Trust/PPO |
$216.55
|
| Rate for Payer: BCN Commercial |
$216.55
|
| Rate for Payer: Cash Price |
$210.12
|
| Rate for Payer: Cofinity Commercial |
$246.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.12
|
| Rate for Payer: Healthscope Commercial |
$254.77
|
| Rate for Payer: Healthscope Whirlpool |
$262.65
|
| Rate for Payer: Mclaren Commercial |
$236.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.25
|
| Rate for Payer: Nomi Health Commercial |
$215.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$230.13
|
| Rate for Payer: Priority Health Narrow Network |
$184.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.13
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
IP
|
$291.83
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$218.87 |
| Max. Negotiated Rate |
$291.83 |
| Rate for Payer: Aetna Commercial |
$262.65
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: BCBS Trust/PPO |
$239.65
|
| Rate for Payer: BCN Commercial |
$239.65
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cofinity Commercial |
$274.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.46
|
| Rate for Payer: Healthscope Commercial |
$283.08
|
| Rate for Payer: Healthscope Whirlpool |
$291.83
|
| Rate for Payer: Mclaren Commercial |
$262.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.81
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$291.83
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$107.98 |
| Max. Negotiated Rate |
$291.83 |
| Rate for Payer: Aetna Commercial |
$262.65
|
| Rate for Payer: Aetna Medicare |
$107.98
|
| Rate for Payer: ASR ASR |
$283.08
|
| Rate for Payer: BCBS Complete |
$116.73
|
| Rate for Payer: BCBS Trust/PPO |
$240.61
|
| Rate for Payer: BCN Commercial |
$240.61
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cofinity Commercial |
$274.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.46
|
| Rate for Payer: Healthscope Commercial |
$283.08
|
| Rate for Payer: Healthscope Whirlpool |
$291.83
|
| Rate for Payer: Mclaren Commercial |
$262.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$255.70
|
| Rate for Payer: Priority Health Narrow Network |
$204.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$256.81
|
|
|
HC PT MIX 1:1
|
Facility
|
IP
|
$71.85
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$71.85 |
| Rate for Payer: Aetna Commercial |
$64.67
|
| Rate for Payer: ASR ASR |
$69.69
|
| Rate for Payer: BCBS Trust/PPO |
$59.00
|
| Rate for Payer: BCN Commercial |
$59.00
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Healthscope Commercial |
$69.69
|
| Rate for Payer: Healthscope Whirlpool |
$71.85
|
| Rate for Payer: Mclaren Commercial |
$64.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.07
|
| Rate for Payer: Nomi Health Commercial |
$58.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.23
|
|
|
HC PT MIX 1:1
|
Facility
|
OP
|
$71.85
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$71.85 |
| Rate for Payer: Aetna Commercial |
$64.67
|
| Rate for Payer: Aetna Medicare |
$3.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.92
|
| Rate for Payer: ASR ASR |
$69.69
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$3.94
|
| Rate for Payer: BCBS Trust/PPO |
$59.24
|
| Rate for Payer: BCN Commercial |
$59.24
|
| Rate for Payer: BCN Medicare Advantage |
$3.94
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$69.69
|
| Rate for Payer: Healthscope Whirlpool |
$71.85
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.94
|
| Rate for Payer: Mclaren Commercial |
$64.67
|
| Rate for Payer: Mclaren Medicaid |
$3.94
|
| Rate for Payer: Mclaren Medicare |
$3.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.14
|
| Rate for Payer: Meridian Medicaid |
$2.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.07
|
| Rate for Payer: Nomi Health Commercial |
$58.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.89
|
| Rate for Payer: PACE Medicare |
$3.74
|
| Rate for Payer: PACE SWMI |
$3.94
|
| Rate for Payer: PHP Commercial |
$4.33
|
| Rate for Payer: PHP Medicaid |
$2.11
|
| Rate for Payer: PHP Medicare Advantage |
$3.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.95
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow Network |
$50.37
|
| Rate for Payer: Railroad Medicare Medicare |
$3.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$63.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.94
|
| Rate for Payer: UHC Exchange |
$6.11
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHCCP DNSP |
$3.94
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: VA VA |
$3.94
|
|
|
HC PT NEUROSTIM
|
Facility
|
IP
|
$99.08
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.31 |
| Max. Negotiated Rate |
$99.08 |
| Rate for Payer: Aetna Commercial |
$89.17
|
| Rate for Payer: ASR ASR |
$96.11
|
| Rate for Payer: BCBS Trust/PPO |
$81.36
|
| Rate for Payer: BCN Commercial |
$81.36
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Commercial |
$93.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Healthscope Commercial |
$96.11
|
| Rate for Payer: Healthscope Whirlpool |
$99.08
|
| Rate for Payer: Mclaren Commercial |
$89.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.22
|
| Rate for Payer: Nomi Health Commercial |
$81.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.19
|
|
|
HC PT NEUROSTIM
|
Facility
|
OP
|
$99.08
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$36.66 |
| Max. Negotiated Rate |
$99.08 |
| Rate for Payer: Aetna Commercial |
$89.17
|
| Rate for Payer: Aetna Medicare |
$36.66
|
| Rate for Payer: ASR ASR |
$96.11
|
| Rate for Payer: BCBS Complete |
$39.63
|
| Rate for Payer: BCBS Trust/PPO |
$81.69
|
| Rate for Payer: BCN Commercial |
$81.69
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Commercial |
$93.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Healthscope Commercial |
$96.11
|
| Rate for Payer: Healthscope Whirlpool |
$99.08
|
| Rate for Payer: Mclaren Commercial |
$89.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.22
|
| Rate for Payer: Nomi Health Commercial |
$81.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.43
|
| Rate for Payer: Priority Health Narrow Network |
$38.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.19
|
|
|
HC PT RE-EVALUATION
|
Facility
|
IP
|
$130.72
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$98.04 |
| Max. Negotiated Rate |
$130.72 |
| Rate for Payer: Aetna Commercial |
$117.65
|
| Rate for Payer: ASR ASR |
$126.80
|
| Rate for Payer: BCBS Trust/PPO |
$107.35
|
| Rate for Payer: BCN Commercial |
$107.35
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.58
|
| Rate for Payer: Healthscope Commercial |
$126.80
|
| Rate for Payer: Healthscope Whirlpool |
$130.72
|
| Rate for Payer: Mclaren Commercial |
$117.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.11
|
| Rate for Payer: Nomi Health Commercial |
$107.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.03
|
|
|
HC PT RE-EVALUATION
|
Facility
|
OP
|
$130.72
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$130.72 |
| Rate for Payer: Aetna Commercial |
$117.65
|
| Rate for Payer: Aetna Medicare |
$48.37
|
| Rate for Payer: ASR ASR |
$126.80
|
| Rate for Payer: BCBS Complete |
$52.29
|
| Rate for Payer: BCBS Trust/PPO |
$107.78
|
| Rate for Payer: BCN Commercial |
$107.78
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cofinity Commercial |
$122.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.58
|
| Rate for Payer: Healthscope Commercial |
$126.80
|
| Rate for Payer: Healthscope Whirlpool |
$130.72
|
| Rate for Payer: Mclaren Commercial |
$117.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.11
|
| Rate for Payer: Nomi Health Commercial |
$107.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$114.54
|
| Rate for Payer: Priority Health Narrow Network |
$91.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.03
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
OP
|
$89.43
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$89.43 |
| Rate for Payer: Aetna Commercial |
$80.49
|
| Rate for Payer: Aetna Medicare |
$28.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: ASR ASR |
$86.75
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$73.74
|
| Rate for Payer: BCN Commercial |
$73.74
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cofinity Commercial |
$84.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Healthscope Whirlpool |
$89.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$28.82
|
| Rate for Payer: Mclaren Commercial |
$80.49
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.02
|
| Rate for Payer: Nomi Health Commercial |
$73.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.07
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$31.70
|
| Rate for Payer: PHP Medicaid |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.36
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow Network |
$62.69
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$44.67
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP DNSP |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: VA VA |
$28.82
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
IP
|
$89.43
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.07 |
| Max. Negotiated Rate |
$89.43 |
| Rate for Payer: Aetna Commercial |
$80.49
|
| Rate for Payer: ASR ASR |
$86.75
|
| Rate for Payer: BCBS Trust/PPO |
$73.44
|
| Rate for Payer: BCN Commercial |
$73.44
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cofinity Commercial |
$84.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.54
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Healthscope Whirlpool |
$89.43
|
| Rate for Payer: Mclaren Commercial |
$80.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.02
|
| Rate for Payer: Nomi Health Commercial |
$73.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$78.70
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
OP
|
$1,735.21
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,216.38 |
| Max. Negotiated Rate |
$4,876.50 |
| Rate for Payer: Aetna Commercial |
$1,561.69
|
| Rate for Payer: Aetna Medicare |
$3,146.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: ASR ASR |
$1,683.15
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,430.68
|
| Rate for Payer: BCN Commercial |
$1,430.68
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cofinity Commercial |
$1,631.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,683.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,735.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,146.13
|
| Rate for Payer: Mclaren Commercial |
$1,561.69
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$1,727.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.93
|
| Rate for Payer: Nomi Health Commercial |
$1,422.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,301.41
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,460.74
|
| Rate for Payer: PHP Medicaid |
$1,686.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,520.39
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,216.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,526.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$4,876.50
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP DNSP |
$3,146.13
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
IP
|
$1,735.21
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,301.41 |
| Max. Negotiated Rate |
$1,735.21 |
| Rate for Payer: Aetna Commercial |
$1,561.69
|
| Rate for Payer: ASR ASR |
$1,683.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,424.95
|
| Rate for Payer: BCN Commercial |
$1,424.95
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cofinity Commercial |
$1,631.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.17
|
| Rate for Payer: Healthscope Commercial |
$1,683.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,735.21
|
| Rate for Payer: Mclaren Commercial |
$1,561.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.93
|
| Rate for Payer: Nomi Health Commercial |
$1,422.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,301.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,526.98
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
OP
|
$107.30
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$107.30 |
| Rate for Payer: Aetna Commercial |
$96.57
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: ASR ASR |
$104.08
|
| Rate for Payer: BCBS Complete |
$20.44
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$88.47
|
| Rate for Payer: BCN Commercial |
$88.47
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cofinity Commercial |
$100.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Healthscope Whirlpool |
$107.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.22
|
| Rate for Payer: Mclaren Commercial |
$96.57
|
| Rate for Payer: Mclaren Medicaid |
$37.22
|
| Rate for Payer: Mclaren Medicare |
$37.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$20.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.20
|
| Rate for Payer: Nomi Health Commercial |
$87.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.47
|
| Rate for Payer: PACE Medicare |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$40.94
|
| Rate for Payer: PHP Medicaid |
$19.95
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.02
|
| Rate for Payer: Priority Health Medicare |
$37.22
|
| Rate for Payer: Priority Health Narrow Network |
$75.22
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.22
|
| Rate for Payer: UHC Exchange |
$57.69
|
| Rate for Payer: UHC Medicaid |
$19.47
|
| Rate for Payer: UHCCP DNSP |
$37.22
|
| Rate for Payer: UHCCP Medicaid |
$19.47
|
| Rate for Payer: VA VA |
$37.22
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
IP
|
$107.30
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$80.47 |
| Max. Negotiated Rate |
$107.30 |
| Rate for Payer: Aetna Commercial |
$96.57
|
| Rate for Payer: ASR ASR |
$104.08
|
| Rate for Payer: BCBS Trust/PPO |
$88.11
|
| Rate for Payer: BCN Commercial |
$88.11
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cofinity Commercial |
$100.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.84
|
| Rate for Payer: Healthscope Commercial |
$104.08
|
| Rate for Payer: Healthscope Whirlpool |
$107.30
|
| Rate for Payer: Mclaren Commercial |
$96.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.20
|
| Rate for Payer: Nomi Health Commercial |
$87.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.42
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
OP
|
$379.26
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$379.26 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare |
$132.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: ASR ASR |
$367.88
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$312.70
|
| Rate for Payer: BCN Commercial |
$312.70
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$367.88
|
| Rate for Payer: Healthscope Whirlpool |
$379.26
|
| Rate for Payer: Humana Choice PPO Medicare |
$132.57
|
| Rate for Payer: Mclaren Commercial |
$341.33
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.37
|
| Rate for Payer: Nomi Health Commercial |
$310.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.44
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$145.83
|
| Rate for Payer: PHP Medicaid |
$71.06
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.57
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health Narrow Network |
$106.06
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$205.48
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP DNSP |
$132.57
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: VA VA |
$132.57
|
|
