|
HC PSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HOUR
|
Facility
|
IP
|
$542.64
|
|
|
Service Code
|
CPT 96131
|
| Hospital Charge Code |
91800449
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$352.72 |
| Max. Negotiated Rate |
$542.64 |
| Rate for Payer: Aetna Commercial |
$488.38
|
| Rate for Payer: ASR ASR |
$526.36
|
| Rate for Payer: ASR Commercial |
$526.36
|
| Rate for Payer: BCBS Trust/PPO |
$442.20
|
| Rate for Payer: BCN Commercial |
$420.71
|
| Rate for Payer: Cash Price |
$434.11
|
| Rate for Payer: Cofinity Commercial |
$510.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.11
|
| Rate for Payer: Healthscope Commercial |
$542.64
|
| Rate for Payer: Healthscope Whirlpool |
$526.36
|
| Rate for Payer: Mclaren Commercial |
$488.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.24
|
| Rate for Payer: Nomi Health Commercial |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$477.52
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
OP
|
$86.96
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$56.52 |
| Max. Negotiated Rate |
$242.88 |
| Rate for Payer: Aetna Commercial |
$78.26
|
| Rate for Payer: Aetna Medicare |
$156.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: ASR ASR |
$84.35
|
| Rate for Payer: ASR Commercial |
$84.35
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCBS Trust/PPO |
$71.21
|
| Rate for Payer: BCN Commercial |
$67.42
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cofinity Commercial |
$81.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$86.96
|
| Rate for Payer: Healthscope Whirlpool |
$84.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$156.70
|
| Rate for Payer: Mclaren Commercial |
$78.26
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.92
|
| Rate for Payer: Nomi Health Commercial |
$71.31
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$172.37
|
| Rate for Payer: PHP Medicaid |
$83.99
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.19
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health Narrow Network |
$60.96
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$242.88
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP DNSP |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: VA VA |
$156.70
|
|
|
HC PSYCHOTHERAPY 30 MIN W/PATIENT
|
Facility
|
IP
|
$86.96
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
91400001
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$56.52 |
| Max. Negotiated Rate |
$86.96 |
| Rate for Payer: Aetna Commercial |
$78.26
|
| Rate for Payer: ASR ASR |
$84.35
|
| Rate for Payer: ASR Commercial |
$84.35
|
| Rate for Payer: BCBS Trust/PPO |
$70.86
|
| Rate for Payer: BCN Commercial |
$67.42
|
| Rate for Payer: Cash Price |
$69.57
|
| Rate for Payer: Cofinity Commercial |
$81.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.57
|
| Rate for Payer: Healthscope Commercial |
$86.96
|
| Rate for Payer: Healthscope Whirlpool |
$84.35
|
| Rate for Payer: Mclaren Commercial |
$78.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.92
|
| Rate for Payer: Nomi Health Commercial |
$71.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.52
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
IP
|
$156.11
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$101.47 |
| Max. Negotiated Rate |
$156.11 |
| Rate for Payer: Aetna Commercial |
$140.50
|
| Rate for Payer: ASR ASR |
$151.43
|
| Rate for Payer: ASR Commercial |
$151.43
|
| Rate for Payer: BCBS Trust/PPO |
$127.21
|
| Rate for Payer: BCN Commercial |
$121.03
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$146.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.89
|
| Rate for Payer: Healthscope Commercial |
$156.11
|
| Rate for Payer: Healthscope Whirlpool |
$151.43
|
| Rate for Payer: Mclaren Commercial |
$140.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: Nomi Health Commercial |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.38
|
|
|
HC PSYCHOTHERAPY 45 MIN W/PATIENT
|
Facility
|
OP
|
$156.11
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
91400002
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$83.99 |
| Max. Negotiated Rate |
$242.88 |
| Rate for Payer: Aetna Commercial |
$140.50
|
| Rate for Payer: Aetna Medicare |
$156.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: ASR ASR |
$151.43
|
| Rate for Payer: ASR Commercial |
$151.43
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCBS Trust/PPO |
$127.84
|
| Rate for Payer: BCN Commercial |
$121.03
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cash Price |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$146.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$156.11
|
| Rate for Payer: Healthscope Whirlpool |
$151.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$156.70
|
| Rate for Payer: Mclaren Commercial |
$140.50
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.69
|
| Rate for Payer: Nomi Health Commercial |
$128.01
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$172.37
|
| Rate for Payer: PHP Medicaid |
$83.99
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.78
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health Narrow Network |
$109.43
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$242.88
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP DNSP |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: VA VA |
$156.70
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
OP
|
$131.09
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$83.99 |
| Max. Negotiated Rate |
$242.88 |
| Rate for Payer: Aetna Commercial |
$117.98
|
| Rate for Payer: Aetna Medicare |
$156.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: ASR ASR |
$127.16
|
| Rate for Payer: ASR Commercial |
$127.16
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCBS Trust/PPO |
$107.35
|
| Rate for Payer: BCN Commercial |
$101.63
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cofinity Commercial |
$123.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Healthscope Whirlpool |
$127.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$156.70
|
| Rate for Payer: Mclaren Commercial |
$117.98
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.43
|
| Rate for Payer: Nomi Health Commercial |
$107.49
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$172.37
|
| Rate for Payer: PHP Medicaid |
$83.99
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.86
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health Narrow Network |
$91.89
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$242.88
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP DNSP |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: VA VA |
$156.70
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
IP
|
$131.09
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
91400005
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$85.21 |
| Max. Negotiated Rate |
$131.09 |
| Rate for Payer: Aetna Commercial |
$117.98
|
| Rate for Payer: ASR ASR |
$127.16
|
| Rate for Payer: ASR Commercial |
$127.16
|
| Rate for Payer: BCBS Trust/PPO |
$106.83
|
| Rate for Payer: BCN Commercial |
$101.63
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cofinity Commercial |
$123.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.87
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Healthscope Whirlpool |
$127.16
|
| Rate for Payer: Mclaren Commercial |
$117.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.43
|
| Rate for Payer: Nomi Health Commercial |
$107.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.36
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Trust/PPO |
$37.40
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
91400012
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$41.31
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: ASR ASR |
$44.52
|
| Rate for Payer: ASR Commercial |
$44.52
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$37.59
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Healthscope Whirlpool |
$44.52
|
| Rate for Payer: Mclaren Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.22
|
| Rate for Payer: Priority Health Narrow Network |
$32.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.39
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
OP
|
$118.32
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$47.33 |
| Max. Negotiated Rate |
$118.32 |
| Rate for Payer: Aetna Commercial |
$106.49
|
| Rate for Payer: Aetna Medicare |
$59.16
|
| Rate for Payer: ASR ASR |
$114.77
|
| Rate for Payer: ASR Commercial |
$114.77
|
| Rate for Payer: BCBS Complete |
$47.33
|
| Rate for Payer: BCBS Trust/PPO |
$96.89
|
| Rate for Payer: BCN Commercial |
$91.73
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cofinity Commercial |
$111.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$118.32
|
| Rate for Payer: Healthscope Whirlpool |
$114.77
|
| Rate for Payer: Mclaren Commercial |
$106.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.57
|
| Rate for Payer: Nomi Health Commercial |
$97.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.67
|
| Rate for Payer: Priority Health Narrow Network |
$82.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.12
|
|
|
HC PSYCHOTHERAPY FOR CRISIS EA ADDL 15 MIN
|
Facility
|
IP
|
$118.32
|
|
|
Service Code
|
CPT 90840
|
| Hospital Charge Code |
91400014
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$76.91 |
| Max. Negotiated Rate |
$118.32 |
| Rate for Payer: Aetna Commercial |
$106.49
|
| Rate for Payer: ASR ASR |
$114.77
|
| Rate for Payer: ASR Commercial |
$114.77
|
| Rate for Payer: BCBS Trust/PPO |
$96.42
|
| Rate for Payer: BCN Commercial |
$91.73
|
| Rate for Payer: Cash Price |
$94.66
|
| Rate for Payer: Cofinity Commercial |
$111.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$118.32
|
| Rate for Payer: Healthscope Whirlpool |
$114.77
|
| Rate for Payer: Mclaren Commercial |
$106.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.57
|
| Rate for Payer: Nomi Health Commercial |
$97.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.12
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
OP
|
$229.50
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$83.99 |
| Max. Negotiated Rate |
$242.88 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: Aetna Medicare |
$156.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.88
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: ASR Commercial |
$222.62
|
| Rate for Payer: BCBS Complete |
$88.19
|
| Rate for Payer: BCBS MAPPO |
$156.70
|
| Rate for Payer: BCBS Trust/PPO |
$187.94
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: BCN Medicare Advantage |
$156.70
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.70
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$156.70
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Mclaren Medicaid |
$83.99
|
| Rate for Payer: Mclaren Medicare |
$156.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.53
|
| Rate for Payer: Meridian Medicaid |
$88.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.07
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: PACE Medicare |
$148.87
|
| Rate for Payer: PACE SWMI |
$156.70
|
| Rate for Payer: PHP Commercial |
$172.37
|
| Rate for Payer: PHP Medicaid |
$83.99
|
| Rate for Payer: PHP Medicare Advantage |
$156.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.09
|
| Rate for Payer: Priority Health Medicare |
$156.70
|
| Rate for Payer: Priority Health Narrow Network |
$160.88
|
| Rate for Payer: Railroad Medicare Medicare |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.70
|
| Rate for Payer: UHC Exchange |
$242.88
|
| Rate for Payer: UHC Medicare Advantage |
$156.70
|
| Rate for Payer: UHCCP DNSP |
$156.70
|
| Rate for Payer: UHCCP Medicaid |
$83.99
|
| Rate for Payer: VA VA |
$156.70
|
|
|
HC PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN
|
Facility
|
IP
|
$229.50
|
|
|
Service Code
|
CPT 90839
|
| Hospital Charge Code |
91400003
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$149.18 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$206.55
|
| Rate for Payer: ASR ASR |
$222.62
|
| Rate for Payer: ASR Commercial |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$187.02
|
| Rate for Payer: BCN Commercial |
$177.93
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$215.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Healthscope Whirlpool |
$222.62
|
| Rate for Payer: Mclaren Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.07
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.96
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
IP
|
$7,290.61
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,738.90 |
| Max. Negotiated Rate |
$7,290.61 |
| Rate for Payer: Aetna Commercial |
$6,561.55
|
| Rate for Payer: ASR ASR |
$7,071.89
|
| Rate for Payer: ASR Commercial |
$7,071.89
|
| Rate for Payer: BCBS Trust/PPO |
$5,941.12
|
| Rate for Payer: BCN Commercial |
$5,652.41
|
| Rate for Payer: Cash Price |
$5,832.49
|
| Rate for Payer: Cofinity Commercial |
$6,853.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.49
|
| Rate for Payer: Healthscope Commercial |
$7,290.61
|
| Rate for Payer: Healthscope Whirlpool |
$7,071.89
|
| Rate for Payer: Mclaren Commercial |
$6,561.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,197.02
|
| Rate for Payer: Nomi Health Commercial |
$5,978.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,415.74
|
|
|
HC PTCA ADD/BRANCH
|
Facility
|
OP
|
$7,290.61
|
|
|
Service Code
|
CPT 92921
|
| Hospital Charge Code |
48100099
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,916.24 |
| Max. Negotiated Rate |
$7,290.61 |
| Rate for Payer: Aetna Commercial |
$6,561.55
|
| Rate for Payer: Aetna Medicare |
$3,645.30
|
| Rate for Payer: ASR ASR |
$7,071.89
|
| Rate for Payer: ASR Commercial |
$7,071.89
|
| Rate for Payer: BCBS Complete |
$2,916.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,970.28
|
| Rate for Payer: BCN Commercial |
$5,652.41
|
| Rate for Payer: Cash Price |
$5,832.49
|
| Rate for Payer: Cofinity Commercial |
$6,853.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,832.49
|
| Rate for Payer: Healthscope Commercial |
$7,290.61
|
| Rate for Payer: Healthscope Whirlpool |
$7,071.89
|
| Rate for Payer: Mclaren Commercial |
$6,561.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,197.02
|
| Rate for Payer: Nomi Health Commercial |
$5,978.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,738.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,388.03
|
| Rate for Payer: Priority Health Narrow Network |
$5,110.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,415.74
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
OP
|
$11,199.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$11,199.75 |
| Rate for Payer: Aetna Commercial |
$10,079.77
|
| Rate for Payer: Aetna Medicare |
$5,560.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: ASR ASR |
$10,863.76
|
| Rate for Payer: ASR Commercial |
$10,863.76
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCBS Trust/PPO |
$9,171.48
|
| Rate for Payer: BCN Commercial |
$8,683.17
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cofinity Commercial |
$10,527.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$11,199.75
|
| Rate for Payer: Healthscope Whirlpool |
$10,863.76
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,560.58
|
| Rate for Payer: Mclaren Commercial |
$10,079.77
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.79
|
| Rate for Payer: Nomi Health Commercial |
$9,183.80
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$6,116.64
|
| Rate for Payer: PHP Medicaid |
$2,980.47
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,813.22
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health Narrow Network |
$7,851.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,855.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$8,618.90
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP DNSP |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: VA VA |
$5,560.58
|
|
|
HC PTCA VESSEL/BRANCH
|
Facility
|
IP
|
$11,199.75
|
|
|
Service Code
|
CPT 92920
|
| Hospital Charge Code |
48100098
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,279.84 |
| Max. Negotiated Rate |
$11,199.75 |
| Rate for Payer: Aetna Commercial |
$10,079.77
|
| Rate for Payer: ASR ASR |
$10,863.76
|
| Rate for Payer: ASR Commercial |
$10,863.76
|
| Rate for Payer: BCBS Trust/PPO |
$9,126.68
|
| Rate for Payer: BCN Commercial |
$8,683.17
|
| Rate for Payer: Cash Price |
$8,959.80
|
| Rate for Payer: Cofinity Commercial |
$10,527.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.80
|
| Rate for Payer: Healthscope Commercial |
$11,199.75
|
| Rate for Payer: Healthscope Whirlpool |
$10,863.76
|
| Rate for Payer: Mclaren Commercial |
$10,079.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.79
|
| Rate for Payer: Nomi Health Commercial |
$9,183.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9,855.78
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,416.24 |
| Max. Negotiated Rate |
$19,101.90 |
| Rate for Payer: Aetna Commercial |
$17,191.71
|
| Rate for Payer: ASR ASR |
$18,528.84
|
| Rate for Payer: ASR Commercial |
$18,528.84
|
| Rate for Payer: BCBS Trust/PPO |
$15,566.14
|
| Rate for Payer: BCN Commercial |
$14,809.70
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$17,955.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$19,101.90
|
| Rate for Payer: Healthscope Whirlpool |
$18,528.84
|
| Rate for Payer: Mclaren Commercial |
$17,191.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,809.67
|
|
|
HC PTCRAWDES ADD.BRANCH
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
48100080
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,640.76 |
| Max. Negotiated Rate |
$19,101.90 |
| Rate for Payer: Aetna Commercial |
$17,191.71
|
| Rate for Payer: Aetna Medicare |
$9,550.95
|
| Rate for Payer: ASR ASR |
$18,528.84
|
| Rate for Payer: ASR Commercial |
$18,528.84
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: BCBS Trust/PPO |
$15,642.55
|
| Rate for Payer: BCN Commercial |
$14,809.70
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$17,955.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$19,101.90
|
| Rate for Payer: Healthscope Whirlpool |
$18,528.84
|
| Rate for Payer: Mclaren Commercial |
$17,191.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,737.08
|
| Rate for Payer: Priority Health Narrow Network |
$13,390.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,809.67
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$29,158.60 |
| Rate for Payer: Aetna Commercial |
$26,242.74
|
| Rate for Payer: Aetna Medicare |
$17,512.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: ASR ASR |
$28,283.84
|
| Rate for Payer: ASR Commercial |
$28,283.84
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCBS Trust/PPO |
$23,877.98
|
| Rate for Payer: BCN Commercial |
$22,606.66
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$27,409.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$29,158.60
|
| Rate for Payer: Healthscope Whirlpool |
$28,283.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$17,512.83
|
| Rate for Payer: Mclaren Commercial |
$26,242.74
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$19,264.11
|
| Rate for Payer: PHP Medicaid |
$9,386.88
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,548.77
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health Narrow Network |
$20,440.18
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,659.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$27,144.89
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP DNSP |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: VA VA |
$17,512.83
|
|
|
HC PTCRAWDES VES/BRANCH
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
48100079
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$18,953.09 |
| Max. Negotiated Rate |
$29,158.60 |
| Rate for Payer: Aetna Commercial |
$26,242.74
|
| Rate for Payer: ASR ASR |
$28,283.84
|
| Rate for Payer: ASR Commercial |
$28,283.84
|
| Rate for Payer: BCBS Trust/PPO |
$23,761.34
|
| Rate for Payer: BCN Commercial |
$22,606.66
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$27,409.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$29,158.60
|
| Rate for Payer: Healthscope Whirlpool |
$28,283.84
|
| Rate for Payer: Mclaren Commercial |
$26,242.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$25,659.57
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
OP
|
$11,940.30
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,776.12 |
| Max. Negotiated Rate |
$11,940.30 |
| Rate for Payer: Aetna Commercial |
$10,746.27
|
| Rate for Payer: Aetna Medicare |
$5,970.15
|
| Rate for Payer: ASR ASR |
$11,582.09
|
| Rate for Payer: ASR Commercial |
$11,582.09
|
| Rate for Payer: BCBS Complete |
$4,776.12
|
| Rate for Payer: BCBS Trust/PPO |
$9,777.91
|
| Rate for Payer: BCN Commercial |
$9,257.31
|
| Rate for Payer: Cash Price |
$9,552.24
|
| Rate for Payer: Cofinity Commercial |
$11,223.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,552.24
|
| Rate for Payer: Healthscope Commercial |
$11,940.30
|
| Rate for Payer: Healthscope Whirlpool |
$11,582.09
|
| Rate for Payer: Mclaren Commercial |
$10,746.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,149.25
|
| Rate for Payer: Nomi Health Commercial |
$9,791.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,761.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,462.09
|
| Rate for Payer: Priority Health Narrow Network |
$8,370.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,507.46
|
|
|
HC PTCRAWPTCA ADD.BRANCH
|
Facility
|
IP
|
$11,940.30
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
48100097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,761.19 |
| Max. Negotiated Rate |
$11,940.30 |
| Rate for Payer: Aetna Commercial |
$10,746.27
|
| Rate for Payer: ASR ASR |
$11,582.09
|
| Rate for Payer: ASR Commercial |
$11,582.09
|
| Rate for Payer: BCBS Trust/PPO |
$9,730.15
|
| Rate for Payer: BCN Commercial |
$9,257.31
|
| Rate for Payer: Cash Price |
$9,552.24
|
| Rate for Payer: Cofinity Commercial |
$11,223.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,552.24
|
| Rate for Payer: Healthscope Commercial |
$11,940.30
|
| Rate for Payer: Healthscope Whirlpool |
$11,582.09
|
| Rate for Payer: Mclaren Commercial |
$10,746.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,149.25
|
| Rate for Payer: Nomi Health Commercial |
$9,791.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,761.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10,507.46
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,640.76 |
| Max. Negotiated Rate |
$19,101.90 |
| Rate for Payer: Aetna Commercial |
$17,191.71
|
| Rate for Payer: Aetna Medicare |
$9,550.95
|
| Rate for Payer: ASR ASR |
$18,528.84
|
| Rate for Payer: ASR Commercial |
$18,528.84
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: BCBS Trust/PPO |
$15,642.55
|
| Rate for Payer: BCN Commercial |
$14,809.70
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$17,955.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$19,101.90
|
| Rate for Payer: Healthscope Whirlpool |
$18,528.84
|
| Rate for Payer: Mclaren Commercial |
$17,191.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,737.08
|
| Rate for Payer: Priority Health Narrow Network |
$13,390.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,809.67
|
|
|
HC PTCRAWSTENT ADD.BRANCH
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
48100078
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,416.24 |
| Max. Negotiated Rate |
$19,101.90 |
| Rate for Payer: Aetna Commercial |
$17,191.71
|
| Rate for Payer: ASR ASR |
$18,528.84
|
| Rate for Payer: ASR Commercial |
$18,528.84
|
| Rate for Payer: BCBS Trust/PPO |
$15,566.14
|
| Rate for Payer: BCN Commercial |
$14,809.70
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$17,955.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$19,101.90
|
| Rate for Payer: Healthscope Whirlpool |
$18,528.84
|
| Rate for Payer: Mclaren Commercial |
$17,191.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16,809.67
|
|
