|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
IP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$168.71 |
| Max. Negotiated Rate |
$259.56 |
| Rate for Payer: Aetna Commercial |
$233.60
|
| Rate for Payer: ASR ASR |
$251.77
|
| Rate for Payer: ASR Commercial |
$251.77
|
| Rate for Payer: BCBS Trust/PPO |
$211.52
|
| Rate for Payer: BCN Commercial |
$201.24
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$243.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$259.56
|
| Rate for Payer: Healthscope Whirlpool |
$251.77
|
| Rate for Payer: Mclaren Commercial |
$233.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$212.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.41
|
|
|
HC SPEECH SOUND PRODUCTION EVAL
|
Facility
|
OP
|
$259.56
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
44400010
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$103.82 |
| Max. Negotiated Rate |
$259.56 |
| Rate for Payer: Aetna Commercial |
$233.60
|
| Rate for Payer: Aetna Medicare |
$129.78
|
| Rate for Payer: ASR ASR |
$251.77
|
| Rate for Payer: ASR Commercial |
$251.77
|
| Rate for Payer: BCBS Complete |
$103.82
|
| Rate for Payer: BCBS Trust/PPO |
$212.55
|
| Rate for Payer: BCN Commercial |
$201.24
|
| Rate for Payer: Cash Price |
$207.65
|
| Rate for Payer: Cofinity Commercial |
$243.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.65
|
| Rate for Payer: Healthscope Commercial |
$259.56
|
| Rate for Payer: Healthscope Whirlpool |
$251.77
|
| Rate for Payer: Mclaren Commercial |
$233.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.63
|
| Rate for Payer: Nomi Health Commercial |
$212.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$227.43
|
| Rate for Payer: Priority Health Narrow Network |
$181.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.41
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
IP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$50.12 |
| Rate for Payer: Aetna Commercial |
$45.11
|
| Rate for Payer: ASR ASR |
$48.62
|
| Rate for Payer: ASR Commercial |
$48.62
|
| Rate for Payer: BCBS Trust/PPO |
$40.84
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$47.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Healthscope Commercial |
$50.12
|
| Rate for Payer: Healthscope Whirlpool |
$48.62
|
| Rate for Payer: Mclaren Commercial |
$45.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.11
|
|
|
HC SPEECH THRESHOLD AUDIOMETRY
|
Facility
|
OP
|
$50.12
|
|
|
Service Code
|
CPT 92555
|
| Hospital Charge Code |
47100011
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$89.79 |
| Rate for Payer: Aetna Commercial |
$45.11
|
| Rate for Payer: Aetna Medicare |
$57.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: ASR ASR |
$48.62
|
| Rate for Payer: ASR Commercial |
$48.62
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$41.04
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cash Price |
$40.10
|
| Rate for Payer: Cofinity Commercial |
$47.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$50.12
|
| Rate for Payer: Healthscope Whirlpool |
$48.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.93
|
| Rate for Payer: Mclaren Commercial |
$45.11
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.60
|
| Rate for Payer: Nomi Health Commercial |
$41.10
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$63.72
|
| Rate for Payer: PHP Medicaid |
$31.05
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.92
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health Narrow Network |
$35.13
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$89.79
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP DNSP |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: VA VA |
$57.93
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
OP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$397.01 |
| Rate for Payer: Aetna Commercial |
$357.31
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: ASR ASR |
$385.10
|
| Rate for Payer: ASR Commercial |
$385.10
|
| Rate for Payer: BCBS Complete |
$158.80
|
| Rate for Payer: BCBS Trust/PPO |
$325.11
|
| Rate for Payer: BCN Commercial |
$307.80
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$373.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$397.01
|
| Rate for Payer: Healthscope Whirlpool |
$385.10
|
| Rate for Payer: Mclaren Commercial |
$357.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$325.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$347.86
|
| Rate for Payer: Priority Health Narrow Network |
$278.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.37
|
|
|
HC SPEECH VIDEO FLUORO EVAL
|
Facility
|
IP
|
$397.01
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
44000004
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$258.06 |
| Max. Negotiated Rate |
$397.01 |
| Rate for Payer: Aetna Commercial |
$357.31
|
| Rate for Payer: ASR ASR |
$385.10
|
| Rate for Payer: ASR Commercial |
$385.10
|
| Rate for Payer: BCBS Trust/PPO |
$323.52
|
| Rate for Payer: BCN Commercial |
$307.80
|
| Rate for Payer: Cash Price |
$317.61
|
| Rate for Payer: Cofinity Commercial |
$373.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.61
|
| Rate for Payer: Healthscope Commercial |
$397.01
|
| Rate for Payer: Healthscope Whirlpool |
$385.10
|
| Rate for Payer: Mclaren Commercial |
$357.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.46
|
| Rate for Payer: Nomi Health Commercial |
$325.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.37
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
OP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$115.38 |
| Max. Negotiated Rate |
$288.45 |
| Rate for Payer: Aetna Commercial |
$259.61
|
| Rate for Payer: Aetna Medicare |
$144.22
|
| Rate for Payer: ASR ASR |
$279.80
|
| Rate for Payer: ASR Commercial |
$279.80
|
| Rate for Payer: BCBS Complete |
$115.38
|
| Rate for Payer: BCBS Trust/PPO |
$236.21
|
| Rate for Payer: BCN Commercial |
$223.64
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$271.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$288.45
|
| Rate for Payer: Healthscope Whirlpool |
$279.80
|
| Rate for Payer: Mclaren Commercial |
$259.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$236.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.74
|
| Rate for Payer: Priority Health Narrow Network |
$202.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.84
|
|
|
HC SPEECH VOICE EVALUATION
|
Facility
|
IP
|
$288.45
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
44400011
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$187.49 |
| Max. Negotiated Rate |
$288.45 |
| Rate for Payer: Aetna Commercial |
$259.61
|
| Rate for Payer: ASR ASR |
$279.80
|
| Rate for Payer: ASR Commercial |
$279.80
|
| Rate for Payer: BCBS Trust/PPO |
$235.06
|
| Rate for Payer: BCN Commercial |
$223.64
|
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Cofinity Commercial |
$271.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.76
|
| Rate for Payer: Healthscope Commercial |
$288.45
|
| Rate for Payer: Healthscope Whirlpool |
$279.80
|
| Rate for Payer: Mclaren Commercial |
$259.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.18
|
| Rate for Payer: Nomi Health Commercial |
$236.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.84
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
IP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Aetna Commercial |
$14.46
|
| Rate for Payer: ASR ASR |
$15.59
|
| Rate for Payer: ASR Commercial |
$15.59
|
| Rate for Payer: BCBS Trust/PPO |
$13.10
|
| Rate for Payer: BCN Commercial |
$12.46
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$16.07
|
| Rate for Payer: Healthscope Whirlpool |
$15.59
|
| Rate for Payer: Mclaren Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.14
|
|
|
HC SPIKE BLOOD ACCESS
|
Facility
|
OP
|
$16.07
|
|
| Hospital Charge Code |
27000669
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Aetna Commercial |
$14.46
|
| Rate for Payer: Aetna Medicare |
$8.04
|
| Rate for Payer: ASR ASR |
$15.59
|
| Rate for Payer: ASR Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$6.43
|
| Rate for Payer: BCBS Trust/PPO |
$13.16
|
| Rate for Payer: BCN Commercial |
$12.46
|
| Rate for Payer: Cash Price |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$15.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.86
|
| Rate for Payer: Healthscope Commercial |
$16.07
|
| Rate for Payer: Healthscope Whirlpool |
$15.59
|
| Rate for Payer: Mclaren Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.66
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.08
|
| Rate for Payer: Priority Health Narrow Network |
$11.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.14
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
IP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$103.81 |
| Max. Negotiated Rate |
$159.71 |
| Rate for Payer: Aetna Commercial |
$143.74
|
| Rate for Payer: ASR ASR |
$154.92
|
| Rate for Payer: ASR Commercial |
$154.92
|
| Rate for Payer: BCBS Trust/PPO |
$130.15
|
| Rate for Payer: BCN Commercial |
$123.82
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$150.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$159.71
|
| Rate for Payer: Healthscope Whirlpool |
$154.92
|
| Rate for Payer: Mclaren Commercial |
$143.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.54
|
|
|
HC SPINAL/EPI ADDL 15 MIN
|
Facility
|
OP
|
$159.71
|
|
| Hospital Charge Code |
37000013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.88 |
| Max. Negotiated Rate |
$159.71 |
| Rate for Payer: Aetna Commercial |
$143.74
|
| Rate for Payer: Aetna Medicare |
$79.86
|
| Rate for Payer: ASR ASR |
$154.92
|
| Rate for Payer: ASR Commercial |
$154.92
|
| Rate for Payer: BCBS Complete |
$63.88
|
| Rate for Payer: BCBS Trust/PPO |
$130.79
|
| Rate for Payer: BCN Commercial |
$123.82
|
| Rate for Payer: Cash Price |
$127.77
|
| Rate for Payer: Cofinity Commercial |
$150.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.77
|
| Rate for Payer: Healthscope Commercial |
$159.71
|
| Rate for Payer: Healthscope Whirlpool |
$154.92
|
| Rate for Payer: Mclaren Commercial |
$143.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.75
|
| Rate for Payer: Nomi Health Commercial |
$130.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.94
|
| Rate for Payer: Priority Health Narrow Network |
$111.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.54
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
IP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$283.87 |
| Max. Negotiated Rate |
$436.73 |
| Rate for Payer: Aetna Commercial |
$393.06
|
| Rate for Payer: ASR ASR |
$423.63
|
| Rate for Payer: ASR Commercial |
$423.63
|
| Rate for Payer: BCBS Trust/PPO |
$355.89
|
| Rate for Payer: BCN Commercial |
$338.60
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$410.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$436.73
|
| Rate for Payer: Healthscope Whirlpool |
$423.63
|
| Rate for Payer: Mclaren Commercial |
$393.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: Nomi Health Commercial |
$358.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.32
|
|
|
HC SPINAL/EPI INIT 30 MIN
|
Facility
|
OP
|
$436.73
|
|
| Hospital Charge Code |
37000014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.69 |
| Max. Negotiated Rate |
$436.73 |
| Rate for Payer: Aetna Commercial |
$393.06
|
| Rate for Payer: Aetna Medicare |
$218.37
|
| Rate for Payer: ASR ASR |
$423.63
|
| Rate for Payer: ASR Commercial |
$423.63
|
| Rate for Payer: BCBS Complete |
$174.69
|
| Rate for Payer: BCBS Trust/PPO |
$357.64
|
| Rate for Payer: BCN Commercial |
$338.60
|
| Rate for Payer: Cash Price |
$349.38
|
| Rate for Payer: Cofinity Commercial |
$410.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.38
|
| Rate for Payer: Healthscope Commercial |
$436.73
|
| Rate for Payer: Healthscope Whirlpool |
$423.63
|
| Rate for Payer: Mclaren Commercial |
$393.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.22
|
| Rate for Payer: Nomi Health Commercial |
$358.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.66
|
| Rate for Payer: Priority Health Narrow Network |
$306.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.32
|
|
|
HC SPINE JACK
|
Facility
|
IP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,177.35 |
| Max. Negotiated Rate |
$14,119.00 |
| Rate for Payer: Aetna Commercial |
$12,707.10
|
| Rate for Payer: ASR ASR |
$13,695.43
|
| Rate for Payer: ASR Commercial |
$13,695.43
|
| Rate for Payer: BCBS Trust/PPO |
$11,505.57
|
| Rate for Payer: BCN Commercial |
$10,946.46
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$13,271.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$14,119.00
|
| Rate for Payer: Healthscope Whirlpool |
$13,695.43
|
| Rate for Payer: Mclaren Commercial |
$12,707.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: Nomi Health Commercial |
$11,577.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,424.72
|
|
|
HC SPINE JACK
|
Facility
|
OP
|
$14,119.00
|
|
|
Service Code
|
CPT C1062
|
| Hospital Charge Code |
27800148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,647.60 |
| Max. Negotiated Rate |
$14,119.00 |
| Rate for Payer: Aetna Commercial |
$12,707.10
|
| Rate for Payer: Aetna Medicare |
$7,059.50
|
| Rate for Payer: ASR ASR |
$13,695.43
|
| Rate for Payer: ASR Commercial |
$13,695.43
|
| Rate for Payer: BCBS Complete |
$5,647.60
|
| Rate for Payer: BCBS Trust/PPO |
$11,562.05
|
| Rate for Payer: BCN Commercial |
$10,946.46
|
| Rate for Payer: Cash Price |
$11,295.20
|
| Rate for Payer: Cofinity Commercial |
$13,271.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,295.20
|
| Rate for Payer: Healthscope Commercial |
$14,119.00
|
| Rate for Payer: Healthscope Whirlpool |
$13,695.43
|
| Rate for Payer: Mclaren Commercial |
$12,707.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,001.15
|
| Rate for Payer: Nomi Health Commercial |
$11,577.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,177.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,371.07
|
| Rate for Payer: Priority Health Narrow Network |
$9,897.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12,424.72
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
IP
|
$150.54
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$150.54 |
| Rate for Payer: Aetna Commercial |
$135.49
|
| Rate for Payer: ASR ASR |
$146.02
|
| Rate for Payer: ASR Commercial |
$146.02
|
| Rate for Payer: BCBS Trust/PPO |
$122.68
|
| Rate for Payer: BCN Commercial |
$116.71
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$141.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Healthscope Commercial |
$150.54
|
| Rate for Payer: Healthscope Whirlpool |
$146.02
|
| Rate for Payer: Mclaren Commercial |
$135.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.48
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 1 VIEW
|
Facility
|
OP
|
$150.54
|
|
|
Service Code
|
CPT 72081
|
| Hospital Charge Code |
32000317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$150.54 |
| Rate for Payer: Aetna Commercial |
$135.49
|
| Rate for Payer: Aetna Medicare |
$85.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: ASR ASR |
$146.02
|
| Rate for Payer: ASR Commercial |
$146.02
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$123.28
|
| Rate for Payer: BCN Commercial |
$116.71
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$141.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$150.54
|
| Rate for Payer: Healthscope Whirlpool |
$146.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$85.87
|
| Rate for Payer: Mclaren Commercial |
$135.49
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$94.46
|
| Rate for Payer: PHP Medicaid |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.90
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$105.53
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$133.10
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP DNSP |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: VA VA |
$85.87
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
OP
|
$361.32
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$361.32 |
| Rate for Payer: Aetna Commercial |
$325.19
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$350.48
|
| Rate for Payer: ASR Commercial |
$350.48
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$295.88
|
| Rate for Payer: BCN Commercial |
$280.13
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cofinity Commercial |
$339.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$361.32
|
| Rate for Payer: Healthscope Whirlpool |
$350.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$325.19
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.12
|
| Rate for Payer: Nomi Health Commercial |
$296.28
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.59
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$253.29
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 2 OR 3 VIEW
|
Facility
|
IP
|
$361.32
|
|
|
Service Code
|
CPT 72082
|
| Hospital Charge Code |
32000306
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$234.86 |
| Max. Negotiated Rate |
$361.32 |
| Rate for Payer: Aetna Commercial |
$325.19
|
| Rate for Payer: ASR ASR |
$350.48
|
| Rate for Payer: ASR Commercial |
$350.48
|
| Rate for Payer: BCBS Trust/PPO |
$294.44
|
| Rate for Payer: BCN Commercial |
$280.13
|
| Rate for Payer: Cash Price |
$289.06
|
| Rate for Payer: Cofinity Commercial |
$339.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.06
|
| Rate for Payer: Healthscope Commercial |
$361.32
|
| Rate for Payer: Healthscope Whirlpool |
$350.48
|
| Rate for Payer: Mclaren Commercial |
$325.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.12
|
| Rate for Payer: Nomi Health Commercial |
$296.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$317.96
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$481.76 |
| Rate for Payer: Aetna Commercial |
$433.58
|
| Rate for Payer: ASR ASR |
$467.31
|
| Rate for Payer: ASR Commercial |
$467.31
|
| Rate for Payer: BCBS Trust/PPO |
$392.59
|
| Rate for Payer: BCN Commercial |
$373.51
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Healthscope Commercial |
$481.76
|
| Rate for Payer: Healthscope Whirlpool |
$467.31
|
| Rate for Payer: Mclaren Commercial |
$433.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL 4 OR 5 VIEW
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 72083
|
| Hospital Charge Code |
32000307
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$481.76 |
| Rate for Payer: Aetna Commercial |
$433.58
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$467.31
|
| Rate for Payer: ASR Commercial |
$467.31
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$394.51
|
| Rate for Payer: BCN Commercial |
$373.51
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$452.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$481.76
|
| Rate for Payer: Healthscope Whirlpool |
$467.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$433.58
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.12
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$337.71
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
OP
|
$602.20
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$602.20 |
| Rate for Payer: Aetna Commercial |
$541.98
|
| Rate for Payer: Aetna Medicare |
$103.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: ASR ASR |
$584.13
|
| Rate for Payer: ASR Commercial |
$584.13
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCBS Trust/PPO |
$493.14
|
| Rate for Payer: BCN Commercial |
$466.89
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$566.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$602.20
|
| Rate for Payer: Healthscope Whirlpool |
$584.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$103.71
|
| Rate for Payer: Mclaren Commercial |
$541.98
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: Nomi Health Commercial |
$493.80
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicaid |
$55.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.65
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health Narrow Network |
$422.14
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$160.75
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP DNSP |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: VA VA |
$103.71
|
|
|
HC SPINE THORACIC AND LUMBAR INC SKULL CERVICAL AND SACRAL MIN 6 VIEW
|
Facility
|
IP
|
$602.20
|
|
|
Service Code
|
CPT 72084
|
| Hospital Charge Code |
32000308
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$391.43 |
| Max. Negotiated Rate |
$602.20 |
| Rate for Payer: Aetna Commercial |
$541.98
|
| Rate for Payer: ASR ASR |
$584.13
|
| Rate for Payer: ASR Commercial |
$584.13
|
| Rate for Payer: BCBS Trust/PPO |
$490.73
|
| Rate for Payer: BCN Commercial |
$466.89
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$566.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Healthscope Commercial |
$602.20
|
| Rate for Payer: Healthscope Whirlpool |
$584.13
|
| Rate for Payer: Mclaren Commercial |
$541.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: Nomi Health Commercial |
$493.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.94
|
|
|
HC SPINE THORACIC W CON
|
Facility
|
OP
|
$2,243.18
|
|
|
Service Code
|
CPT 72147
|
| Hospital Charge Code |
61200008
|
|
Hospital Revenue Code
|
612
|
| Min. Negotiated Rate |
$186.69 |
| Max. Negotiated Rate |
$2,243.18 |
| Rate for Payer: Aetna Commercial |
$2,018.86
|
| Rate for Payer: Aetna Medicare |
$348.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: ASR ASR |
$2,175.88
|
| Rate for Payer: ASR Commercial |
$2,175.88
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,836.94
|
| Rate for Payer: BCN Commercial |
$1,739.14
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cash Price |
$1,794.54
|
| Rate for Payer: Cofinity Commercial |
$2,108.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,794.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$2,243.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,175.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$348.30
|
| Rate for Payer: Mclaren Commercial |
$2,018.86
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,906.70
|
| Rate for Payer: Nomi Health Commercial |
$1,839.41
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$383.13
|
| Rate for Payer: PHP Medicaid |
$186.69
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,458.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,965.47
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,572.47
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,974.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$539.87
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP DNSP |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: VA VA |
$348.30
|
|
