|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$61.72 |
| Rate for Payer: Aetna Commercial |
$55.55
|
| Rate for Payer: ASR ASR |
$59.87
|
| Rate for Payer: ASR Commercial |
$59.87
|
| Rate for Payer: BCBS Trust/PPO |
$50.30
|
| Rate for Payer: BCN Commercial |
$47.85
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$61.72
|
| Rate for Payer: Healthscope Whirlpool |
$59.87
|
| Rate for Payer: Mclaren Commercial |
$55.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.31
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.22 |
| Max. Negotiated Rate |
$61.72 |
| Rate for Payer: Aetna Commercial |
$55.55
|
| Rate for Payer: Aetna Medicare |
$37.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: ASR ASR |
$59.87
|
| Rate for Payer: ASR Commercial |
$59.87
|
| Rate for Payer: BCBS Complete |
$21.23
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$47.85
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$61.72
|
| Rate for Payer: Healthscope Whirlpool |
$59.87
|
| Rate for Payer: Humana Choice PPO Medicare |
$37.73
|
| Rate for Payer: Mclaren Commercial |
$55.55
|
| Rate for Payer: Mclaren Medicaid |
$20.22
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: Meridian Medicaid |
$21.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicaid |
$20.22
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.08
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$43.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.73
|
| Rate for Payer: UHC Exchange |
$58.48
|
| Rate for Payer: UHC Medicare Advantage |
$37.73
|
| Rate for Payer: UHCCP DNSP |
$37.73
|
| Rate for Payer: UHCCP Medicaid |
$20.22
|
| Rate for Payer: VA VA |
$37.73
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$61.72 |
| Rate for Payer: Aetna Commercial |
$55.55
|
| Rate for Payer: ASR ASR |
$59.87
|
| Rate for Payer: ASR Commercial |
$59.87
|
| Rate for Payer: BCBS Trust/PPO |
$50.30
|
| Rate for Payer: BCN Commercial |
$47.85
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$61.72
|
| Rate for Payer: Healthscope Whirlpool |
$59.87
|
| Rate for Payer: Mclaren Commercial |
$55.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.31
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: ASR Commercial |
$29.10
|
| Rate for Payer: BCBS Trust/PPO |
$24.45
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$41.51 |
| Rate for Payer: Aetna Commercial |
$27.00
|
| Rate for Payer: Aetna Medicare |
$26.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.48
|
| Rate for Payer: ASR ASR |
$29.10
|
| Rate for Payer: ASR Commercial |
$29.10
|
| Rate for Payer: BCBS Complete |
$15.07
|
| Rate for Payer: BCBS MAPPO |
$26.78
|
| Rate for Payer: BCBS Trust/PPO |
$24.57
|
| Rate for Payer: BCN Commercial |
$23.26
|
| Rate for Payer: BCN Medicare Advantage |
$26.78
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$28.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.78
|
| Rate for Payer: Healthscope Commercial |
$30.00
|
| Rate for Payer: Healthscope Whirlpool |
$29.10
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.78
|
| Rate for Payer: Mclaren Commercial |
$27.00
|
| Rate for Payer: Mclaren Medicaid |
$14.35
|
| Rate for Payer: Mclaren Medicare |
$26.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.12
|
| Rate for Payer: Meridian Medicaid |
$15.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: PACE Medicare |
$25.44
|
| Rate for Payer: PACE SWMI |
$26.78
|
| Rate for Payer: PHP Commercial |
$29.46
|
| Rate for Payer: PHP Medicaid |
$14.35
|
| Rate for Payer: PHP Medicare Advantage |
$26.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.29
|
| Rate for Payer: Priority Health Medicare |
$26.78
|
| Rate for Payer: Priority Health Narrow Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$26.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.78
|
| Rate for Payer: UHC Exchange |
$41.51
|
| Rate for Payer: UHC Medicare Advantage |
$26.78
|
| Rate for Payer: UHCCP DNSP |
$26.78
|
| Rate for Payer: UHCCP Medicaid |
$14.35
|
| Rate for Payer: VA VA |
$26.78
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$83.55
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.42 |
| Max. Negotiated Rate |
$83.55 |
| Rate for Payer: Aetna Commercial |
$75.20
|
| Rate for Payer: Aetna Medicare |
$41.78
|
| Rate for Payer: ASR ASR |
$81.04
|
| Rate for Payer: ASR Commercial |
$81.04
|
| Rate for Payer: BCBS Complete |
$33.42
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$64.78
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$83.55
|
| Rate for Payer: Healthscope Whirlpool |
$81.04
|
| Rate for Payer: Mclaren Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.21
|
| Rate for Payer: Priority Health Narrow Network |
$58.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.52
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$83.55
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$83.55 |
| Rate for Payer: Aetna Commercial |
$75.20
|
| Rate for Payer: ASR ASR |
$81.04
|
| Rate for Payer: ASR Commercial |
$81.04
|
| Rate for Payer: BCBS Trust/PPO |
$68.08
|
| Rate for Payer: BCN Commercial |
$64.78
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$83.55
|
| Rate for Payer: Healthscope Whirlpool |
$81.04
|
| Rate for Payer: Mclaren Commercial |
$75.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$73.52
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$301.75 |
| Rate for Payer: Aetna Commercial |
$248.14
|
| Rate for Payer: Aetna Medicare |
$194.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: ASR ASR |
$267.44
|
| Rate for Payer: ASR Commercial |
$267.44
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$225.78
|
| Rate for Payer: BCN Commercial |
$213.76
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$275.71
|
| Rate for Payer: Healthscope Whirlpool |
$267.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$194.68
|
| Rate for Payer: Mclaren Commercial |
$248.14
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$214.15
|
| Rate for Payer: PHP Medicaid |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.02
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$161.62
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$301.75
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP DNSP |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.21 |
| Max. Negotiated Rate |
$275.71 |
| Rate for Payer: Aetna Commercial |
$248.14
|
| Rate for Payer: ASR ASR |
$267.44
|
| Rate for Payer: ASR Commercial |
$267.44
|
| Rate for Payer: BCBS Trust/PPO |
$224.68
|
| Rate for Payer: BCN Commercial |
$213.76
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$275.71
|
| Rate for Payer: Healthscope Whirlpool |
$267.44
|
| Rate for Payer: Mclaren Commercial |
$248.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.62
|
|
|
HC TAVR CONVERTED TO ON-PUMP
|
Facility
|
OP
|
$6,525.68
|
|
| Hospital Charge Code |
27000703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,610.27 |
| Max. Negotiated Rate |
$6,525.68 |
| Rate for Payer: Aetna Commercial |
$5,873.11
|
| Rate for Payer: Aetna Medicare |
$3,262.84
|
| Rate for Payer: ASR ASR |
$6,329.91
|
| Rate for Payer: ASR Commercial |
$6,329.91
|
| Rate for Payer: BCBS Complete |
$2,610.27
|
| Rate for Payer: BCBS Trust/PPO |
$5,343.88
|
| Rate for Payer: BCN Commercial |
$5,059.36
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$6,134.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Healthscope Commercial |
$6,525.68
|
| Rate for Payer: Healthscope Whirlpool |
$6,329.91
|
| Rate for Payer: Mclaren Commercial |
$5,873.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: Nomi Health Commercial |
$5,351.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,717.80
|
| Rate for Payer: Priority Health Narrow Network |
$4,574.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,742.60
|
|
|
HC TAVR CONVERTED TO ON-PUMP
|
Facility
|
IP
|
$6,525.68
|
|
| Hospital Charge Code |
27000703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,241.69 |
| Max. Negotiated Rate |
$6,525.68 |
| Rate for Payer: Aetna Commercial |
$5,873.11
|
| Rate for Payer: ASR ASR |
$6,329.91
|
| Rate for Payer: ASR Commercial |
$6,329.91
|
| Rate for Payer: BCBS Trust/PPO |
$5,317.78
|
| Rate for Payer: BCN Commercial |
$5,059.36
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$6,134.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Healthscope Commercial |
$6,525.68
|
| Rate for Payer: Healthscope Whirlpool |
$6,329.91
|
| Rate for Payer: Mclaren Commercial |
$5,873.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: Nomi Health Commercial |
$5,351.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,742.60
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
OP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,000.00 |
| Max. Negotiated Rate |
$37,500.00 |
| Rate for Payer: Aetna Commercial |
$33,750.00
|
| Rate for Payer: Aetna Medicare |
$18,750.00
|
| Rate for Payer: ASR ASR |
$36,375.00
|
| Rate for Payer: ASR Commercial |
$36,375.00
|
| Rate for Payer: BCBS Complete |
$15,000.00
|
| Rate for Payer: BCBS Trust/PPO |
$30,708.75
|
| Rate for Payer: BCN Commercial |
$29,073.75
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$35,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Healthscope Commercial |
$37,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$36,375.00
|
| Rate for Payer: Mclaren Commercial |
$33,750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,875.00
|
| Rate for Payer: Nomi Health Commercial |
$30,750.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24,375.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,857.50
|
| Rate for Payer: Priority Health Narrow Network |
$26,287.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33,000.00
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
IP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24,375.00 |
| Max. Negotiated Rate |
$37,500.00 |
| Rate for Payer: Aetna Commercial |
$33,750.00
|
| Rate for Payer: ASR ASR |
$36,375.00
|
| Rate for Payer: ASR Commercial |
$36,375.00
|
| Rate for Payer: BCBS Trust/PPO |
$30,558.75
|
| Rate for Payer: BCN Commercial |
$29,073.75
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$35,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Healthscope Commercial |
$37,500.00
|
| Rate for Payer: Healthscope Whirlpool |
$36,375.00
|
| Rate for Payer: Mclaren Commercial |
$33,750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,875.00
|
| Rate for Payer: Nomi Health Commercial |
$30,750.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24,375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33,000.00
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
IP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26,406.25 |
| Max. Negotiated Rate |
$40,625.00 |
| Rate for Payer: Aetna Commercial |
$36,562.50
|
| Rate for Payer: ASR ASR |
$39,406.25
|
| Rate for Payer: ASR Commercial |
$39,406.25
|
| Rate for Payer: BCBS Trust/PPO |
$33,105.31
|
| Rate for Payer: BCN Commercial |
$31,496.56
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$38,187.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$40,625.00
|
| Rate for Payer: Healthscope Whirlpool |
$39,406.25
|
| Rate for Payer: Mclaren Commercial |
$36,562.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Nomi Health Commercial |
$33,312.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26,406.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35,750.00
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
OP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16,250.00 |
| Max. Negotiated Rate |
$40,625.00 |
| Rate for Payer: Aetna Commercial |
$36,562.50
|
| Rate for Payer: Aetna Medicare |
$20,312.50
|
| Rate for Payer: ASR ASR |
$39,406.25
|
| Rate for Payer: ASR Commercial |
$39,406.25
|
| Rate for Payer: BCBS Complete |
$16,250.00
|
| Rate for Payer: BCBS Trust/PPO |
$33,267.81
|
| Rate for Payer: BCN Commercial |
$31,496.56
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$38,187.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$40,625.00
|
| Rate for Payer: Healthscope Whirlpool |
$39,406.25
|
| Rate for Payer: Mclaren Commercial |
$36,562.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Nomi Health Commercial |
$33,312.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26,406.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35,595.62
|
| Rate for Payer: Priority Health Narrow Network |
$28,478.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35,750.00
|
|
|
HC TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 77089
|
| Hospital Charge Code |
32000343
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.85 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: ASR Commercial |
$41.55
|
| Rate for Payer: BCBS Trust/PPO |
$34.91
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: Nomi Health Commercial |
$35.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 77089
|
| Hospital Charge Code |
32000343
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$17.14 |
| Max. Negotiated Rate |
$42.84 |
| Rate for Payer: Aetna Commercial |
$38.56
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: ASR ASR |
$41.55
|
| Rate for Payer: ASR Commercial |
$41.55
|
| Rate for Payer: BCBS Complete |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$35.08
|
| Rate for Payer: BCN Commercial |
$33.21
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$42.84
|
| Rate for Payer: Healthscope Whirlpool |
$41.55
|
| Rate for Payer: Mclaren Commercial |
$38.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: Nomi Health Commercial |
$35.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.54
|
| Rate for Payer: Priority Health Narrow Network |
$30.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.70
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$249.90 |
| Rate for Payer: Aetna Commercial |
$224.91
|
| Rate for Payer: ASR ASR |
$242.40
|
| Rate for Payer: ASR Commercial |
$242.40
|
| Rate for Payer: BCBS Trust/PPO |
$203.64
|
| Rate for Payer: BCN Commercial |
$193.75
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$234.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$249.90
|
| Rate for Payer: Healthscope Whirlpool |
$242.40
|
| Rate for Payer: Mclaren Commercial |
$224.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.91
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$249.90 |
| Rate for Payer: Aetna Commercial |
$224.91
|
| Rate for Payer: Aetna Medicare |
$86.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: ASR ASR |
$242.40
|
| Rate for Payer: ASR Commercial |
$242.40
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$204.64
|
| Rate for Payer: BCN Commercial |
$193.75
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$234.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$249.90
|
| Rate for Payer: Healthscope Whirlpool |
$242.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$86.27
|
| Rate for Payer: Mclaren Commercial |
$224.91
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$94.90
|
| Rate for Payer: PHP Medicaid |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.96
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$175.18
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$133.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP DNSP |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: VA VA |
$86.27
|
|
|
HC TB TEST
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$37.18 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: Aetna Medicare |
$23.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.99
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.99
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Mclaren Medicaid |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$26.39
|
| Rate for Payer: PHP Medicaid |
$12.86
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.18
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$10.54
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$37.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP DNSP |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: VA VA |
$23.99
|
|
|
HC TB TEST
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: Aetna Commercial |
$22.03
|
| Rate for Payer: ASR ASR |
$23.75
|
| Rate for Payer: ASR Commercial |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$19.95
|
| Rate for Payer: BCN Commercial |
$18.98
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$24.48
|
| Rate for Payer: Healthscope Whirlpool |
$23.75
|
| Rate for Payer: Mclaren Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.54
|
|
|
HC TC 99M ABD PER STUDY
|
Facility
|
IP
|
$157.52
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300019
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$102.39 |
| Max. Negotiated Rate |
$157.52 |
| Rate for Payer: Aetna Commercial |
$141.77
|
| Rate for Payer: ASR ASR |
$152.79
|
| Rate for Payer: ASR Commercial |
$152.79
|
| Rate for Payer: BCBS Trust/PPO |
$128.36
|
| Rate for Payer: BCN Commercial |
$122.13
|
| Rate for Payer: Cash Price |
$126.02
|
| Rate for Payer: Cofinity Commercial |
$148.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.02
|
| Rate for Payer: Healthscope Commercial |
$157.52
|
| Rate for Payer: Healthscope Whirlpool |
$152.79
|
| Rate for Payer: Mclaren Commercial |
$141.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.89
|
| Rate for Payer: Nomi Health Commercial |
$129.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.62
|
|
|
HC TC 99M ABD PER STUDY
|
Facility
|
OP
|
$157.52
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300019
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$63.01 |
| Max. Negotiated Rate |
$276.15 |
| Rate for Payer: Aetna Commercial |
$141.77
|
| Rate for Payer: Aetna Medicare |
$78.76
|
| Rate for Payer: ASR ASR |
$152.79
|
| Rate for Payer: ASR Commercial |
$152.79
|
| Rate for Payer: BCBS Complete |
$63.01
|
| Rate for Payer: BCBS Trust/PPO |
$128.99
|
| Rate for Payer: BCN Commercial |
$122.13
|
| Rate for Payer: Cash Price |
$126.02
|
| Rate for Payer: Cash Price |
$126.02
|
| Rate for Payer: Cofinity Commercial |
$148.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.02
|
| Rate for Payer: Healthscope Commercial |
$157.52
|
| Rate for Payer: Healthscope Whirlpool |
$152.79
|
| Rate for Payer: Mclaren Commercial |
$141.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.89
|
| Rate for Payer: Nomi Health Commercial |
$129.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.15
|
| Rate for Payer: Priority Health Narrow Network |
$220.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.62
|
|
|
HC TC-99M AUTOL WBC DIAG PER DOSE
|
Facility
|
OP
|
$1,779.91
|
|
|
Service Code
|
HCPCS A9569
|
| Hospital Charge Code |
34300027
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$557.61 |
| Max. Negotiated Rate |
$1,779.91 |
| Rate for Payer: Aetna Commercial |
$1,601.92
|
| Rate for Payer: Aetna Medicare |
$1,040.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,300.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,300.40
|
| Rate for Payer: ASR ASR |
$1,726.51
|
| Rate for Payer: ASR Commercial |
$1,726.51
|
| Rate for Payer: BCBS Complete |
$585.49
|
| Rate for Payer: BCBS MAPPO |
$1,040.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.57
|
| Rate for Payer: BCN Commercial |
$1,379.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.32
|
| Rate for Payer: Cash Price |
$1,423.93
|
| Rate for Payer: Cash Price |
$1,423.93
|
| Rate for Payer: Cofinity Commercial |
$1,673.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,423.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.32
|
| Rate for Payer: Healthscope Commercial |
$1,779.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,726.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,040.32
|
| Rate for Payer: Mclaren Commercial |
$1,601.92
|
| Rate for Payer: Mclaren Medicaid |
$557.61
|
| Rate for Payer: Mclaren Medicare |
$1,040.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,092.34
|
| Rate for Payer: Meridian Medicaid |
$585.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,196.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,512.92
|
| Rate for Payer: Nomi Health Commercial |
$1,459.53
|
| Rate for Payer: PACE Medicare |
$988.30
|
| Rate for Payer: PACE SWMI |
$1,040.32
|
| Rate for Payer: PHP Commercial |
$1,144.35
|
| Rate for Payer: PHP Medicaid |
$557.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,156.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,748.25
|
| Rate for Payer: Priority Health Medicare |
$1,040.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,398.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,566.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,040.32
|
| Rate for Payer: UHC Exchange |
$1,612.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,040.32
|
| Rate for Payer: UHCCP DNSP |
$1,040.32
|
| Rate for Payer: UHCCP Medicaid |
$557.61
|
| Rate for Payer: VA VA |
$1,040.32
|
|
|
HC TC-99M AUTOL WBC DIAG PER DOSE
|
Facility
|
IP
|
$1,779.91
|
|
|
Service Code
|
HCPCS A9569
|
| Hospital Charge Code |
34300027
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,156.94 |
| Max. Negotiated Rate |
$1,779.91 |
| Rate for Payer: Aetna Commercial |
$1,601.92
|
| Rate for Payer: ASR ASR |
$1,726.51
|
| Rate for Payer: ASR Commercial |
$1,726.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,450.45
|
| Rate for Payer: BCN Commercial |
$1,379.96
|
| Rate for Payer: Cash Price |
$1,423.93
|
| Rate for Payer: Cofinity Commercial |
$1,673.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,423.93
|
| Rate for Payer: Healthscope Commercial |
$1,779.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,726.51
|
| Rate for Payer: Mclaren Commercial |
$1,601.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,512.92
|
| Rate for Payer: Nomi Health Commercial |
$1,459.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,156.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,566.32
|
|
