|
HC TETANUS ANTIBODIES
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 86774
|
| Hospital Charge Code |
30200320
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$55.08
|
| Rate for Payer: Aetna Medicare |
$14.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.50
|
| Rate for Payer: ASR ASR |
$59.36
|
| Rate for Payer: ASR Commercial |
$59.36
|
| Rate for Payer: BCBS Complete |
$8.33
|
| Rate for Payer: BCBS MAPPO |
$14.80
|
| Rate for Payer: BCBS Trust/PPO |
$50.12
|
| Rate for Payer: BCN Commercial |
$47.45
|
| Rate for Payer: BCN Medicare Advantage |
$14.80
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$57.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.80
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Healthscope Whirlpool |
$59.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.80
|
| Rate for Payer: Mclaren Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$7.93
|
| Rate for Payer: Mclaren Medicare |
$14.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.54
|
| Rate for Payer: Meridian Medicaid |
$8.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PACE Medicare |
$14.06
|
| Rate for Payer: PACE SWMI |
$14.80
|
| Rate for Payer: PHP Commercial |
$16.28
|
| Rate for Payer: PHP Medicaid |
$7.93
|
| Rate for Payer: PHP Medicare Advantage |
$14.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.62
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow Network |
$42.90
|
| Rate for Payer: Railroad Medicare Medicare |
$14.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.80
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$14.80
|
| Rate for Payer: UHCCP DNSP |
$14.80
|
| Rate for Payer: UHCCP Medicaid |
$7.93
|
| Rate for Payer: VA VA |
$14.80
|
|
|
HC TETANUS/DIPHTHERIA/PERTUSIS VACCINE
|
Facility
|
IP
|
$124.62
|
|
|
Service Code
|
CPT 90715
|
| Hospital Charge Code |
63600022
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$124.62 |
| Rate for Payer: Aetna Commercial |
$112.16
|
| Rate for Payer: ASR ASR |
$120.88
|
| Rate for Payer: ASR Commercial |
$120.88
|
| Rate for Payer: BCBS Trust/PPO |
$101.55
|
| Rate for Payer: BCN Commercial |
$96.62
|
| Rate for Payer: Cash Price |
$99.70
|
| Rate for Payer: Cofinity Commercial |
$117.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.70
|
| Rate for Payer: Healthscope Commercial |
$124.62
|
| Rate for Payer: Healthscope Whirlpool |
$120.88
|
| Rate for Payer: Mclaren Commercial |
$112.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.93
|
| Rate for Payer: Nomi Health Commercial |
$102.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.67
|
|
|
HC TETANUS/DIPHTHERIA/PERTUSIS VACCINE
|
Facility
|
OP
|
$124.62
|
|
|
Service Code
|
CPT 90715
|
| Hospital Charge Code |
63600022
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$44.12 |
| Max. Negotiated Rate |
$124.62 |
| Rate for Payer: Aetna Commercial |
$112.16
|
| Rate for Payer: Aetna Medicare |
$62.31
|
| Rate for Payer: ASR ASR |
$120.88
|
| Rate for Payer: ASR Commercial |
$120.88
|
| Rate for Payer: BCBS Complete |
$49.85
|
| Rate for Payer: BCBS Trust/PPO |
$102.05
|
| Rate for Payer: BCN Commercial |
$96.62
|
| Rate for Payer: Cash Price |
$99.70
|
| Rate for Payer: Cash Price |
$99.70
|
| Rate for Payer: Cofinity Commercial |
$117.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.70
|
| Rate for Payer: Healthscope Commercial |
$124.62
|
| Rate for Payer: Healthscope Whirlpool |
$120.88
|
| Rate for Payer: Mclaren Commercial |
$112.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.93
|
| Rate for Payer: Nomi Health Commercial |
$102.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.15
|
| Rate for Payer: Priority Health Narrow Network |
$44.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.67
|
|
|
HC THC URINE CONFIRM
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100568
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$51.53
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC THC URINE CONFIRM
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100568
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$63.24 |
| Rate for Payer: Aetna Commercial |
$56.92
|
| Rate for Payer: Aetna Medicare |
$31.62
|
| Rate for Payer: ASR ASR |
$61.34
|
| Rate for Payer: ASR Commercial |
$61.34
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS Trust/PPO |
$51.79
|
| Rate for Payer: BCN Commercial |
$49.03
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$59.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$61.34
|
| Rate for Payer: Mclaren Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.41
|
| Rate for Payer: Priority Health Narrow Network |
$44.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.65
|
|
|
HC THEOPHYLLINE LEVEL
|
Facility
|
IP
|
$92.21
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
30100048
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.94 |
| Max. Negotiated Rate |
$92.21 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: ASR ASR |
$89.44
|
| Rate for Payer: ASR Commercial |
$89.44
|
| Rate for Payer: BCBS Trust/PPO |
$75.14
|
| Rate for Payer: BCN Commercial |
$71.49
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$86.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Healthscope Commercial |
$92.21
|
| Rate for Payer: Healthscope Whirlpool |
$89.44
|
| Rate for Payer: Mclaren Commercial |
$82.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.14
|
|
|
HC THEOPHYLLINE LEVEL
|
Facility
|
OP
|
$92.21
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
30100048
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$92.21 |
| Rate for Payer: Aetna Commercial |
$82.99
|
| Rate for Payer: Aetna Medicare |
$14.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.68
|
| Rate for Payer: ASR ASR |
$89.44
|
| Rate for Payer: ASR Commercial |
$89.44
|
| Rate for Payer: BCBS Complete |
$7.96
|
| Rate for Payer: BCBS MAPPO |
$14.14
|
| Rate for Payer: BCBS Trust/PPO |
$75.51
|
| Rate for Payer: BCN Commercial |
$71.49
|
| Rate for Payer: BCN Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$86.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.14
|
| Rate for Payer: Healthscope Commercial |
$92.21
|
| Rate for Payer: Healthscope Whirlpool |
$89.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.14
|
| Rate for Payer: Mclaren Commercial |
$82.99
|
| Rate for Payer: Mclaren Medicaid |
$7.58
|
| Rate for Payer: Mclaren Medicare |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.85
|
| Rate for Payer: Meridian Medicaid |
$7.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PACE Medicare |
$13.43
|
| Rate for Payer: PACE SWMI |
$14.14
|
| Rate for Payer: PHP Commercial |
$15.55
|
| Rate for Payer: PHP Medicaid |
$7.58
|
| Rate for Payer: PHP Medicare Advantage |
$14.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.68
|
| Rate for Payer: Priority Health Medicare |
$14.14
|
| Rate for Payer: Priority Health Narrow Network |
$59.74
|
| Rate for Payer: Railroad Medicare Medicare |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.14
|
| Rate for Payer: UHC Exchange |
$21.92
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: UHCCP DNSP |
$14.14
|
| Rate for Payer: UHCCP Medicaid |
$7.58
|
| Rate for Payer: VA VA |
$14.14
|
|
|
HC THERAPEUTIC ACTIVITIES EA 15 MIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
42000028
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Trust/PPO |
$80.54
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC THERAPEUTIC ACTIVITIES EA 15 MIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
42000028
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.54 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$49.42
|
| Rate for Payer: ASR ASR |
$95.87
|
| Rate for Payer: ASR Commercial |
$95.87
|
| Rate for Payer: BCBS Complete |
$39.54
|
| Rate for Payer: BCBS Trust/PPO |
$80.94
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$92.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$98.84
|
| Rate for Payer: Healthscope Whirlpool |
$95.87
|
| Rate for Payer: Mclaren Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.05
|
| Rate for Payer: Priority Health Narrow Network |
$63.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.98
|
|
|
HC THERAPEUTIC APHERESIS PLASMA PHERESIS
|
Facility
|
OP
|
$2,555.49
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
36100520
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.89 |
| Max. Negotiated Rate |
$2,555.49 |
| Rate for Payer: Aetna Commercial |
$2,299.94
|
| Rate for Payer: Aetna Medicare |
$1,606.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,007.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,007.66
|
| Rate for Payer: ASR ASR |
$2,478.83
|
| Rate for Payer: ASR Commercial |
$2,478.83
|
| Rate for Payer: BCBS Complete |
$903.93
|
| Rate for Payer: BCBS MAPPO |
$1,606.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.69
|
| Rate for Payer: BCN Commercial |
$1,981.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,606.13
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cofinity Commercial |
$2,402.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,606.13
|
| Rate for Payer: Healthscope Commercial |
$2,555.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,478.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,606.13
|
| Rate for Payer: Mclaren Commercial |
$2,299.94
|
| Rate for Payer: Mclaren Medicaid |
$860.89
|
| Rate for Payer: Mclaren Medicare |
$1,606.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,686.44
|
| Rate for Payer: Meridian Medicaid |
$903.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,847.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,172.17
|
| Rate for Payer: Nomi Health Commercial |
$2,095.50
|
| Rate for Payer: PACE Medicare |
$1,525.82
|
| Rate for Payer: PACE SWMI |
$1,606.13
|
| Rate for Payer: PHP Commercial |
$1,766.74
|
| Rate for Payer: PHP Medicaid |
$860.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,606.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,873.21
|
| Rate for Payer: Priority Health Medicare |
$1,606.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,498.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,606.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,248.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,606.13
|
| Rate for Payer: UHC Exchange |
$2,489.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,606.13
|
| Rate for Payer: UHCCP DNSP |
$1,606.13
|
| Rate for Payer: UHCCP Medicaid |
$860.89
|
| Rate for Payer: VA VA |
$1,606.13
|
|
|
HC THERAPEUTIC APHERESIS PLASMA PHERESIS
|
Facility
|
IP
|
$2,555.49
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
36100520
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,661.07 |
| Max. Negotiated Rate |
$2,555.49 |
| Rate for Payer: Aetna Commercial |
$2,299.94
|
| Rate for Payer: ASR ASR |
$2,478.83
|
| Rate for Payer: ASR Commercial |
$2,478.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.47
|
| Rate for Payer: BCN Commercial |
$1,981.27
|
| Rate for Payer: Cash Price |
$2,044.39
|
| Rate for Payer: Cofinity Commercial |
$2,402.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.39
|
| Rate for Payer: Healthscope Commercial |
$2,555.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,478.83
|
| Rate for Payer: Mclaren Commercial |
$2,299.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,172.17
|
| Rate for Payer: Nomi Health Commercial |
$2,095.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,661.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,248.83
|
|
|
HC THERAPEUTIC APHERESIS RED BLOOD CELLS
|
Facility
|
IP
|
$2,481.05
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
76100326
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,612.68 |
| Max. Negotiated Rate |
$2,481.05 |
| Rate for Payer: Aetna Commercial |
$2,232.94
|
| Rate for Payer: ASR ASR |
$2,406.62
|
| Rate for Payer: ASR Commercial |
$2,406.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.81
|
| Rate for Payer: BCN Commercial |
$1,923.56
|
| Rate for Payer: Cash Price |
$1,984.84
|
| Rate for Payer: Cofinity Commercial |
$2,332.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,984.84
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.62
|
| Rate for Payer: Mclaren Commercial |
$2,232.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,108.89
|
| Rate for Payer: Nomi Health Commercial |
$2,034.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.32
|
|
|
HC THERAPEUTIC APHERESIS RED BLOOD CELLS
|
Facility
|
OP
|
$2,481.05
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
76100326
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.89 |
| Max. Negotiated Rate |
$2,489.50 |
| Rate for Payer: Aetna Commercial |
$2,232.94
|
| Rate for Payer: Aetna Medicare |
$1,606.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,007.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,007.66
|
| Rate for Payer: ASR ASR |
$2,406.62
|
| Rate for Payer: ASR Commercial |
$2,406.62
|
| Rate for Payer: BCBS Complete |
$903.93
|
| Rate for Payer: BCBS MAPPO |
$1,606.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.73
|
| Rate for Payer: BCN Commercial |
$1,923.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,606.13
|
| Rate for Payer: Cash Price |
$1,984.84
|
| Rate for Payer: Cash Price |
$1,984.84
|
| Rate for Payer: Cofinity Commercial |
$2,332.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,984.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,606.13
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,606.13
|
| Rate for Payer: Mclaren Commercial |
$2,232.94
|
| Rate for Payer: Mclaren Medicaid |
$860.89
|
| Rate for Payer: Mclaren Medicare |
$1,606.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,686.44
|
| Rate for Payer: Meridian Medicaid |
$903.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,847.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,108.89
|
| Rate for Payer: Nomi Health Commercial |
$2,034.46
|
| Rate for Payer: PACE Medicare |
$1,525.82
|
| Rate for Payer: PACE SWMI |
$1,606.13
|
| Rate for Payer: PHP Commercial |
$1,766.74
|
| Rate for Payer: PHP Medicaid |
$860.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,606.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,873.21
|
| Rate for Payer: Priority Health Medicare |
$1,606.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,498.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,606.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,606.13
|
| Rate for Payer: UHC Exchange |
$2,489.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,606.13
|
| Rate for Payer: UHCCP DNSP |
$1,606.13
|
| Rate for Payer: UHCCP Medicaid |
$860.89
|
| Rate for Payer: VA VA |
$1,606.13
|
|
|
HC THERAPEUTIC APHERESIS WHITE BLOOD CELL
|
Facility
|
IP
|
$2,481.05
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
76100327
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,612.68 |
| Max. Negotiated Rate |
$2,481.05 |
| Rate for Payer: Aetna Commercial |
$2,232.94
|
| Rate for Payer: ASR ASR |
$2,406.62
|
| Rate for Payer: ASR Commercial |
$2,406.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.81
|
| Rate for Payer: BCN Commercial |
$1,923.56
|
| Rate for Payer: Cash Price |
$1,984.84
|
| Rate for Payer: Cofinity Commercial |
$2,332.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,984.84
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.62
|
| Rate for Payer: Mclaren Commercial |
$2,232.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,108.89
|
| Rate for Payer: Nomi Health Commercial |
$2,034.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.32
|
|
|
HC THERAPEUTIC APHERESIS WHITE BLOOD CELL
|
Facility
|
OP
|
$2,481.05
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
76100327
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.89 |
| Max. Negotiated Rate |
$2,489.50 |
| Rate for Payer: Aetna Commercial |
$2,232.94
|
| Rate for Payer: Aetna Medicare |
$1,606.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,007.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,007.66
|
| Rate for Payer: ASR ASR |
$2,406.62
|
| Rate for Payer: ASR Commercial |
$2,406.62
|
| Rate for Payer: BCBS Complete |
$903.93
|
| Rate for Payer: BCBS MAPPO |
$1,606.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.73
|
| Rate for Payer: BCN Commercial |
$1,923.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,606.13
|
| Rate for Payer: Cash Price |
$1,984.84
|
| Rate for Payer: Cash Price |
$1,984.84
|
| Rate for Payer: Cofinity Commercial |
$2,332.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,984.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,606.13
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,606.13
|
| Rate for Payer: Mclaren Commercial |
$2,232.94
|
| Rate for Payer: Mclaren Medicaid |
$860.89
|
| Rate for Payer: Mclaren Medicare |
$1,606.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,686.44
|
| Rate for Payer: Meridian Medicaid |
$903.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,847.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,108.89
|
| Rate for Payer: Nomi Health Commercial |
$2,034.46
|
| Rate for Payer: PACE Medicare |
$1,525.82
|
| Rate for Payer: PACE SWMI |
$1,606.13
|
| Rate for Payer: PHP Commercial |
$1,766.74
|
| Rate for Payer: PHP Medicaid |
$860.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,606.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,873.21
|
| Rate for Payer: Priority Health Medicare |
$1,606.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,498.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,606.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,606.13
|
| Rate for Payer: UHC Exchange |
$2,489.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,606.13
|
| Rate for Payer: UHCCP DNSP |
$1,606.13
|
| Rate for Payer: UHCCP Medicaid |
$860.89
|
| Rate for Payer: VA VA |
$1,606.13
|
|
|
HC THERAPEUTIC EX EACH 15 MIN
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
42000020
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$114.44 |
| Rate for Payer: Aetna Commercial |
$103.00
|
| Rate for Payer: Aetna Medicare |
$57.22
|
| Rate for Payer: ASR ASR |
$111.01
|
| Rate for Payer: ASR Commercial |
$111.01
|
| Rate for Payer: BCBS Complete |
$45.78
|
| Rate for Payer: BCBS Trust/PPO |
$93.71
|
| Rate for Payer: BCN Commercial |
$88.73
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$107.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$114.44
|
| Rate for Payer: Healthscope Whirlpool |
$111.01
|
| Rate for Payer: Mclaren Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.57
|
| Rate for Payer: Priority Health Narrow Network |
$58.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.71
|
|
|
HC THERAPEUTIC EX EACH 15 MIN
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
42000020
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.39 |
| Max. Negotiated Rate |
$114.44 |
| Rate for Payer: Aetna Commercial |
$103.00
|
| Rate for Payer: ASR ASR |
$111.01
|
| Rate for Payer: ASR Commercial |
$111.01
|
| Rate for Payer: BCBS Trust/PPO |
$93.26
|
| Rate for Payer: BCN Commercial |
$88.73
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$107.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$114.44
|
| Rate for Payer: Healthscope Whirlpool |
$111.01
|
| Rate for Payer: Mclaren Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$100.71
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
|
IP
|
$863.24
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
76100010
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$561.11 |
| Max. Negotiated Rate |
$863.24 |
| Rate for Payer: Aetna Commercial |
$776.92
|
| Rate for Payer: ASR ASR |
$837.34
|
| Rate for Payer: ASR Commercial |
$837.34
|
| Rate for Payer: BCBS Trust/PPO |
$703.45
|
| Rate for Payer: BCN Commercial |
$669.27
|
| Rate for Payer: Cash Price |
$690.59
|
| Rate for Payer: Cofinity Commercial |
$811.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$690.59
|
| Rate for Payer: Healthscope Commercial |
$863.24
|
| Rate for Payer: Healthscope Whirlpool |
$837.34
|
| Rate for Payer: Mclaren Commercial |
$776.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.75
|
| Rate for Payer: Nomi Health Commercial |
$707.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$759.65
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
|
OP
|
$863.24
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
76100010
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$863.24 |
| Rate for Payer: Aetna Commercial |
$776.92
|
| Rate for Payer: Aetna Medicare |
$126.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: ASR ASR |
$837.34
|
| Rate for Payer: ASR Commercial |
$837.34
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$706.91
|
| Rate for Payer: BCN Commercial |
$669.27
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$690.59
|
| Rate for Payer: Cash Price |
$690.59
|
| Rate for Payer: Cofinity Commercial |
$811.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$690.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$863.24
|
| Rate for Payer: Healthscope Whirlpool |
$837.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$126.29
|
| Rate for Payer: Mclaren Commercial |
$776.92
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.75
|
| Rate for Payer: Nomi Health Commercial |
$707.86
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$138.92
|
| Rate for Payer: PHP Medicaid |
$67.69
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.53
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$76.42
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$759.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP DNSP |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: VA VA |
$126.29
|
|
|
HC THERASKIN PER SQ CM (116 SQ CM)
|
Facility
|
IP
|
$59.43
|
|
|
Service Code
|
HCPCS Q4121
|
| Hospital Charge Code |
63600219
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$59.43 |
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: ASR ASR |
$57.65
|
| Rate for Payer: ASR Commercial |
$57.65
|
| Rate for Payer: BCBS Trust/PPO |
$48.43
|
| Rate for Payer: BCN Commercial |
$46.08
|
| Rate for Payer: Cash Price |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$55.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.54
|
| Rate for Payer: Healthscope Commercial |
$59.43
|
| Rate for Payer: Healthscope Whirlpool |
$57.65
|
| Rate for Payer: Mclaren Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.52
|
| Rate for Payer: Nomi Health Commercial |
$48.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.30
|
|
|
HC THERASKIN PER SQ CM (116 SQ CM)
|
Facility
|
OP
|
$59.43
|
|
|
Service Code
|
HCPCS Q4121
|
| Hospital Charge Code |
63600219
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.77 |
| Max. Negotiated Rate |
$59.43 |
| Rate for Payer: Aetna Commercial |
$53.49
|
| Rate for Payer: Aetna Medicare |
$29.72
|
| Rate for Payer: ASR ASR |
$57.65
|
| Rate for Payer: ASR Commercial |
$57.65
|
| Rate for Payer: BCBS Complete |
$23.77
|
| Rate for Payer: BCBS Trust/PPO |
$48.67
|
| Rate for Payer: BCN Commercial |
$46.08
|
| Rate for Payer: Cash Price |
$47.54
|
| Rate for Payer: Cash Price |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$55.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.54
|
| Rate for Payer: Healthscope Commercial |
$59.43
|
| Rate for Payer: Healthscope Whirlpool |
$57.65
|
| Rate for Payer: Mclaren Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.52
|
| Rate for Payer: Nomi Health Commercial |
$48.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.74
|
| Rate for Payer: Priority Health Narrow Network |
$42.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.30
|
|
|
HC THERASKIN PER SQ CM (13 SQ CM)
|
Facility
|
OP
|
$184.13
|
|
|
Service Code
|
CPT Q4121
|
| Hospital Charge Code |
63600064
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.99 |
| Max. Negotiated Rate |
$184.13 |
| Rate for Payer: Aetna Commercial |
$165.72
|
| Rate for Payer: Aetna Medicare |
$92.06
|
| Rate for Payer: ASR ASR |
$178.61
|
| Rate for Payer: ASR Commercial |
$178.61
|
| Rate for Payer: BCBS Complete |
$73.65
|
| Rate for Payer: BCBS Trust/PPO |
$150.78
|
| Rate for Payer: BCN Commercial |
$142.76
|
| Rate for Payer: Cash Price |
$147.30
|
| Rate for Payer: Cash Price |
$147.30
|
| Rate for Payer: Cofinity Commercial |
$173.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.30
|
| Rate for Payer: Healthscope Commercial |
$184.13
|
| Rate for Payer: Healthscope Whirlpool |
$178.61
|
| Rate for Payer: Mclaren Commercial |
$165.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.51
|
| Rate for Payer: Nomi Health Commercial |
$150.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.74
|
| Rate for Payer: Priority Health Narrow Network |
$42.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.03
|
|
|
HC THERASKIN PER SQ CM (13 SQ CM)
|
Facility
|
IP
|
$184.13
|
|
|
Service Code
|
CPT Q4121
|
| Hospital Charge Code |
63600064
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$119.68 |
| Max. Negotiated Rate |
$184.13 |
| Rate for Payer: Aetna Commercial |
$165.72
|
| Rate for Payer: ASR ASR |
$178.61
|
| Rate for Payer: ASR Commercial |
$178.61
|
| Rate for Payer: BCBS Trust/PPO |
$150.05
|
| Rate for Payer: BCN Commercial |
$142.76
|
| Rate for Payer: Cash Price |
$147.30
|
| Rate for Payer: Cofinity Commercial |
$173.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.30
|
| Rate for Payer: Healthscope Commercial |
$184.13
|
| Rate for Payer: Healthscope Whirlpool |
$178.61
|
| Rate for Payer: Mclaren Commercial |
$165.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.51
|
| Rate for Payer: Nomi Health Commercial |
$150.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.03
|
|
|
HC THERASKIN PER SQ CM (39 SQ CM)
|
Facility
|
IP
|
$84.55
|
|
|
Service Code
|
CPT Q4121
|
| Hospital Charge Code |
63600065
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.96 |
| Max. Negotiated Rate |
$84.55 |
| Rate for Payer: Aetna Commercial |
$76.10
|
| Rate for Payer: ASR ASR |
$82.01
|
| Rate for Payer: ASR Commercial |
$82.01
|
| Rate for Payer: BCBS Trust/PPO |
$68.90
|
| Rate for Payer: BCN Commercial |
$65.55
|
| Rate for Payer: Cash Price |
$67.64
|
| Rate for Payer: Cofinity Commercial |
$79.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.64
|
| Rate for Payer: Healthscope Commercial |
$84.55
|
| Rate for Payer: Healthscope Whirlpool |
$82.01
|
| Rate for Payer: Mclaren Commercial |
$76.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.87
|
| Rate for Payer: Nomi Health Commercial |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.40
|
|
|
HC THERASKIN PER SQ CM (39 SQ CM)
|
Facility
|
OP
|
$84.55
|
|
|
Service Code
|
CPT Q4121
|
| Hospital Charge Code |
63600065
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.82 |
| Max. Negotiated Rate |
$84.55 |
| Rate for Payer: Aetna Commercial |
$76.10
|
| Rate for Payer: Aetna Medicare |
$42.28
|
| Rate for Payer: ASR ASR |
$82.01
|
| Rate for Payer: ASR Commercial |
$82.01
|
| Rate for Payer: BCBS Complete |
$33.82
|
| Rate for Payer: BCBS Trust/PPO |
$69.24
|
| Rate for Payer: BCN Commercial |
$65.55
|
| Rate for Payer: Cash Price |
$67.64
|
| Rate for Payer: Cash Price |
$67.64
|
| Rate for Payer: Cofinity Commercial |
$79.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.64
|
| Rate for Payer: Healthscope Commercial |
$84.55
|
| Rate for Payer: Healthscope Whirlpool |
$82.01
|
| Rate for Payer: Mclaren Commercial |
$76.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.87
|
| Rate for Payer: Nomi Health Commercial |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.74
|
| Rate for Payer: Priority Health Narrow Network |
$42.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.40
|
|
