|
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
|
OP
|
$2,481.05
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
76100326
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$856.94 |
| Max. Negotiated Rate |
$2,481.05 |
| Rate for Payer: Aetna Commercial |
$2,232.95
|
| Rate for Payer: Aetna Medicare |
$1,598.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,998.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,998.45
|
| Rate for Payer: ASR ASR |
$2,406.62
|
| Rate for Payer: ASR Commercial |
$2,406.62
|
| Rate for Payer: BCBS Complete |
$899.78
|
| Rate for Payer: BCBS MAPPO |
$1,598.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.73
|
| Rate for Payer: BCN Commercial |
$1,923.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,598.76
|
| 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 |
$1,598.76
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,598.76
|
| Rate for Payer: Mclaren Commercial |
$2,232.95
|
| Rate for Payer: Mclaren Medicaid |
$856.94
|
| Rate for Payer: Mclaren Medicare |
$1,598.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,678.70
|
| Rate for Payer: Meridian Medicaid |
$899.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,838.57
|
| 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 |
$1,518.82
|
| Rate for Payer: PACE SWMI |
$1,598.76
|
| Rate for Payer: PHP Commercial |
$1,758.64
|
| Rate for Payer: PHP Medicaid |
$856.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,598.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,173.90
|
| Rate for Payer: Priority Health Medicare |
$1,598.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,739.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,598.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,598.76
|
| Rate for Payer: UHC Exchange |
$2,478.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,598.76
|
| Rate for Payer: UHCCP DNSP |
$1,598.76
|
| Rate for Payer: UHCCP Medicaid |
$856.94
|
| Rate for Payer: VA VA |
$1,598.76
|
|
|
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 |
$2,232.95
|
| 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 |
$2,232.95
|
| 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 |
$856.94 |
| Max. Negotiated Rate |
$2,481.05 |
| Rate for Payer: Aetna Commercial |
$2,232.95
|
| Rate for Payer: Aetna Medicare |
$1,598.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,998.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,998.45
|
| Rate for Payer: ASR ASR |
$2,406.62
|
| Rate for Payer: ASR Commercial |
$2,406.62
|
| Rate for Payer: BCBS Complete |
$899.78
|
| Rate for Payer: BCBS MAPPO |
$1,598.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.73
|
| Rate for Payer: BCN Commercial |
$1,923.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,598.76
|
| 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 |
$1,598.76
|
| Rate for Payer: Healthscope Commercial |
$2,481.05
|
| Rate for Payer: Healthscope Whirlpool |
$2,406.62
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,598.76
|
| Rate for Payer: Mclaren Commercial |
$2,232.95
|
| Rate for Payer: Mclaren Medicaid |
$856.94
|
| Rate for Payer: Mclaren Medicare |
$1,598.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,678.70
|
| Rate for Payer: Meridian Medicaid |
$899.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,838.57
|
| 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 |
$1,518.82
|
| Rate for Payer: PACE SWMI |
$1,598.76
|
| Rate for Payer: PHP Commercial |
$1,758.64
|
| Rate for Payer: PHP Medicaid |
$856.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,598.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,173.90
|
| Rate for Payer: Priority Health Medicare |
$1,598.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,739.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,598.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,183.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,598.76
|
| Rate for Payer: UHC Exchange |
$2,478.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,598.76
|
| Rate for Payer: UHCCP DNSP |
$1,598.76
|
| Rate for Payer: UHCCP Medicaid |
$856.94
|
| Rate for Payer: VA VA |
$1,598.76
|
|
|
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 |
$2,232.95
|
| 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 |
$2,232.95
|
| 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 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 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: 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 |
$100.27
|
| Rate for Payer: Priority Health Narrow Network |
$80.22
|
| 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 |
$67.38 |
| Max. Negotiated Rate |
$863.24 |
| Rate for Payer: Aetna Commercial |
$776.92
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$837.34
|
| Rate for Payer: ASR Commercial |
$837.34
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$706.91
|
| Rate for Payer: BCN Commercial |
$669.27
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| 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 |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$863.24
|
| Rate for Payer: Healthscope Whirlpool |
$837.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$776.92
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.75
|
| Rate for Payer: Nomi Health Commercial |
$707.86
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.37
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$605.13
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$759.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
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 |
$29.71
|
| 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: 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 |
$52.07
|
| Rate for Payer: Priority Health Narrow Network |
$41.66
|
| 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 |
$73.65 |
| 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: 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 |
$161.33
|
| Rate for Payer: Priority Health Narrow Network |
$129.08
|
| 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
|
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 |
$76.09
|
| Rate for Payer: Aetna Medicare |
$42.27
|
| 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: 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 |
$76.09
|
| 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 |
$74.08
|
| Rate for Payer: Priority Health Narrow Network |
$59.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.40
|
|
|
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 |
$76.09
|
| 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 |
$76.09
|
| 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 (6 SQ CM)
|
Facility
|
IP
|
$421.04
|
|
|
Service Code
|
HCPCS Q4121
|
| Hospital Charge Code |
63600127
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$273.68 |
| Max. Negotiated Rate |
$421.04 |
| Rate for Payer: Aetna Commercial |
$378.94
|
| Rate for Payer: ASR ASR |
$408.41
|
| Rate for Payer: ASR Commercial |
$408.41
|
| Rate for Payer: BCBS Trust/PPO |
$343.11
|
| Rate for Payer: BCN Commercial |
$326.43
|
| Rate for Payer: Cash Price |
$336.83
|
| Rate for Payer: Cofinity Commercial |
$395.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.83
|
| Rate for Payer: Healthscope Commercial |
$421.04
|
| Rate for Payer: Healthscope Whirlpool |
$408.41
|
| Rate for Payer: Mclaren Commercial |
$378.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.88
|
| Rate for Payer: Nomi Health Commercial |
$345.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.52
|
|
|
HC THERASKIN PER SQ CM (6 SQ CM)
|
Facility
|
OP
|
$421.04
|
|
|
Service Code
|
HCPCS Q4121
|
| Hospital Charge Code |
63600127
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$168.42 |
| Max. Negotiated Rate |
$421.04 |
| Rate for Payer: Aetna Commercial |
$378.94
|
| Rate for Payer: Aetna Medicare |
$210.52
|
| Rate for Payer: ASR ASR |
$408.41
|
| Rate for Payer: ASR Commercial |
$408.41
|
| Rate for Payer: BCBS Complete |
$168.42
|
| Rate for Payer: BCBS Trust/PPO |
$344.79
|
| Rate for Payer: BCN Commercial |
$326.43
|
| Rate for Payer: Cash Price |
$336.83
|
| Rate for Payer: Cofinity Commercial |
$395.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.83
|
| Rate for Payer: Healthscope Commercial |
$421.04
|
| Rate for Payer: Healthscope Whirlpool |
$408.41
|
| Rate for Payer: Mclaren Commercial |
$378.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.88
|
| Rate for Payer: Nomi Health Commercial |
$345.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.92
|
| Rate for Payer: Priority Health Narrow Network |
$295.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$370.52
|
|
|
HC THER PROC STRGTH/END RESP 15M
|
Facility
|
IP
|
$87.68
|
|
|
Service Code
|
HCPCS G0237
|
| Hospital Charge Code |
41000047
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$56.99 |
| Max. Negotiated Rate |
$87.68 |
| Rate for Payer: Aetna Commercial |
$78.91
|
| Rate for Payer: ASR ASR |
$85.05
|
| Rate for Payer: ASR Commercial |
$85.05
|
| Rate for Payer: BCBS Trust/PPO |
$71.45
|
| Rate for Payer: BCN Commercial |
$67.98
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Commercial |
$82.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Healthscope Commercial |
$87.68
|
| Rate for Payer: Healthscope Whirlpool |
$85.05
|
| Rate for Payer: Mclaren Commercial |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: Nomi Health Commercial |
$71.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.16
|
|
|
HC THER PROC STRGTH/END RESP 15M
|
Facility
|
OP
|
$87.68
|
|
|
Service Code
|
HCPCS G0237
|
| Hospital Charge Code |
41000047
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$87.68 |
| Rate for Payer: Aetna Commercial |
$78.91
|
| Rate for Payer: Aetna Medicare |
$23.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: ASR ASR |
$85.05
|
| Rate for Payer: ASR Commercial |
$85.05
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$71.80
|
| Rate for Payer: BCN Commercial |
$67.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Commercial |
$82.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$87.68
|
| Rate for Payer: Healthscope Whirlpool |
$85.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.88
|
| Rate for Payer: Mclaren Commercial |
$78.91
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: Nomi Health Commercial |
$71.90
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$26.27
|
| Rate for Payer: PHP Medicaid |
$12.80
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.83
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health Narrow Network |
$61.46
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$37.01
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP DNSP |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: VA VA |
$23.88
|
|
|
HC THIAMINE LEVEL VITAMIN B1
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 84425
|
| Hospital Charge Code |
30100432
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$61.38 |
| Rate for Payer: Aetna Commercial |
$55.24
|
| Rate for Payer: ASR ASR |
$59.54
|
| Rate for Payer: ASR Commercial |
$59.54
|
| Rate for Payer: BCBS Trust/PPO |
$50.02
|
| Rate for Payer: BCN Commercial |
$47.59
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Healthscope Whirlpool |
$59.54
|
| Rate for Payer: Mclaren Commercial |
$55.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.01
|
|
|
HC THIAMINE LEVEL VITAMIN B1
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 84425
|
| Hospital Charge Code |
30100432
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$61.38 |
| Rate for Payer: Aetna Commercial |
$55.24
|
| Rate for Payer: Aetna Medicare |
$21.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.54
|
| Rate for Payer: ASR ASR |
$59.54
|
| Rate for Payer: ASR Commercial |
$59.54
|
| Rate for Payer: BCBS Complete |
$11.95
|
| Rate for Payer: BCBS MAPPO |
$21.23
|
| Rate for Payer: BCBS Trust/PPO |
$50.26
|
| Rate for Payer: BCN Commercial |
$47.59
|
| Rate for Payer: BCN Medicare Advantage |
$21.23
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.23
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Healthscope Whirlpool |
$59.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.23
|
| Rate for Payer: Mclaren Commercial |
$55.24
|
| Rate for Payer: Mclaren Medicaid |
$11.38
|
| Rate for Payer: Mclaren Medicare |
$21.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.29
|
| Rate for Payer: Meridian Medicaid |
$11.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: PACE Medicare |
$20.17
|
| Rate for Payer: PACE SWMI |
$21.23
|
| Rate for Payer: PHP Commercial |
$23.35
|
| Rate for Payer: PHP Medicaid |
$11.38
|
| Rate for Payer: PHP Medicare Advantage |
$21.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.78
|
| Rate for Payer: Priority Health Medicare |
$21.23
|
| Rate for Payer: Priority Health Narrow Network |
$43.03
|
| Rate for Payer: Railroad Medicare Medicare |
$21.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.23
|
| Rate for Payer: UHC Exchange |
$32.91
|
| Rate for Payer: UHC Medicare Advantage |
$21.23
|
| Rate for Payer: UHCCP DNSP |
$21.23
|
| Rate for Payer: UHCCP Medicaid |
$11.38
|
| Rate for Payer: VA VA |
$21.23
|
|
|
HC THIN PREP PAP DIAGNOSTIC
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
31100004
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC THIN PREP PAP DIAGNOSTIC
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
31100004
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$20.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.32
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.26
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$10.86
|
| Rate for Payer: Mclaren Medicare |
$20.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$19.25
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Commercial |
$22.29
|
| Rate for Payer: PHP Medicaid |
$10.86
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$20.26
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$20.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.26
|
| Rate for Payer: UHC Exchange |
$31.40
|
| Rate for Payer: UHC Medicare Advantage |
$20.26
|
| Rate for Payer: UHCCP DNSP |
$20.26
|
| Rate for Payer: UHCCP Medicaid |
$10.86
|
| Rate for Payer: VA VA |
$20.26
|
|
|
HC THIN PREP PAP DIAGNOSTIC AUTO
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
31100031
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
|
|
HC THIN PREP PAP DIAGNOSTIC AUTO
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
31100031
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$26.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.26
|
| Rate for Payer: ASR ASR |
$75.69
|
| Rate for Payer: ASR Commercial |
$75.69
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCBS MAPPO |
$26.61
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$60.50
|
| Rate for Payer: BCN Medicare Advantage |
$26.61
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$73.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.61
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Healthscope Whirlpool |
$75.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$26.61
|
| Rate for Payer: Mclaren Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$14.26
|
| Rate for Payer: Mclaren Medicare |
$26.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.94
|
| Rate for Payer: Meridian Medicaid |
$14.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Medicare |
$25.28
|
| Rate for Payer: PACE SWMI |
$26.61
|
| Rate for Payer: PHP Commercial |
$29.27
|
| Rate for Payer: PHP Medicaid |
$14.26
|
| Rate for Payer: PHP Medicare Advantage |
$26.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.37
|
| Rate for Payer: Priority Health Medicare |
$26.61
|
| Rate for Payer: Priority Health Narrow Network |
$54.70
|
| Rate for Payer: Railroad Medicare Medicare |
$26.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.61
|
| Rate for Payer: UHC Exchange |
$41.25
|
| Rate for Payer: UHC Medicare Advantage |
$26.61
|
| Rate for Payer: UHCCP DNSP |
$26.61
|
| Rate for Payer: UHCCP Medicaid |
$14.26
|
| Rate for Payer: VA VA |
$26.61
|
|
