|
HC UA MICROSCOPIC ONLY
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: Aetna Medicare |
$3.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Complete |
$1.72
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$3.05
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Mclaren Medicaid |
$1.63
|
| Rate for Payer: Mclaren Medicare |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Medicaid |
$1.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Medicare |
$2.90
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Commercial |
$3.35
|
| Rate for Payer: PHP Medicaid |
$1.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.87
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$27.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Exchange |
$4.73
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
| Rate for Payer: UHCCP DNSP |
$3.05
|
| Rate for Payer: UHCCP Medicaid |
$1.63
|
| Rate for Payer: VA VA |
$3.05
|
|
|
HC UA MICROSCOPIC ONLY
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$38.66 |
| Rate for Payer: Aetna Commercial |
$34.79
|
| Rate for Payer: ASR ASR |
$37.50
|
| Rate for Payer: ASR Commercial |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$31.50
|
| Rate for Payer: BCN Commercial |
$29.97
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$38.66
|
| Rate for Payer: Healthscope Whirlpool |
$37.50
|
| Rate for Payer: Mclaren Commercial |
$34.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.02
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$33.71 |
| Max. Negotiated Rate |
$84.27 |
| Rate for Payer: Aetna Commercial |
$75.84
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: ASR ASR |
$81.74
|
| Rate for Payer: ASR Commercial |
$81.74
|
| Rate for Payer: BCBS Complete |
$33.71
|
| Rate for Payer: BCBS Trust/PPO |
$69.01
|
| Rate for Payer: BCN Commercial |
$65.33
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$79.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$84.27
|
| Rate for Payer: Healthscope Whirlpool |
$81.74
|
| Rate for Payer: Mclaren Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.84
|
| Rate for Payer: Priority Health Narrow Network |
$59.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.16
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$54.78 |
| Max. Negotiated Rate |
$84.27 |
| Rate for Payer: Aetna Commercial |
$75.84
|
| Rate for Payer: ASR ASR |
$81.74
|
| Rate for Payer: ASR Commercial |
$81.74
|
| Rate for Payer: BCBS Trust/PPO |
$68.67
|
| Rate for Payer: BCN Commercial |
$65.33
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$79.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$84.27
|
| Rate for Payer: Healthscope Whirlpool |
$81.74
|
| Rate for Payer: Mclaren Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.16
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
OP
|
$9,635.14
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,865.64 |
| Max. Negotiated Rate |
$11,178.62 |
| Rate for Payer: Aetna Commercial |
$8,671.63
|
| Rate for Payer: Aetna Medicare |
$7,212.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,015.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,015.01
|
| Rate for Payer: ASR ASR |
$9,346.09
|
| Rate for Payer: ASR Commercial |
$9,346.09
|
| Rate for Payer: BCBS Complete |
$4,058.92
|
| Rate for Payer: BCBS MAPPO |
$7,212.01
|
| Rate for Payer: BCBS Trust/PPO |
$7,890.22
|
| Rate for Payer: BCN Commercial |
$7,470.12
|
| Rate for Payer: BCN Medicare Advantage |
$7,212.01
|
| Rate for Payer: Cash Price |
$7,708.11
|
| Rate for Payer: Cash Price |
$7,708.11
|
| Rate for Payer: Cofinity Commercial |
$9,057.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,708.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,212.01
|
| Rate for Payer: Healthscope Commercial |
$9,635.14
|
| Rate for Payer: Healthscope Whirlpool |
$9,346.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$7,212.01
|
| Rate for Payer: Mclaren Commercial |
$8,671.63
|
| Rate for Payer: Mclaren Medicaid |
$3,865.64
|
| Rate for Payer: Mclaren Medicare |
$7,212.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,572.61
|
| Rate for Payer: Meridian Medicaid |
$4,058.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,293.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,189.87
|
| Rate for Payer: Nomi Health Commercial |
$7,900.81
|
| Rate for Payer: PACE Medicare |
$6,851.41
|
| Rate for Payer: PACE SWMI |
$7,212.01
|
| Rate for Payer: PHP Commercial |
$7,933.21
|
| Rate for Payer: PHP Medicaid |
$3,865.64
|
| Rate for Payer: PHP Medicare Advantage |
$7,212.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,865.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,262.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,442.31
|
| Rate for Payer: Priority Health Medicare |
$7,212.01
|
| Rate for Payer: Priority Health Narrow Network |
$6,754.23
|
| Rate for Payer: Railroad Medicare Medicare |
$7,212.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,478.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,212.01
|
| Rate for Payer: UHC Exchange |
$11,178.62
|
| Rate for Payer: UHC Medicare Advantage |
$7,212.01
|
| Rate for Payer: UHCCP DNSP |
$7,212.01
|
| Rate for Payer: UHCCP Medicaid |
$3,865.64
|
| Rate for Payer: VA VA |
$7,212.01
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
IP
|
$9,635.14
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,262.84 |
| Max. Negotiated Rate |
$9,635.14 |
| Rate for Payer: Aetna Commercial |
$8,671.63
|
| Rate for Payer: ASR ASR |
$9,346.09
|
| Rate for Payer: ASR Commercial |
$9,346.09
|
| Rate for Payer: BCBS Trust/PPO |
$7,851.68
|
| Rate for Payer: BCN Commercial |
$7,470.12
|
| Rate for Payer: Cash Price |
$7,708.11
|
| Rate for Payer: Cofinity Commercial |
$9,057.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,708.11
|
| Rate for Payer: Healthscope Commercial |
$9,635.14
|
| Rate for Payer: Healthscope Whirlpool |
$9,346.09
|
| Rate for Payer: Mclaren Commercial |
$8,671.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,189.87
|
| Rate for Payer: Nomi Health Commercial |
$7,900.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,262.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,478.92
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
IP
|
$244.45
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$158.89 |
| Max. Negotiated Rate |
$244.45 |
| Rate for Payer: Aetna Commercial |
$220.00
|
| Rate for Payer: ASR ASR |
$237.12
|
| Rate for Payer: ASR Commercial |
$237.12
|
| Rate for Payer: BCBS Trust/PPO |
$199.20
|
| Rate for Payer: BCN Commercial |
$189.52
|
| Rate for Payer: Cash Price |
$195.56
|
| Rate for Payer: Cofinity Commercial |
$229.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.56
|
| Rate for Payer: Healthscope Commercial |
$244.45
|
| Rate for Payer: Healthscope Whirlpool |
$237.12
|
| Rate for Payer: Mclaren Commercial |
$220.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.78
|
| Rate for Payer: Nomi Health Commercial |
$200.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.12
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
OP
|
$244.45
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$97.78 |
| Max. Negotiated Rate |
$244.45 |
| Rate for Payer: Aetna Commercial |
$220.00
|
| Rate for Payer: Aetna Medicare |
$122.22
|
| Rate for Payer: ASR ASR |
$237.12
|
| Rate for Payer: ASR Commercial |
$237.12
|
| Rate for Payer: BCBS Complete |
$97.78
|
| Rate for Payer: BCBS Trust/PPO |
$200.18
|
| Rate for Payer: BCN Commercial |
$189.52
|
| Rate for Payer: Cash Price |
$195.56
|
| Rate for Payer: Cofinity Commercial |
$229.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.56
|
| Rate for Payer: Healthscope Commercial |
$244.45
|
| Rate for Payer: Healthscope Whirlpool |
$237.12
|
| Rate for Payer: Mclaren Commercial |
$220.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.78
|
| Rate for Payer: Nomi Health Commercial |
$200.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.19
|
| Rate for Payer: Priority Health Narrow Network |
$171.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.12
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
IP
|
$213.64
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.87 |
| Max. Negotiated Rate |
$213.64 |
| Rate for Payer: Aetna Commercial |
$192.28
|
| Rate for Payer: ASR ASR |
$207.23
|
| Rate for Payer: ASR Commercial |
$207.23
|
| Rate for Payer: BCBS Trust/PPO |
$174.10
|
| Rate for Payer: BCN Commercial |
$165.64
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$200.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$213.64
|
| Rate for Payer: Healthscope Whirlpool |
$207.23
|
| Rate for Payer: Mclaren Commercial |
$192.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: Nomi Health Commercial |
$175.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.00
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
OP
|
$213.64
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.46 |
| Max. Negotiated Rate |
$213.64 |
| Rate for Payer: Aetna Commercial |
$192.28
|
| Rate for Payer: Aetna Medicare |
$106.82
|
| Rate for Payer: ASR ASR |
$207.23
|
| Rate for Payer: ASR Commercial |
$207.23
|
| Rate for Payer: BCBS Complete |
$85.46
|
| Rate for Payer: BCBS Trust/PPO |
$174.95
|
| Rate for Payer: BCN Commercial |
$165.64
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$200.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$213.64
|
| Rate for Payer: Healthscope Whirlpool |
$207.23
|
| Rate for Payer: Mclaren Commercial |
$192.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: Nomi Health Commercial |
$175.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.19
|
| Rate for Payer: Priority Health Narrow Network |
$149.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.00
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
IP
|
$213.64
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.87 |
| Max. Negotiated Rate |
$213.64 |
| Rate for Payer: Aetna Commercial |
$192.28
|
| Rate for Payer: ASR ASR |
$207.23
|
| Rate for Payer: ASR Commercial |
$207.23
|
| Rate for Payer: BCBS Trust/PPO |
$174.10
|
| Rate for Payer: BCN Commercial |
$165.64
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$200.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$213.64
|
| Rate for Payer: Healthscope Whirlpool |
$207.23
|
| Rate for Payer: Mclaren Commercial |
$192.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: Nomi Health Commercial |
$175.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.00
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
OP
|
$213.64
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.46 |
| Max. Negotiated Rate |
$213.64 |
| Rate for Payer: Aetna Commercial |
$192.28
|
| Rate for Payer: Aetna Medicare |
$106.82
|
| Rate for Payer: ASR ASR |
$207.23
|
| Rate for Payer: ASR Commercial |
$207.23
|
| Rate for Payer: BCBS Complete |
$85.46
|
| Rate for Payer: BCBS Trust/PPO |
$174.95
|
| Rate for Payer: BCN Commercial |
$165.64
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$200.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$213.64
|
| Rate for Payer: Healthscope Whirlpool |
$207.23
|
| Rate for Payer: Mclaren Commercial |
$192.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: Nomi Health Commercial |
$175.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.19
|
| Rate for Payer: Priority Health Narrow Network |
$149.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.00
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
IP
|
$330.35
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$214.73 |
| Max. Negotiated Rate |
$330.35 |
| Rate for Payer: Aetna Commercial |
$297.31
|
| Rate for Payer: ASR ASR |
$320.44
|
| Rate for Payer: ASR Commercial |
$320.44
|
| Rate for Payer: BCBS Trust/PPO |
$269.20
|
| Rate for Payer: BCN Commercial |
$256.12
|
| Rate for Payer: Cash Price |
$264.28
|
| Rate for Payer: Cofinity Commercial |
$310.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.28
|
| Rate for Payer: Healthscope Commercial |
$330.35
|
| Rate for Payer: Healthscope Whirlpool |
$320.44
|
| Rate for Payer: Mclaren Commercial |
$297.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.80
|
| Rate for Payer: Nomi Health Commercial |
$270.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.71
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
OP
|
$330.35
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$132.14 |
| Max. Negotiated Rate |
$330.35 |
| Rate for Payer: Aetna Commercial |
$297.31
|
| Rate for Payer: Aetna Medicare |
$165.18
|
| Rate for Payer: ASR ASR |
$320.44
|
| Rate for Payer: ASR Commercial |
$320.44
|
| Rate for Payer: BCBS Complete |
$132.14
|
| Rate for Payer: BCBS Trust/PPO |
$270.52
|
| Rate for Payer: BCN Commercial |
$256.12
|
| Rate for Payer: Cash Price |
$264.28
|
| Rate for Payer: Cofinity Commercial |
$310.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.28
|
| Rate for Payer: Healthscope Commercial |
$330.35
|
| Rate for Payer: Healthscope Whirlpool |
$320.44
|
| Rate for Payer: Mclaren Commercial |
$297.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.80
|
| Rate for Payer: Nomi Health Commercial |
$270.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.45
|
| Rate for Payer: Priority Health Narrow Network |
$231.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.71
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$92.89
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: ASR ASR |
$100.11
|
| Rate for Payer: ASR Commercial |
$100.11
|
| Rate for Payer: BCBS Complete |
$41.28
|
| Rate for Payer: BCBS Trust/PPO |
$84.52
|
| Rate for Payer: BCN Commercial |
$80.02
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$97.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$103.21
|
| Rate for Payer: Healthscope Whirlpool |
$100.11
|
| Rate for Payer: Mclaren Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.43
|
| Rate for Payer: Priority Health Narrow Network |
$72.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.82
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$103.21 |
| Rate for Payer: Aetna Commercial |
$92.89
|
| Rate for Payer: ASR ASR |
$100.11
|
| Rate for Payer: ASR Commercial |
$100.11
|
| Rate for Payer: BCBS Trust/PPO |
$84.11
|
| Rate for Payer: BCN Commercial |
$80.02
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$97.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$103.21
|
| Rate for Payer: Healthscope Whirlpool |
$100.11
|
| Rate for Payer: Mclaren Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: Nomi Health Commercial |
$84.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.82
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$9,655.64
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,276.17 |
| Max. Negotiated Rate |
$9,655.64 |
| Rate for Payer: Aetna Commercial |
$8,690.08
|
| Rate for Payer: ASR ASR |
$9,365.97
|
| Rate for Payer: ASR Commercial |
$9,365.97
|
| Rate for Payer: BCBS Trust/PPO |
$7,868.38
|
| Rate for Payer: BCN Commercial |
$7,486.02
|
| Rate for Payer: Cash Price |
$7,724.51
|
| Rate for Payer: Cofinity Commercial |
$9,076.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,724.51
|
| Rate for Payer: Healthscope Commercial |
$9,655.64
|
| Rate for Payer: Healthscope Whirlpool |
$9,365.97
|
| Rate for Payer: Mclaren Commercial |
$8,690.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,207.29
|
| Rate for Payer: Nomi Health Commercial |
$7,917.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,276.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,496.96
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$9,655.64
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,430.76 |
| Max. Negotiated Rate |
$9,921.04 |
| Rate for Payer: Aetna Commercial |
$8,690.08
|
| Rate for Payer: Aetna Medicare |
$6,400.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,000.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,000.84
|
| Rate for Payer: ASR ASR |
$9,365.97
|
| Rate for Payer: ASR Commercial |
$9,365.97
|
| Rate for Payer: BCBS Complete |
$3,602.30
|
| Rate for Payer: BCBS MAPPO |
$6,400.67
|
| Rate for Payer: BCBS Trust/PPO |
$7,907.00
|
| Rate for Payer: BCN Commercial |
$7,486.02
|
| Rate for Payer: BCN Medicare Advantage |
$6,400.67
|
| Rate for Payer: Cash Price |
$7,724.51
|
| Rate for Payer: Cash Price |
$7,724.51
|
| Rate for Payer: Cofinity Commercial |
$9,076.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,724.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,400.67
|
| Rate for Payer: Healthscope Commercial |
$9,655.64
|
| Rate for Payer: Healthscope Whirlpool |
$9,365.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,400.67
|
| Rate for Payer: Mclaren Commercial |
$8,690.08
|
| Rate for Payer: Mclaren Medicaid |
$3,430.76
|
| Rate for Payer: Mclaren Medicare |
$6,400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,720.70
|
| Rate for Payer: Meridian Medicaid |
$3,602.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,207.29
|
| Rate for Payer: Nomi Health Commercial |
$7,917.62
|
| Rate for Payer: PACE Medicare |
$6,080.64
|
| Rate for Payer: PACE SWMI |
$6,400.67
|
| Rate for Payer: PHP Commercial |
$7,040.74
|
| Rate for Payer: PHP Medicaid |
$3,430.76
|
| Rate for Payer: PHP Medicare Advantage |
$6,400.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,430.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,276.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,460.27
|
| Rate for Payer: Priority Health Medicare |
$6,400.67
|
| Rate for Payer: Priority Health Narrow Network |
$6,768.60
|
| Rate for Payer: Railroad Medicare Medicare |
$6,400.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8,496.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,400.67
|
| Rate for Payer: UHC Exchange |
$9,921.04
|
| Rate for Payer: UHC Medicare Advantage |
$6,400.67
|
| Rate for Payer: UHCCP DNSP |
$6,400.67
|
| Rate for Payer: UHCCP Medicaid |
$3,430.76
|
| Rate for Payer: VA VA |
$6,400.67
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
IP
|
$1,125.34
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$731.47 |
| Max. Negotiated Rate |
$1,125.34 |
| Rate for Payer: Aetna Commercial |
$1,012.81
|
| Rate for Payer: ASR ASR |
$1,091.58
|
| Rate for Payer: ASR Commercial |
$1,091.58
|
| Rate for Payer: BCBS Trust/PPO |
$917.04
|
| Rate for Payer: BCN Commercial |
$872.48
|
| Rate for Payer: Cash Price |
$900.27
|
| Rate for Payer: Cofinity Commercial |
$1,057.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.27
|
| Rate for Payer: Healthscope Commercial |
$1,125.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,091.58
|
| Rate for Payer: Mclaren Commercial |
$1,012.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.54
|
| Rate for Payer: Nomi Health Commercial |
$922.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$990.30
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
OP
|
$1,125.34
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.16 |
| Max. Negotiated Rate |
$1,125.34 |
| Rate for Payer: Aetna Commercial |
$1,012.81
|
| Rate for Payer: Aetna Medicare |
$196.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.25
|
| Rate for Payer: ASR ASR |
$1,091.58
|
| Rate for Payer: ASR Commercial |
$1,091.58
|
| Rate for Payer: BCBS Complete |
$110.42
|
| Rate for Payer: BCBS MAPPO |
$196.20
|
| Rate for Payer: BCBS Trust/PPO |
$921.54
|
| Rate for Payer: BCN Commercial |
$872.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.20
|
| Rate for Payer: Cash Price |
$900.27
|
| Rate for Payer: Cash Price |
$900.27
|
| Rate for Payer: Cofinity Commercial |
$1,057.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.20
|
| Rate for Payer: Healthscope Commercial |
$1,125.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,091.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$196.20
|
| Rate for Payer: Mclaren Commercial |
$1,012.81
|
| Rate for Payer: Mclaren Medicaid |
$105.16
|
| Rate for Payer: Mclaren Medicare |
$196.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.01
|
| Rate for Payer: Meridian Medicaid |
$110.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.54
|
| Rate for Payer: Nomi Health Commercial |
$922.78
|
| Rate for Payer: PACE Medicare |
$186.39
|
| Rate for Payer: PACE SWMI |
$196.20
|
| Rate for Payer: PHP Commercial |
$215.82
|
| Rate for Payer: PHP Medicaid |
$105.16
|
| Rate for Payer: PHP Medicare Advantage |
$196.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.02
|
| Rate for Payer: Priority Health Medicare |
$196.20
|
| Rate for Payer: Priority Health Narrow Network |
$788.86
|
| Rate for Payer: Railroad Medicare Medicare |
$196.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$990.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.20
|
| Rate for Payer: UHC Exchange |
$304.11
|
| Rate for Payer: UHC Medicare Advantage |
$196.20
|
| Rate for Payer: UHCCP DNSP |
$196.20
|
| Rate for Payer: UHCCP Medicaid |
$105.16
|
| Rate for Payer: VA VA |
$196.20
|
|
|
HC UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
76100418
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$551.28
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.86
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$471.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
HC UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
76100418
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$437.58 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Trust/PPO |
$548.59
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
|
|
HC UNLISTED PROCEDURE FOREARM WRIST
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 25999
|
| Hospital Charge Code |
76100410
|
| Min. Negotiated Rate |
$437.58 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Trust/PPO |
$548.59
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
|
|
HC UNLISTED PROCEDURE FOREARM WRIST
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 25999
|
| Hospital Charge Code |
76100410
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$551.28
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.86
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$471.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
|
HC UNLISTED PROCEDURE HUMERUS ELBOW
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 24999
|
| Hospital Charge Code |
76100409
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$673.20 |
| Rate for Payer: Aetna Commercial |
$605.88
|
| Rate for Payer: Aetna Medicare |
$233.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: ASR ASR |
$653.00
|
| Rate for Payer: ASR Commercial |
$653.00
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCBS Trust/PPO |
$551.28
|
| Rate for Payer: BCN Commercial |
$521.93
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$632.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$673.20
|
| Rate for Payer: Healthscope Whirlpool |
$653.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$233.95
|
| Rate for Payer: Mclaren Commercial |
$605.88
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$257.35
|
| Rate for Payer: PHP Medicaid |
$125.40
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.86
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health Narrow Network |
$471.91
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$362.62
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP DNSP |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: VA VA |
$233.95
|
|
