|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,846.08
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,884.56 |
| Max. Negotiated Rate |
$7,846.08 |
| Rate for Payer: Aetna Commercial |
$7,061.47
|
| Rate for Payer: ASR ASR |
$7,610.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,443.20
|
| Rate for Payer: BCN Commercial |
$6,443.20
|
| Rate for Payer: Cash Price |
$6,276.86
|
| Rate for Payer: Cofinity Commercial |
$7,375.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,276.86
|
| Rate for Payer: Healthscope Commercial |
$7,610.70
|
| Rate for Payer: Healthscope Whirlpool |
$7,846.08
|
| Rate for Payer: Mclaren Commercial |
$7,061.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,669.17
|
| Rate for Payer: Nomi Health Commercial |
$6,433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,884.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,904.55
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,273.70
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$841.27 |
| Max. Negotiated Rate |
$3,570.00 |
| Rate for Payer: Aetna Commercial |
$2,046.33
|
| Rate for Payer: Aetna Medicare |
$841.27
|
| Rate for Payer: ASR ASR |
$2,205.49
|
| Rate for Payer: BCBS Complete |
$909.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,874.67
|
| Rate for Payer: BCN Commercial |
$1,874.67
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cofinity Commercial |
$2,137.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,818.96
|
| Rate for Payer: Healthscope Commercial |
$2,205.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,273.70
|
| Rate for Payer: Mclaren Commercial |
$2,046.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,818.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.64
|
| Rate for Payer: Nomi Health Commercial |
$1,864.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,705.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,570.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,856.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,000.86
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,273.70
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,705.28 |
| Max. Negotiated Rate |
$2,273.70 |
| Rate for Payer: Aetna Commercial |
$2,046.33
|
| Rate for Payer: ASR ASR |
$2,205.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,867.16
|
| Rate for Payer: BCN Commercial |
$1,867.16
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cofinity Commercial |
$2,137.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,818.96
|
| Rate for Payer: Healthscope Commercial |
$2,205.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,273.70
|
| Rate for Payer: Mclaren Commercial |
$2,046.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.64
|
| Rate for Payer: Nomi Health Commercial |
$1,864.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,705.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,000.86
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$63,202.66
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$47,402.00 |
| Max. Negotiated Rate |
$63,202.66 |
| Rate for Payer: Aetna Commercial |
$56,882.39
|
| Rate for Payer: ASR ASR |
$61,306.58
|
| Rate for Payer: BCBS Trust/PPO |
$51,902.02
|
| Rate for Payer: BCN Commercial |
$51,902.02
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cofinity Commercial |
$59,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,562.13
|
| Rate for Payer: Healthscope Commercial |
$61,306.58
|
| Rate for Payer: Healthscope Whirlpool |
$63,202.66
|
| Rate for Payer: Mclaren Commercial |
$56,882.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,722.26
|
| Rate for Payer: Nomi Health Commercial |
$51,826.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47,402.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55,618.34
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$63,202.66
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$29,719.24 |
| Max. Negotiated Rate |
$88,078.05 |
| Rate for Payer: Aetna Commercial |
$56,882.39
|
| Rate for Payer: Aetna Medicare |
$56,824.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71,030.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71,030.69
|
| Rate for Payer: ASR ASR |
$61,306.58
|
| Rate for Payer: BCBS Complete |
$31,208.04
|
| Rate for Payer: BCBS MAPPO |
$56,824.55
|
| Rate for Payer: BCBS Trust/PPO |
$52,110.59
|
| Rate for Payer: BCN Commercial |
$52,110.59
|
| Rate for Payer: BCN Medicare Advantage |
$56,824.55
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cofinity Commercial |
$59,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,562.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,824.55
|
| Rate for Payer: Healthscope Commercial |
$61,306.58
|
| Rate for Payer: Healthscope Whirlpool |
$63,202.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$56,824.55
|
| Rate for Payer: Mclaren Commercial |
$56,882.39
|
| Rate for Payer: Mclaren Medicaid |
$56,824.55
|
| Rate for Payer: Mclaren Medicare |
$56,824.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,665.78
|
| Rate for Payer: Meridian Medicaid |
$31,208.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,348.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$62,507.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,722.26
|
| Rate for Payer: Nomi Health Commercial |
$51,826.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47,402.00
|
| Rate for Payer: PACE Medicare |
$53,983.32
|
| Rate for Payer: PACE SWMI |
$56,824.55
|
| Rate for Payer: PHP Commercial |
$62,507.00
|
| Rate for Payer: PHP Medicaid |
$30,457.96
|
| Rate for Payer: PHP Medicare Advantage |
$56,824.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$29,719.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69,162.84
|
| Rate for Payer: Priority Health Medicare |
$56,824.55
|
| Rate for Payer: Priority Health Narrow Network |
$55,330.27
|
| Rate for Payer: Railroad Medicare Medicare |
$56,824.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55,618.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56,824.55
|
| Rate for Payer: UHC Exchange |
$88,078.05
|
| Rate for Payer: UHC Medicaid |
$29,719.24
|
| Rate for Payer: UHCCP DNSP |
$56,824.55
|
| Rate for Payer: UHCCP Medicaid |
$29,719.24
|
| Rate for Payer: VA VA |
$56,824.55
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,561.51
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$577.76 |
| Max. Negotiated Rate |
$1,561.51 |
| Rate for Payer: Aetna Commercial |
$1,405.36
|
| Rate for Payer: Aetna Medicare |
$577.76
|
| Rate for Payer: ASR ASR |
$1,514.66
|
| Rate for Payer: BCBS Complete |
$624.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.46
|
| Rate for Payer: BCN Commercial |
$1,287.46
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,467.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,514.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.51
|
| Rate for Payer: Mclaren Commercial |
$1,405.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,249.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,368.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,094.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,374.13
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,561.51
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,171.13 |
| Max. Negotiated Rate |
$1,561.51 |
| Rate for Payer: Aetna Commercial |
$1,405.36
|
| Rate for Payer: ASR ASR |
$1,514.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.31
|
| Rate for Payer: BCN Commercial |
$1,282.31
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,467.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,514.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,561.51
|
| Rate for Payer: Mclaren Commercial |
$1,405.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,374.13
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,247.81
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$935.86 |
| Max. Negotiated Rate |
$1,247.81 |
| Rate for Payer: Aetna Commercial |
$1,123.03
|
| Rate for Payer: ASR ASR |
$1,210.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.70
|
| Rate for Payer: BCN Commercial |
$1,024.70
|
| Rate for Payer: Cash Price |
$998.25
|
| Rate for Payer: Cofinity Commercial |
$1,172.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.25
|
| Rate for Payer: Healthscope Commercial |
$1,210.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,247.81
|
| Rate for Payer: Mclaren Commercial |
$1,123.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.64
|
| Rate for Payer: Nomi Health Commercial |
$1,023.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,098.07
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,247.81
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$461.69 |
| Max. Negotiated Rate |
$1,247.81 |
| Rate for Payer: Aetna Commercial |
$1,123.03
|
| Rate for Payer: Aetna Medicare |
$461.69
|
| Rate for Payer: ASR ASR |
$1,210.38
|
| Rate for Payer: BCBS Complete |
$499.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.82
|
| Rate for Payer: BCN Commercial |
$1,028.82
|
| Rate for Payer: Cash Price |
$998.25
|
| Rate for Payer: Cofinity Commercial |
$1,172.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.25
|
| Rate for Payer: Healthscope Commercial |
$1,210.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,247.81
|
| Rate for Payer: Mclaren Commercial |
$1,123.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.64
|
| Rate for Payer: Nomi Health Commercial |
$1,023.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,093.33
|
| Rate for Payer: Priority Health Narrow Network |
$874.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,098.07
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,614.79
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,211.09 |
| Max. Negotiated Rate |
$1,614.79 |
| Rate for Payer: Aetna Commercial |
$1,453.31
|
| Rate for Payer: ASR ASR |
$1,566.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.07
|
| Rate for Payer: BCN Commercial |
$1,326.07
|
| Rate for Payer: Cash Price |
$1,291.83
|
| Rate for Payer: Cofinity Commercial |
$1,517.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.83
|
| Rate for Payer: Healthscope Commercial |
$1,566.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,614.79
|
| Rate for Payer: Mclaren Commercial |
$1,453.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,372.57
|
| Rate for Payer: Nomi Health Commercial |
$1,324.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,211.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,421.02
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,614.79
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$597.47 |
| Max. Negotiated Rate |
$1,614.79 |
| Rate for Payer: Aetna Commercial |
$1,453.31
|
| Rate for Payer: Aetna Medicare |
$597.47
|
| Rate for Payer: ASR ASR |
$1,566.35
|
| Rate for Payer: BCBS Complete |
$645.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,331.39
|
| Rate for Payer: BCN Commercial |
$1,331.39
|
| Rate for Payer: Cash Price |
$1,291.83
|
| Rate for Payer: Cofinity Commercial |
$1,517.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.83
|
| Rate for Payer: Healthscope Commercial |
$1,566.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,614.79
|
| Rate for Payer: Mclaren Commercial |
$1,453.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,291.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,372.57
|
| Rate for Payer: Nomi Health Commercial |
$1,324.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,211.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,414.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,421.02
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
OP
|
$2,263.31
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$837.42 |
| Max. Negotiated Rate |
$2,263.31 |
| Rate for Payer: Aetna Commercial |
$2,036.98
|
| Rate for Payer: Aetna Medicare |
$837.42
|
| Rate for Payer: ASR ASR |
$2,195.41
|
| Rate for Payer: BCBS Complete |
$905.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.10
|
| Rate for Payer: BCN Commercial |
$1,866.10
|
| Rate for Payer: Cash Price |
$1,810.65
|
| Rate for Payer: Cofinity Commercial |
$2,127.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.65
|
| Rate for Payer: Healthscope Commercial |
$2,195.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,263.31
|
| Rate for Payer: Mclaren Commercial |
$2,036.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,810.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,923.81
|
| Rate for Payer: Nomi Health Commercial |
$1,855.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,983.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,991.71
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
IP
|
$2,263.31
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,697.48 |
| Max. Negotiated Rate |
$2,263.31 |
| Rate for Payer: Aetna Commercial |
$2,036.98
|
| Rate for Payer: ASR ASR |
$2,195.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.63
|
| Rate for Payer: BCN Commercial |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,810.65
|
| Rate for Payer: Cofinity Commercial |
$2,127.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.65
|
| Rate for Payer: Healthscope Commercial |
$2,195.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,263.31
|
| Rate for Payer: Mclaren Commercial |
$2,036.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,923.81
|
| Rate for Payer: Nomi Health Commercial |
$1,855.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,991.71
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$191.43
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$191.43 |
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$185.69
|
| Rate for Payer: BCBS Complete |
$9.25
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$157.83
|
| Rate for Payer: BCN Commercial |
$157.83
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cofinity Commercial |
$179.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$185.69
|
| Rate for Payer: Healthscope Whirlpool |
$191.43
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$172.29
|
| Rate for Payer: Mclaren Medicaid |
$16.85
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.72
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.57
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$23.02
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$18.41
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.85
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHCCP DNSP |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: VA VA |
$16.85
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$191.43
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$143.57 |
| Max. Negotiated Rate |
$191.43 |
| Rate for Payer: Aetna Commercial |
$172.29
|
| Rate for Payer: ASR ASR |
$185.69
|
| Rate for Payer: BCBS Trust/PPO |
$157.20
|
| Rate for Payer: BCN Commercial |
$157.20
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cofinity Commercial |
$179.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.14
|
| Rate for Payer: Healthscope Commercial |
$185.69
|
| Rate for Payer: Healthscope Whirlpool |
$191.43
|
| Rate for Payer: Mclaren Commercial |
$172.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.72
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.46
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$198.97 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: ASR ASR |
$257.34
|
| Rate for Payer: BCBS Trust/PPO |
$217.86
|
| Rate for Payer: BCN Commercial |
$217.86
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$249.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$257.34
|
| Rate for Payer: Healthscope Whirlpool |
$265.30
|
| Rate for Payer: Mclaren Commercial |
$238.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.46
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$257.34
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$218.74
|
| Rate for Payer: BCN Commercial |
$218.74
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$249.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$257.34
|
| Rate for Payer: Healthscope Whirlpool |
$265.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$238.77
|
| Rate for Payer: Mclaren Medicaid |
$51.31
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.85
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$71.08
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: ASR ASR |
$257.34
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$218.74
|
| Rate for Payer: BCN Commercial |
$218.74
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$249.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$257.34
|
| Rate for Payer: Healthscope Whirlpool |
$265.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$51.31
|
| Rate for Payer: Mclaren Commercial |
$238.77
|
| Rate for Payer: Mclaren Medicaid |
$51.31
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicaid |
$27.50
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$88.85
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$71.08
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.31
|
| Rate for Payer: UHC Exchange |
$79.53
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: VA VA |
$51.31
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$198.97 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: ASR ASR |
$257.34
|
| Rate for Payer: BCBS Trust/PPO |
$217.86
|
| Rate for Payer: BCN Commercial |
$217.86
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$249.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$257.34
|
| Rate for Payer: Healthscope Whirlpool |
$265.30
|
| Rate for Payer: Mclaren Commercial |
$238.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.46
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
IP
|
$3,160.38
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,370.28 |
| Max. Negotiated Rate |
$3,160.38 |
| Rate for Payer: Aetna Commercial |
$2,844.34
|
| Rate for Payer: ASR ASR |
$3,065.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,595.30
|
| Rate for Payer: BCN Commercial |
$2,595.30
|
| Rate for Payer: Cash Price |
$2,528.30
|
| Rate for Payer: Cofinity Commercial |
$2,970.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.30
|
| Rate for Payer: Healthscope Commercial |
$3,065.57
|
| Rate for Payer: Healthscope Whirlpool |
$3,160.38
|
| Rate for Payer: Mclaren Commercial |
$2,844.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,686.32
|
| Rate for Payer: Nomi Health Commercial |
$2,591.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,370.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,781.13
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
OP
|
$3,160.38
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,169.34 |
| Max. Negotiated Rate |
$3,160.38 |
| Rate for Payer: Aetna Commercial |
$2,844.34
|
| Rate for Payer: Aetna Medicare |
$1,169.34
|
| Rate for Payer: ASR ASR |
$3,065.57
|
| Rate for Payer: BCBS Complete |
$1,264.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,605.73
|
| Rate for Payer: BCN Commercial |
$2,605.73
|
| Rate for Payer: Cash Price |
$2,528.30
|
| Rate for Payer: Cofinity Commercial |
$2,970.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.30
|
| Rate for Payer: Healthscope Commercial |
$3,065.57
|
| Rate for Payer: Healthscope Whirlpool |
$3,160.38
|
| Rate for Payer: Mclaren Commercial |
$2,844.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,528.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,686.32
|
| Rate for Payer: Nomi Health Commercial |
$2,591.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,370.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,769.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,215.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,781.13
|
|
|
HC ZINC LEVEL
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.23 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.86
|
| Rate for Payer: BCN Commercial |
$41.86
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Healthscope Whirlpool |
$50.98
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
|
|
HC ZINC LEVEL
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$56.91 |
| Rate for Payer: Aetna Commercial |
$45.88
|
| Rate for Payer: Aetna Medicare |
$11.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.24
|
| Rate for Payer: ASR ASR |
$49.45
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$11.39
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$47.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.39
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Healthscope Whirlpool |
$50.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$11.39
|
| Rate for Payer: Mclaren Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$11.39
|
| Rate for Payer: Mclaren Medicare |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.96
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: PACE Medicare |
$10.82
|
| Rate for Payer: PACE SWMI |
$11.39
|
| Rate for Payer: PHP Commercial |
$12.53
|
| Rate for Payer: PHP Medicaid |
$6.11
|
| Rate for Payer: PHP Medicare Advantage |
$11.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.91
|
| Rate for Payer: Priority Health Medicare |
$11.39
|
| Rate for Payer: Priority Health Narrow Network |
$45.53
|
| Rate for Payer: Railroad Medicare Medicare |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.39
|
| Rate for Payer: UHC Exchange |
$17.65
|
| Rate for Payer: UHC Medicaid |
$5.96
|
| Rate for Payer: UHCCP DNSP |
$11.39
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: VA VA |
$11.39
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$344.25 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: ASR ASR |
$445.23
|
| Rate for Payer: BCBS Trust/PPO |
$376.93
|
| Rate for Payer: BCN Commercial |
$376.93
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$431.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.20
|
| Rate for Payer: Healthscope Commercial |
$445.23
|
| Rate for Payer: Healthscope Whirlpool |
$459.00
|
| Rate for Payer: Mclaren Commercial |
$413.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.15
|
| Rate for Payer: Nomi Health Commercial |
$376.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$403.92
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$23.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: ASR ASR |
$445.23
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$378.45
|
| Rate for Payer: BCN Commercial |
$378.45
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$431.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$445.23
|
| Rate for Payer: Healthscope Whirlpool |
$459.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$23.57
|
| Rate for Payer: Mclaren Commercial |
$413.10
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.15
|
| Rate for Payer: Nomi Health Commercial |
$376.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$25.93
|
| Rate for Payer: PHP Medicaid |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$402.18
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health Narrow Network |
$321.76
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$403.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.57
|
| Rate for Payer: UHC Exchange |
$36.53
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHCCP DNSP |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: VA VA |
$23.57
|
|
