|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$57.31 |
| Max. Negotiated Rate |
$925.40 |
| Rate for Payer: Aetna Commercial |
$667.45
|
| Rate for Payer: Aetna Medicare |
$498.10
|
| Rate for Payer: BCBS Complete |
$344.87
|
| Rate for Payer: BCBS MAPPO |
$498.10
|
| Rate for Payer: BCBS Trust/PPO |
$57.31
|
| Rate for Payer: BCN Commercial |
$747.68
|
| Rate for Payer: BCN Medicare Advantage |
$498.10
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$717.26
|
| Rate for Payer: Cofinity Commercial |
$667.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.10
|
| Rate for Payer: Healthscope Commercial |
$597.72
|
| Rate for Payer: Healthscope Whirlpool |
$597.72
|
| Rate for Payer: Meridian Medicaid |
$344.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$523.00
|
| Rate for Payer: PACE SWMI |
$498.10
|
| Rate for Payer: PHP Medicare Advantage |
$498.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.29
|
| Rate for Payer: Priority Health Medicare |
$498.10
|
| Rate for Payer: Priority Health Narrow Network |
$781.29
|
| Rate for Payer: UHC Medicare Advantage |
$513.04
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$193.15 |
| Max. Negotiated Rate |
$885.50 |
| Rate for Payer: Aetna Commercial |
$426.58
|
| Rate for Payer: Aetna Medicare |
$318.34
|
| Rate for Payer: BCBS Complete |
$222.76
|
| Rate for Payer: BCBS MAPPO |
$318.34
|
| Rate for Payer: BCBS Trust/PPO |
$193.15
|
| Rate for Payer: BCN Commercial |
$479.88
|
| Rate for Payer: BCN Medicare Advantage |
$318.34
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$458.41
|
| Rate for Payer: Cofinity Commercial |
$426.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.34
|
| Rate for Payer: Healthscope Commercial |
$382.01
|
| Rate for Payer: Healthscope Whirlpool |
$382.01
|
| Rate for Payer: Meridian Medicaid |
$222.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.26
|
| Rate for Payer: PACE SWMI |
$318.34
|
| Rate for Payer: PHP Medicare Advantage |
$318.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$501.45
|
| Rate for Payer: Priority Health Medicare |
$318.34
|
| Rate for Payer: Priority Health Narrow Network |
$501.45
|
| Rate for Payer: UHC Medicare Advantage |
$327.89
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$132.87 |
| Max. Negotiated Rate |
$747.60 |
| Rate for Payer: Aetna Commercial |
$525.59
|
| Rate for Payer: Aetna Medicare |
$392.23
|
| Rate for Payer: BCBS Complete |
$274.87
|
| Rate for Payer: BCBS MAPPO |
$392.23
|
| Rate for Payer: BCBS Trust/PPO |
$132.87
|
| Rate for Payer: BCN Commercial |
$592.28
|
| Rate for Payer: BCN Medicare Advantage |
$392.23
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$564.81
|
| Rate for Payer: Cofinity Commercial |
$525.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.23
|
| Rate for Payer: Healthscope Commercial |
$470.68
|
| Rate for Payer: Healthscope Whirlpool |
$470.68
|
| Rate for Payer: Meridian Medicaid |
$274.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.84
|
| Rate for Payer: PACE SWMI |
$392.23
|
| Rate for Payer: PHP Medicare Advantage |
$392.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.90
|
| Rate for Payer: Priority Health Medicare |
$392.23
|
| Rate for Payer: Priority Health Narrow Network |
$618.90
|
| Rate for Payer: UHC Medicare Advantage |
$404.00
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$526.48 |
| Rate for Payer: Aetna Commercial |
$447.69
|
| Rate for Payer: Aetna Medicare |
$334.10
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$334.10
|
| Rate for Payer: BCBS Trust/PPO |
$120.56
|
| Rate for Payer: BCN Commercial |
$503.83
|
| Rate for Payer: BCN Medicare Advantage |
$334.10
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$447.69
|
| Rate for Payer: Cofinity Commercial |
$481.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.10
|
| Rate for Payer: Healthscope Commercial |
$400.92
|
| Rate for Payer: Healthscope Whirlpool |
$400.92
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$350.80
|
| Rate for Payer: PACE SWMI |
$334.10
|
| Rate for Payer: PHP Medicare Advantage |
$334.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$526.48
|
| Rate for Payer: Priority Health Medicare |
$334.10
|
| Rate for Payer: Priority Health Narrow Network |
$526.48
|
| Rate for Payer: UHC Medicare Advantage |
$344.12
|
|
|
PR ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,230.00
|
|
|
Service Code
|
HCPCS 23107
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$1,020.28 |
| Rate for Payer: Aetna Commercial |
$875.41
|
| Rate for Payer: Aetna Medicare |
$653.29
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$653.29
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$653.29
|
| Rate for Payer: Cash Price |
$984.00
|
| Rate for Payer: Cash Price |
$984.00
|
| Rate for Payer: Cofinity Commercial |
$875.41
|
| Rate for Payer: Cofinity Commercial |
$940.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.29
|
| Rate for Payer: Healthscope Commercial |
$783.95
|
| Rate for Payer: Healthscope Whirlpool |
$783.95
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$685.95
|
| Rate for Payer: PACE SWMI |
$653.29
|
| Rate for Payer: PHP Medicare Advantage |
$653.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.28
|
| Rate for Payer: Priority Health Medicare |
$653.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.28
|
| Rate for Payer: UHC Medicare Advantage |
$672.89
|
|
|
PR ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX
|
Professional
|
Both
|
$981.00
|
|
|
Service Code
|
HCPCS 23106
|
| Min. Negotiated Rate |
$151.62 |
| Max. Negotiated Rate |
$778.23 |
| Rate for Payer: Aetna Commercial |
$664.51
|
| Rate for Payer: Aetna Medicare |
$495.90
|
| Rate for Payer: BCBS Complete |
$344.64
|
| Rate for Payer: BCBS MAPPO |
$495.90
|
| Rate for Payer: BCBS Trust/PPO |
$151.62
|
| Rate for Payer: BCN Commercial |
$744.75
|
| Rate for Payer: BCN Medicare Advantage |
$495.90
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cash Price |
$784.80
|
| Rate for Payer: Cofinity Commercial |
$714.10
|
| Rate for Payer: Cofinity Commercial |
$664.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.90
|
| Rate for Payer: Healthscope Commercial |
$595.08
|
| Rate for Payer: Healthscope Whirlpool |
$595.08
|
| Rate for Payer: Meridian Medicaid |
$344.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$520.70
|
| Rate for Payer: PACE SWMI |
$495.90
|
| Rate for Payer: PHP Medicare Advantage |
$495.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$778.23
|
| Rate for Payer: Priority Health Medicare |
$495.90
|
| Rate for Payer: Priority Health Narrow Network |
$778.23
|
| Rate for Payer: UHC Medicare Advantage |
$510.78
|
|
|
PR ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 23105
|
| Min. Negotiated Rate |
$85.58 |
| Max. Negotiated Rate |
$986.06 |
| Rate for Payer: Aetna Commercial |
$845.59
|
| Rate for Payer: Aetna Medicare |
$631.04
|
| Rate for Payer: BCBS Complete |
$437.68
|
| Rate for Payer: BCBS MAPPO |
$631.04
|
| Rate for Payer: BCBS Trust/PPO |
$85.58
|
| Rate for Payer: BCN Commercial |
$943.64
|
| Rate for Payer: BCN Medicare Advantage |
$631.04
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$845.59
|
| Rate for Payer: Cofinity Commercial |
$908.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.04
|
| Rate for Payer: Healthscope Commercial |
$757.25
|
| Rate for Payer: Healthscope Whirlpool |
$757.25
|
| Rate for Payer: Meridian Medicaid |
$437.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$662.59
|
| Rate for Payer: PACE SWMI |
$631.04
|
| Rate for Payer: PHP Medicare Advantage |
$631.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.06
|
| Rate for Payer: Priority Health Medicare |
$631.04
|
| Rate for Payer: Priority Health Narrow Network |
$986.06
|
| Rate for Payer: UHC Medicare Advantage |
$649.97
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Facility
|
OP
|
$2,638.00
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$1,573.80 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$2,374.20
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$2,558.86
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.24
|
| Rate for Payer: BCN Commercial |
$2,045.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cofinity Commercial |
$2,479.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,110.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$2,638.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,558.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$2,374.20
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,242.30
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,400.58
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,872.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,321.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,638.00
|
|
|
Service Code
|
HCPCS 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$474.78 |
| Max. Negotiated Rate |
$2,115.84 |
| Rate for Payer: Aetna Commercial |
$969.13
|
| Rate for Payer: Aetna Medicare |
$723.23
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$723.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,115.84
|
| Rate for Payer: BCN Commercial |
$1,079.48
|
| Rate for Payer: BCN Medicare Advantage |
$723.23
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cofinity Commercial |
$969.13
|
| Rate for Payer: Cofinity Commercial |
$1,041.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$723.23
|
| Rate for Payer: Healthscope Commercial |
$867.88
|
| Rate for Payer: Healthscope Whirlpool |
$867.88
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$759.39
|
| Rate for Payer: PACE SWMI |
$723.23
|
| Rate for Payer: PHP Medicare Advantage |
$723.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.03
|
| Rate for Payer: Priority Health Medicare |
$723.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.03
|
| Rate for Payer: UHC Medicare Advantage |
$744.93
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,638.00
|
|
|
Service Code
|
HCPCS 27310
|
| Min. Negotiated Rate |
$474.78 |
| Max. Negotiated Rate |
$2,115.84 |
| Rate for Payer: Aetna Commercial |
$969.13
|
| Rate for Payer: Aetna Medicare |
$723.23
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$723.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,115.84
|
| Rate for Payer: BCN Commercial |
$1,079.48
|
| Rate for Payer: BCN Medicare Advantage |
$723.23
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cofinity Commercial |
$969.13
|
| Rate for Payer: Cofinity Commercial |
$1,041.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$723.23
|
| Rate for Payer: Healthscope Commercial |
$867.88
|
| Rate for Payer: Healthscope Whirlpool |
$867.88
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$759.39
|
| Rate for Payer: PACE SWMI |
$723.23
|
| Rate for Payer: PHP Medicare Advantage |
$723.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.03
|
| Rate for Payer: Priority Health Medicare |
$723.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.03
|
| Rate for Payer: UHC Medicare Advantage |
$744.93
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Facility
|
IP
|
$2,638.00
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
27310
|
| Min. Negotiated Rate |
$1,846.60 |
| Max. Negotiated Rate |
$2,638.00 |
| Rate for Payer: Aetna Commercial |
$2,374.20
|
| Rate for Payer: ASR ASR |
$2,558.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.24
|
| Rate for Payer: BCN Commercial |
$2,045.24
|
| Rate for Payer: Cash Price |
$2,110.40
|
| Rate for Payer: Cofinity Commercial |
$2,479.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,110.40
|
| Rate for Payer: Healthscope Commercial |
$2,638.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,558.86
|
| Rate for Payer: Mclaren Commercial |
$2,374.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,242.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,846.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,321.44
|
|
|
PR ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 27331
|
| Min. Negotiated Rate |
$311.19 |
| Max. Negotiated Rate |
$1,200.50 |
| Rate for Payer: Aetna Commercial |
$631.49
|
| Rate for Payer: Aetna Medicare |
$471.26
|
| Rate for Payer: BCBS Complete |
$326.75
|
| Rate for Payer: BCBS MAPPO |
$471.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.32
|
| Rate for Payer: BCN Commercial |
$706.63
|
| Rate for Payer: BCN Medicare Advantage |
$471.26
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$631.49
|
| Rate for Payer: Cofinity Commercial |
$678.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.26
|
| Rate for Payer: Healthscope Commercial |
$565.51
|
| Rate for Payer: Healthscope Whirlpool |
$565.51
|
| Rate for Payer: Meridian Medicaid |
$326.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$494.82
|
| Rate for Payer: PACE SWMI |
$471.26
|
| Rate for Payer: PHP Medicare Advantage |
$471.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.40
|
| Rate for Payer: Priority Health Medicare |
$471.26
|
| Rate for Payer: Priority Health Narrow Network |
$738.40
|
| Rate for Payer: UHC Medicare Advantage |
$485.40
|
|
|
PR ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 28052
|
| Min. Negotiated Rate |
$165.08 |
| Max. Negotiated Rate |
$1,658.33 |
| Rate for Payer: Aetna Commercial |
$332.23
|
| Rate for Payer: Aetna Medicare |
$247.93
|
| Rate for Payer: BCBS Complete |
$173.33
|
| Rate for Payer: BCBS MAPPO |
$247.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.33
|
| Rate for Payer: BCN Commercial |
$563.94
|
| Rate for Payer: BCN Medicare Advantage |
$247.93
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$357.02
|
| Rate for Payer: Cofinity Commercial |
$332.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.93
|
| Rate for Payer: Healthscope Commercial |
$297.52
|
| Rate for Payer: Healthscope Whirlpool |
$297.52
|
| Rate for Payer: Meridian Medicaid |
$173.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$260.33
|
| Rate for Payer: PACE SWMI |
$247.93
|
| Rate for Payer: PHP Medicare Advantage |
$247.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.07
|
| Rate for Payer: Priority Health Medicare |
$247.93
|
| Rate for Payer: Priority Health Narrow Network |
$387.07
|
| Rate for Payer: UHC Medicare Advantage |
$255.37
|
|
|
PR ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH
|
Professional
|
Both
|
$2,126.00
|
|
|
Service Code
|
HCPCS 27612
|
| Min. Negotiated Rate |
$369.98 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$745.59
|
| Rate for Payer: Aetna Medicare |
$556.41
|
| Rate for Payer: BCBS Complete |
$388.48
|
| Rate for Payer: BCBS MAPPO |
$556.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$831.24
|
| Rate for Payer: BCN Medicare Advantage |
$556.41
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cash Price |
$1,700.80
|
| Rate for Payer: Cofinity Commercial |
$801.23
|
| Rate for Payer: Cofinity Commercial |
$745.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.41
|
| Rate for Payer: Healthscope Commercial |
$667.69
|
| Rate for Payer: Healthscope Whirlpool |
$667.69
|
| Rate for Payer: Meridian Medicaid |
$388.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.23
|
| Rate for Payer: PACE SWMI |
$556.41
|
| Rate for Payer: PHP Medicare Advantage |
$556.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,488.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$868.61
|
| Rate for Payer: Priority Health Medicare |
$556.41
|
| Rate for Payer: Priority Health Narrow Network |
$868.61
|
| Rate for Payer: UHC Medicare Advantage |
$573.10
|
|
|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,851.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,295.70 |
| Rate for Payer: Aetna Commercial |
$740.24
|
| Rate for Payer: Aetna Medicare |
$552.42
|
| Rate for Payer: BCBS Complete |
$381.55
|
| Rate for Payer: BCBS MAPPO |
$552.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.13
|
| Rate for Payer: BCN Commercial |
$826.36
|
| Rate for Payer: BCN Medicare Advantage |
$552.42
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Cash Price |
$1,480.80
|
| Rate for Payer: Cofinity Commercial |
$795.48
|
| Rate for Payer: Cofinity Commercial |
$740.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.42
|
| Rate for Payer: Healthscope Commercial |
$662.90
|
| Rate for Payer: Healthscope Whirlpool |
$662.90
|
| Rate for Payer: Meridian Medicaid |
$381.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$580.04
|
| Rate for Payer: PACE SWMI |
$552.42
|
| Rate for Payer: PHP Medicare Advantage |
$552.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$863.51
|
| Rate for Payer: Priority Health Medicare |
$552.42
|
| Rate for Payer: Priority Health Narrow Network |
$863.51
|
| Rate for Payer: UHC Medicare Advantage |
$568.99
|
|
|
PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 27332
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$1,639.40 |
| Rate for Payer: Aetna Commercial |
$853.93
|
| Rate for Payer: Aetna Medicare |
$637.26
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$637.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.22
|
| Rate for Payer: BCN Commercial |
$953.41
|
| Rate for Payer: BCN Medicare Advantage |
$637.26
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$853.93
|
| Rate for Payer: Cofinity Commercial |
$917.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.26
|
| Rate for Payer: Healthscope Commercial |
$764.71
|
| Rate for Payer: Healthscope Whirlpool |
$764.71
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.12
|
| Rate for Payer: PACE SWMI |
$637.26
|
| Rate for Payer: PHP Medicare Advantage |
$637.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,639.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$996.28
|
| Rate for Payer: Priority Health Medicare |
$637.26
|
| Rate for Payer: Priority Health Narrow Network |
$996.28
|
| Rate for Payer: UHC Medicare Advantage |
$656.38
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 28024
|
| Min. Negotiated Rate |
$199.16 |
| Max. Negotiated Rate |
$678.87 |
| Rate for Payer: Aetna Commercial |
$399.67
|
| Rate for Payer: Aetna Medicare |
$298.26
|
| Rate for Payer: BCBS Complete |
$209.12
|
| Rate for Payer: BCBS MAPPO |
$298.26
|
| Rate for Payer: BCBS Trust/PPO |
$678.87
|
| Rate for Payer: BCN Commercial |
$667.54
|
| Rate for Payer: BCN Medicare Advantage |
$298.26
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$399.67
|
| Rate for Payer: Cofinity Commercial |
$429.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.26
|
| Rate for Payer: Healthscope Commercial |
$357.91
|
| Rate for Payer: Healthscope Whirlpool |
$357.91
|
| Rate for Payer: Meridian Medicaid |
$209.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$313.17
|
| Rate for Payer: PACE SWMI |
$298.26
|
| Rate for Payer: PHP Medicare Advantage |
$298.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$503.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$466.74
|
| Rate for Payer: Priority Health Medicare |
$298.26
|
| Rate for Payer: Priority Health Narrow Network |
$466.74
|
| Rate for Payer: UHC Medicare Advantage |
$307.21
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 28022
|
| Min. Negotiated Rate |
$211.51 |
| Max. Negotiated Rate |
$708.10 |
| Rate for Payer: Aetna Commercial |
$427.15
|
| Rate for Payer: Aetna Medicare |
$318.77
|
| Rate for Payer: BCBS Complete |
$222.09
|
| Rate for Payer: BCBS MAPPO |
$318.77
|
| Rate for Payer: BCBS Trust/PPO |
$383.55
|
| Rate for Payer: BCN Commercial |
$708.10
|
| Rate for Payer: BCN Medicare Advantage |
$318.77
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cofinity Commercial |
$459.03
|
| Rate for Payer: Cofinity Commercial |
$427.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.77
|
| Rate for Payer: Healthscope Commercial |
$382.52
|
| Rate for Payer: Healthscope Whirlpool |
$382.52
|
| Rate for Payer: Meridian Medicaid |
$222.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.71
|
| Rate for Payer: PACE SWMI |
$318.77
|
| Rate for Payer: PHP Medicare Advantage |
$318.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.40
|
| Rate for Payer: Priority Health Medicare |
$318.77
|
| Rate for Payer: Priority Health Narrow Network |
$498.40
|
| Rate for Payer: UHC Medicare Advantage |
$328.33
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 28020
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$1,710.64 |
| Rate for Payer: Aetna Commercial |
$482.68
|
| Rate for Payer: Aetna Medicare |
$360.21
|
| Rate for Payer: BCBS Complete |
$247.80
|
| Rate for Payer: BCBS MAPPO |
$360.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,710.64
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$360.21
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$518.70
|
| Rate for Payer: Cofinity Commercial |
$482.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.21
|
| Rate for Payer: Healthscope Commercial |
$432.25
|
| Rate for Payer: Healthscope Whirlpool |
$432.25
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$378.22
|
| Rate for Payer: PACE SWMI |
$360.21
|
| Rate for Payer: PHP Medicare Advantage |
$360.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.75
|
| Rate for Payer: Priority Health Medicare |
$360.21
|
| Rate for Payer: Priority Health Narrow Network |
$563.75
|
| Rate for Payer: UHC Medicare Advantage |
$371.02
|
|
|
PR ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,350.00
|
|
|
Service Code
|
HCPCS 25101
|
| Min. Negotiated Rate |
$107.77 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Aetna Commercial |
$535.16
|
| Rate for Payer: Aetna Medicare |
$399.37
|
| Rate for Payer: BCBS Complete |
$279.56
|
| Rate for Payer: BCBS MAPPO |
$399.37
|
| Rate for Payer: BCBS Trust/PPO |
$107.77
|
| Rate for Payer: BCN Commercial |
$601.07
|
| Rate for Payer: BCN Medicare Advantage |
$399.37
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$535.16
|
| Rate for Payer: Cofinity Commercial |
$575.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.37
|
| Rate for Payer: Healthscope Commercial |
$479.24
|
| Rate for Payer: Healthscope Whirlpool |
$479.24
|
| Rate for Payer: Meridian Medicaid |
$279.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$419.34
|
| Rate for Payer: PACE SWMI |
$399.37
|
| Rate for Payer: PHP Medicare Advantage |
$399.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.10
|
| Rate for Payer: Priority Health Medicare |
$399.37
|
| Rate for Payer: Priority Health Narrow Network |
$628.10
|
| Rate for Payer: UHC Medicare Advantage |
$411.35
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,726.00
|
|
|
Service Code
|
HCPCS 27335
|
| Hospital Charge Code |
27335
|
| Min. Negotiated Rate |
$496.29 |
| Max. Negotiated Rate |
$1,908.20 |
| Rate for Payer: Aetna Commercial |
$1,012.72
|
| Rate for Payer: Aetna Medicare |
$755.76
|
| Rate for Payer: BCBS Complete |
$521.10
|
| Rate for Payer: BCBS MAPPO |
$755.76
|
| Rate for Payer: BCBS Trust/PPO |
$901.28
|
| Rate for Payer: BCN Commercial |
$1,127.38
|
| Rate for Payer: BCN Medicare Advantage |
$755.76
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cofinity Commercial |
$1,012.72
|
| Rate for Payer: Cofinity Commercial |
$1,088.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.76
|
| Rate for Payer: Healthscope Commercial |
$906.91
|
| Rate for Payer: Healthscope Whirlpool |
$906.91
|
| Rate for Payer: Meridian Medicaid |
$521.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$793.55
|
| Rate for Payer: PACE SWMI |
$755.76
|
| Rate for Payer: PHP Medicare Advantage |
$755.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.07
|
| Rate for Payer: Priority Health Medicare |
$755.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,178.07
|
| Rate for Payer: UHC Medicare Advantage |
$778.43
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,726.00
|
|
|
Service Code
|
HCPCS 27335
|
| Min. Negotiated Rate |
$496.29 |
| Max. Negotiated Rate |
$1,908.20 |
| Rate for Payer: Aetna Commercial |
$1,012.72
|
| Rate for Payer: Aetna Medicare |
$755.76
|
| Rate for Payer: BCBS Complete |
$521.10
|
| Rate for Payer: BCBS MAPPO |
$755.76
|
| Rate for Payer: BCBS Trust/PPO |
$901.28
|
| Rate for Payer: BCN Commercial |
$1,127.38
|
| Rate for Payer: BCN Medicare Advantage |
$755.76
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cofinity Commercial |
$1,088.29
|
| Rate for Payer: Cofinity Commercial |
$1,012.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.76
|
| Rate for Payer: Healthscope Commercial |
$906.91
|
| Rate for Payer: Healthscope Whirlpool |
$906.91
|
| Rate for Payer: Meridian Medicaid |
$521.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$793.55
|
| Rate for Payer: PACE SWMI |
$755.76
|
| Rate for Payer: PHP Medicare Advantage |
$755.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,178.07
|
| Rate for Payer: Priority Health Medicare |
$755.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,178.07
|
| Rate for Payer: UHC Medicare Advantage |
$778.43
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Facility
|
IP
|
$2,726.00
|
|
|
Service Code
|
CPT 27335
|
| Hospital Charge Code |
27335
|
| Min. Negotiated Rate |
$1,908.20 |
| Max. Negotiated Rate |
$2,726.00 |
| Rate for Payer: Aetna Commercial |
$2,453.40
|
| Rate for Payer: ASR ASR |
$2,644.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,113.47
|
| Rate for Payer: BCN Commercial |
$2,113.47
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cofinity Commercial |
$2,562.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,180.80
|
| Rate for Payer: Healthscope Commercial |
$2,726.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,644.22
|
| Rate for Payer: Mclaren Commercial |
$2,453.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,317.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,398.88
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Facility
|
OP
|
$2,726.00
|
|
|
Service Code
|
CPT 27335
|
| Hospital Charge Code |
27335
|
| Min. Negotiated Rate |
$1,908.20 |
| Max. Negotiated Rate |
$7,948.86 |
| Rate for Payer: Aetna Commercial |
$2,453.40
|
| Rate for Payer: Aetna Medicare |
$6,359.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: ASR ASR |
$2,644.22
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,113.47
|
| Rate for Payer: BCN Commercial |
$2,113.47
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cash Price |
$2,180.80
|
| Rate for Payer: Cofinity Commercial |
$2,562.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,180.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$2,726.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,644.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$6,359.09
|
| Rate for Payer: Mclaren Commercial |
$2,453.40
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,317.10
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$6,995.00
|
| Rate for Payer: PHP Medicaid |
$3,478.42
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,480.66
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,935.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,398.88
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: VA VA |
$6,359.09
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-CERVICAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 58321
|
| Min. Negotiated Rate |
$48.49 |
| Max. Negotiated Rate |
$121.19 |
| Rate for Payer: Aetna Commercial |
$64.98
|
| Rate for Payer: Aetna Medicare |
$48.49
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS MAPPO |
$48.49
|
| Rate for Payer: BCBS Trust/PPO |
$80.30
|
| Rate for Payer: BCN Commercial |
$121.19
|
| Rate for Payer: BCN Medicare Advantage |
$48.49
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$64.98
|
| Rate for Payer: Cofinity Commercial |
$69.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.49
|
| Rate for Payer: Healthscope Commercial |
$58.19
|
| Rate for Payer: Healthscope Whirlpool |
$58.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.91
|
| Rate for Payer: PACE SWMI |
$48.49
|
| Rate for Payer: PHP Medicare Advantage |
$48.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.65
|
| Rate for Payer: Priority Health Medicare |
$48.49
|
| Rate for Payer: Priority Health Narrow Network |
$68.65
|
| Rate for Payer: UHC Medicare Advantage |
$49.94
|
|
