|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$262.50 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$337.50
|
| Rate for Payer: ASR ASR |
$363.75
|
| Rate for Payer: BCBS Trust/PPO |
$290.74
|
| Rate for Payer: BCN Commercial |
$290.74
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$352.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$375.00
|
| Rate for Payer: Healthscope Whirlpool |
$363.75
|
| Rate for Payer: Mclaren Commercial |
$337.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.00
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 46900
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.28
|
| Rate for Payer: Aetna Medicare |
$133.79
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$133.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$133.79
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$179.28
|
| Rate for Payer: Cofinity Commercial |
$192.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.79
|
| Rate for Payer: Healthscope Commercial |
$160.55
|
| Rate for Payer: Healthscope Whirlpool |
$160.55
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.48
|
| Rate for Payer: PACE SWMI |
$133.79
|
| Rate for Payer: PHP Medicare Advantage |
$133.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.07
|
| Rate for Payer: Priority Health Medicare |
$133.79
|
| Rate for Payer: Priority Health Narrow Network |
$241.07
|
| Rate for Payer: UHC Medicare Advantage |
$137.80
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$193.87 |
| Max. Negotiated Rate |
$443.04 |
| Rate for Payer: Aetna Commercial |
$337.50
|
| Rate for Payer: Aetna Medicare |
$354.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: ASR ASR |
$363.75
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$290.74
|
| Rate for Payer: BCN Commercial |
$290.74
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$352.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$375.00
|
| Rate for Payer: Healthscope Whirlpool |
$363.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$354.43
|
| Rate for Payer: Mclaren Commercial |
$337.50
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$389.87
|
| Rate for Payer: PHP Medicaid |
$193.87
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.25
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$266.25
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.00
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: VA VA |
$354.43
|
|
|
PR DSTRJ LESION ANUS SIMPLE CHEMICAL
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 46900
|
| Hospital Charge Code |
46900
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$179.28
|
| Rate for Payer: Aetna Medicare |
$133.79
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$133.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$133.79
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$179.28
|
| Rate for Payer: Cofinity Commercial |
$192.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.79
|
| Rate for Payer: Healthscope Commercial |
$160.55
|
| Rate for Payer: Healthscope Whirlpool |
$160.55
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.48
|
| Rate for Payer: PACE SWMI |
$133.79
|
| Rate for Payer: PHP Medicare Advantage |
$133.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.07
|
| Rate for Payer: Priority Health Medicare |
$133.79
|
| Rate for Payer: Priority Health Narrow Network |
$241.07
|
| Rate for Payer: UHC Medicare Advantage |
$137.80
|
|
|
PR DSTRJ LESION ANUS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 46916
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$1,647.77 |
| Rate for Payer: Aetna Commercial |
$183.79
|
| Rate for Payer: Aetna Medicare |
$137.16
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$137.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: BCN Medicare Advantage |
$137.16
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$183.79
|
| Rate for Payer: Cofinity Commercial |
$197.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.16
|
| Rate for Payer: Healthscope Commercial |
$164.59
|
| Rate for Payer: Healthscope Whirlpool |
$164.59
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.02
|
| Rate for Payer: PACE SWMI |
$137.16
|
| Rate for Payer: PHP Medicare Advantage |
$137.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.12
|
| Rate for Payer: Priority Health Medicare |
$137.16
|
| Rate for Payer: Priority Health Narrow Network |
$248.12
|
| Rate for Payer: UHC Medicare Advantage |
$141.27
|
|
|
PR DSTRJ LESION ANUS SIMPLE LASER SURG
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 46917
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$1,832.14 |
| Rate for Payer: Aetna Commercial |
$169.16
|
| Rate for Payer: Aetna Medicare |
$126.24
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS MAPPO |
$126.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.14
|
| Rate for Payer: BCN Commercial |
$659.72
|
| Rate for Payer: BCN Medicare Advantage |
$126.24
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$169.16
|
| Rate for Payer: Cofinity Commercial |
$181.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.24
|
| Rate for Payer: Healthscope Commercial |
$151.49
|
| Rate for Payer: Healthscope Whirlpool |
$151.49
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.55
|
| Rate for Payer: PACE SWMI |
$126.24
|
| Rate for Payer: PHP Medicare Advantage |
$126.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.38
|
| Rate for Payer: Priority Health Medicare |
$126.24
|
| Rate for Payer: Priority Health Narrow Network |
$226.38
|
| Rate for Payer: UHC Medicare Advantage |
$130.03
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 46922
|
| Hospital Charge Code |
46922
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$181.19
|
| Rate for Payer: Aetna Medicare |
$135.22
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$135.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$135.22
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cofinity Commercial |
$181.19
|
| Rate for Payer: Cofinity Commercial |
$194.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.22
|
| Rate for Payer: Healthscope Commercial |
$162.26
|
| Rate for Payer: Healthscope Whirlpool |
$162.26
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.98
|
| Rate for Payer: PACE SWMI |
$135.22
|
| Rate for Payer: PHP Medicare Advantage |
$135.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.83
|
| Rate for Payer: Priority Health Medicare |
$135.22
|
| Rate for Payer: Priority Health Narrow Network |
$242.83
|
| Rate for Payer: UHC Medicare Advantage |
$139.28
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
OP
|
$461.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$322.70 |
| Max. Negotiated Rate |
$3,119.72 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$447.17
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$357.41
|
| Rate for Payer: BCN Commercial |
$357.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$433.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$461.00
|
| Rate for Payer: Healthscope Whirlpool |
$447.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$414.90
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$391.85
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.51
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$327.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Facility
|
IP
|
$461.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
46922
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$322.70 |
| Max. Negotiated Rate |
$461.00 |
| Rate for Payer: Aetna Commercial |
$414.90
|
| Rate for Payer: ASR ASR |
$447.17
|
| Rate for Payer: BCBS Trust/PPO |
$357.41
|
| Rate for Payer: BCN Commercial |
$357.41
|
| Rate for Payer: Cash Price |
$368.80
|
| Rate for Payer: Cofinity Commercial |
$433.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.80
|
| Rate for Payer: Healthscope Commercial |
$461.00
|
| Rate for Payer: Healthscope Whirlpool |
$447.17
|
| Rate for Payer: Mclaren Commercial |
$414.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$391.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.68
|
|
|
PR DSTRJ LESION ANUS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$507.00
|
|
|
Service Code
|
HCPCS 46922
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$1,491.39 |
| Rate for Payer: Aetna Commercial |
$181.19
|
| Rate for Payer: Aetna Medicare |
$135.22
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$135.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,491.39
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: BCN Medicare Advantage |
$135.22
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cash Price |
$405.60
|
| Rate for Payer: Cofinity Commercial |
$181.19
|
| Rate for Payer: Cofinity Commercial |
$194.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.22
|
| Rate for Payer: Healthscope Commercial |
$162.26
|
| Rate for Payer: Healthscope Whirlpool |
$162.26
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.98
|
| Rate for Payer: PACE SWMI |
$135.22
|
| Rate for Payer: PHP Medicare Advantage |
$135.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.83
|
| Rate for Payer: Priority Health Medicare |
$135.22
|
| Rate for Payer: Priority Health Narrow Network |
$242.83
|
| Rate for Payer: UHC Medicare Advantage |
$139.28
|
|
|
PR DSTRJ LESION ANUS SMPL ELTRDSICCATION
|
Professional
|
Both
|
$407.00
|
|
|
Service Code
|
HCPCS 46910
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$2,583.92 |
| Rate for Payer: Aetna Commercial |
$176.26
|
| Rate for Payer: Aetna Medicare |
$131.54
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$131.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,583.92
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: BCN Medicare Advantage |
$131.54
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cash Price |
$325.60
|
| Rate for Payer: Cofinity Commercial |
$189.42
|
| Rate for Payer: Cofinity Commercial |
$176.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.54
|
| Rate for Payer: Healthscope Commercial |
$157.85
|
| Rate for Payer: Healthscope Whirlpool |
$157.85
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.12
|
| Rate for Payer: PACE SWMI |
$131.54
|
| Rate for Payer: PHP Medicare Advantage |
$131.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.37
|
| Rate for Payer: Priority Health Medicare |
$131.54
|
| Rate for Payer: Priority Health Narrow Network |
$236.37
|
| Rate for Payer: UHC Medicare Advantage |
$135.49
|
|
|
PR DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 42160
|
| Min. Negotiated Rate |
$90.53 |
| Max. Negotiated Rate |
$342.56 |
| Rate for Payer: Aetna Commercial |
$187.22
|
| Rate for Payer: Aetna Medicare |
$139.72
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$139.72
|
| Rate for Payer: BCBS Trust/PPO |
$264.46
|
| Rate for Payer: BCN Commercial |
$342.56
|
| Rate for Payer: BCN Medicare Advantage |
$139.72
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$201.20
|
| Rate for Payer: Cofinity Commercial |
$187.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.72
|
| Rate for Payer: Healthscope Commercial |
$167.66
|
| Rate for Payer: Healthscope Whirlpool |
$167.66
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.71
|
| Rate for Payer: PACE SWMI |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$139.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.82
|
| Rate for Payer: Priority Health Medicare |
$139.72
|
| Rate for Payer: Priority Health Narrow Network |
$252.82
|
| Rate for Payer: UHC Medicare Advantage |
$143.91
|
|
|
PR DSTRJ LESION PENIS EXTENSIVE
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 54065
|
| Min. Negotiated Rate |
$110.12 |
| Max. Negotiated Rate |
$1,527.84 |
| Rate for Payer: Aetna Commercial |
$222.91
|
| Rate for Payer: Aetna Medicare |
$166.35
|
| Rate for Payer: BCBS Complete |
$115.63
|
| Rate for Payer: BCBS MAPPO |
$166.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.84
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$166.35
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$222.91
|
| Rate for Payer: Cofinity Commercial |
$239.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.35
|
| Rate for Payer: Healthscope Commercial |
$199.62
|
| Rate for Payer: Healthscope Whirlpool |
$199.62
|
| Rate for Payer: Meridian Medicaid |
$115.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.67
|
| Rate for Payer: PACE SWMI |
$166.35
|
| Rate for Payer: PHP Medicare Advantage |
$166.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.57
|
| Rate for Payer: Priority Health Medicare |
$166.35
|
| Rate for Payer: Priority Health Narrow Network |
$275.57
|
| Rate for Payer: UHC Medicare Advantage |
$171.34
|
|
|
PR DSTRJ LESION PENIS SIMPLE CHEMICAL
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 54050
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$1,664.67 |
| Rate for Payer: Aetna Commercial |
$138.45
|
| Rate for Payer: Aetna Medicare |
$103.32
|
| Rate for Payer: BCBS Complete |
$72.24
|
| Rate for Payer: BCBS MAPPO |
$103.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.67
|
| Rate for Payer: BCN Commercial |
$211.11
|
| Rate for Payer: BCN Medicare Advantage |
$103.32
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$148.78
|
| Rate for Payer: Cofinity Commercial |
$138.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.32
|
| Rate for Payer: Healthscope Commercial |
$123.98
|
| Rate for Payer: Healthscope Whirlpool |
$123.98
|
| Rate for Payer: Meridian Medicaid |
$72.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.49
|
| Rate for Payer: PACE SWMI |
$103.32
|
| Rate for Payer: PHP Medicare Advantage |
$103.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.37
|
| Rate for Payer: Priority Health Medicare |
$103.32
|
| Rate for Payer: Priority Health Narrow Network |
$172.37
|
| Rate for Payer: UHC Medicare Advantage |
$106.42
|
|
|
PR DSTRJ LESION PENIS SIMPLE CRYOSURGERY
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 54056
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$1,380.45 |
| Rate for Payer: Aetna Commercial |
$143.61
|
| Rate for Payer: Aetna Medicare |
$107.17
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS MAPPO |
$107.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.45
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$107.17
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$154.32
|
| Rate for Payer: Cofinity Commercial |
$143.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.17
|
| Rate for Payer: Healthscope Commercial |
$128.60
|
| Rate for Payer: Healthscope Whirlpool |
$128.60
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.53
|
| Rate for Payer: PACE SWMI |
$107.17
|
| Rate for Payer: PHP Medicare Advantage |
$107.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.41
|
| Rate for Payer: Priority Health Medicare |
$107.17
|
| Rate for Payer: Priority Health Narrow Network |
$179.41
|
| Rate for Payer: UHC Medicare Advantage |
$110.39
|
|
|
PR DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 54055
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$1,009.58 |
| Rate for Payer: Aetna Commercial |
$124.63
|
| Rate for Payer: Aetna Medicare |
$93.01
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$93.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.58
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: BCN Medicare Advantage |
$93.01
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$133.93
|
| Rate for Payer: Cofinity Commercial |
$124.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.01
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Healthscope Whirlpool |
$111.61
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.66
|
| Rate for Payer: PACE SWMI |
$93.01
|
| Rate for Payer: PHP Medicare Advantage |
$93.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.55
|
| Rate for Payer: Priority Health Medicare |
$93.01
|
| Rate for Payer: Priority Health Narrow Network |
$154.55
|
| Rate for Payer: UHC Medicare Advantage |
$95.80
|
|
|
PR DSTRJ LESION PENIS SIMPLE LASER
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 54057
|
| Min. Negotiated Rate |
$63.05 |
| Max. Negotiated Rate |
$2,378.41 |
| Rate for Payer: Aetna Commercial |
$127.29
|
| Rate for Payer: Aetna Medicare |
$94.99
|
| Rate for Payer: BCBS Complete |
$66.20
|
| Rate for Payer: BCBS MAPPO |
$94.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,378.41
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$94.99
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$136.79
|
| Rate for Payer: Cofinity Commercial |
$127.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.99
|
| Rate for Payer: Healthscope Commercial |
$113.99
|
| Rate for Payer: Healthscope Whirlpool |
$113.99
|
| Rate for Payer: Meridian Medicaid |
$66.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.74
|
| Rate for Payer: PACE SWMI |
$94.99
|
| Rate for Payer: PHP Medicare Advantage |
$94.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.78
|
| Rate for Payer: Priority Health Medicare |
$94.99
|
| Rate for Payer: Priority Health Narrow Network |
$157.78
|
| Rate for Payer: UHC Medicare Advantage |
$97.84
|
|
|
PR DSTRJ LESION PENIS SIMPLE SURG EXCISION
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 54060
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$1,575.39 |
| Rate for Payer: Aetna Commercial |
$170.65
|
| Rate for Payer: Aetna Medicare |
$127.35
|
| Rate for Payer: BCBS Complete |
$88.79
|
| Rate for Payer: BCBS MAPPO |
$127.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.39
|
| Rate for Payer: BCN Commercial |
$284.41
|
| Rate for Payer: BCN Medicare Advantage |
$127.35
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$183.38
|
| Rate for Payer: Cofinity Commercial |
$170.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.35
|
| Rate for Payer: Healthscope Commercial |
$152.82
|
| Rate for Payer: Healthscope Whirlpool |
$152.82
|
| Rate for Payer: Meridian Medicaid |
$88.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$133.72
|
| Rate for Payer: PACE SWMI |
$127.35
|
| Rate for Payer: PHP Medicare Advantage |
$127.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.20
|
| Rate for Payer: Priority Health Medicare |
$127.35
|
| Rate for Payer: Priority Health Narrow Network |
$210.20
|
| Rate for Payer: UHC Medicare Advantage |
$131.17
|
|
|
PR DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS
|
Professional
|
Both
|
$460.00
|
|
|
Service Code
|
HCPCS 40820
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$963.62 |
| Rate for Payer: Aetna Commercial |
$212.47
|
| Rate for Payer: Aetna Medicare |
$158.56
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$158.56
|
| Rate for Payer: BCBS Trust/PPO |
$963.62
|
| Rate for Payer: BCN Commercial |
$380.68
|
| Rate for Payer: BCN Medicare Advantage |
$158.56
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cofinity Commercial |
$212.47
|
| Rate for Payer: Cofinity Commercial |
$228.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.56
|
| Rate for Payer: Healthscope Commercial |
$190.27
|
| Rate for Payer: Healthscope Whirlpool |
$190.27
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$166.49
|
| Rate for Payer: PACE SWMI |
$158.56
|
| Rate for Payer: PHP Medicare Advantage |
$158.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$322.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.81
|
| Rate for Payer: Priority Health Medicare |
$158.56
|
| Rate for Payer: Priority Health Narrow Network |
$292.81
|
| Rate for Payer: UHC Medicare Advantage |
$163.32
|
|
|
PR DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM
|
Professional
|
Both
|
$557.00
|
|
|
Service Code
|
HCPCS 17276
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$263.55
|
| Rate for Payer: Aetna Medicare |
$196.68
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$196.68
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$334.54
|
| Rate for Payer: BCN Medicare Advantage |
$196.68
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cofinity Commercial |
$283.22
|
| Rate for Payer: Cofinity Commercial |
$263.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.68
|
| Rate for Payer: Healthscope Commercial |
$236.02
|
| Rate for Payer: Healthscope Whirlpool |
$236.02
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.51
|
| Rate for Payer: PACE SWMI |
$196.68
|
| Rate for Payer: PHP Medicare Advantage |
$196.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.21
|
| Rate for Payer: Priority Health Medicare |
$196.68
|
| Rate for Payer: Priority Health Narrow Network |
$246.21
|
| Rate for Payer: UHC Medicare Advantage |
$202.58
|
|
|
PR DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 64610
|
| Min. Negotiated Rate |
$309.49 |
| Max. Negotiated Rate |
$1,151.81 |
| Rate for Payer: Aetna Commercial |
$646.08
|
| Rate for Payer: Aetna Medicare |
$482.15
|
| Rate for Payer: BCBS Complete |
$324.96
|
| Rate for Payer: BCBS MAPPO |
$482.15
|
| Rate for Payer: BCBS Trust/PPO |
$309.58
|
| Rate for Payer: BCN Commercial |
$1,151.81
|
| Rate for Payer: BCN Medicare Advantage |
$482.15
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$694.30
|
| Rate for Payer: Cofinity Commercial |
$646.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.15
|
| Rate for Payer: Healthscope Commercial |
$578.58
|
| Rate for Payer: Healthscope Whirlpool |
$578.58
|
| Rate for Payer: Meridian Medicaid |
$324.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$506.26
|
| Rate for Payer: PACE SWMI |
$482.15
|
| Rate for Payer: PHP Medicare Advantage |
$482.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.90
|
| Rate for Payer: Priority Health Medicare |
$482.15
|
| Rate for Payer: Priority Health Narrow Network |
$819.90
|
| Rate for Payer: UHC Medicare Advantage |
$496.61
|
|
|
PR DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE
|
Professional
|
Both
|
$757.00
|
|
|
Service Code
|
HCPCS 64620
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$1,271.09 |
| Rate for Payer: Aetna Commercial |
$231.82
|
| Rate for Payer: Aetna Medicare |
$173.00
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$173.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.09
|
| Rate for Payer: BCN Commercial |
$304.45
|
| Rate for Payer: BCN Medicare Advantage |
$173.00
|
| Rate for Payer: Cash Price |
$605.60
|
| Rate for Payer: Cash Price |
$605.60
|
| Rate for Payer: Cofinity Commercial |
$249.12
|
| Rate for Payer: Cofinity Commercial |
$231.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.00
|
| Rate for Payer: Healthscope Commercial |
$207.60
|
| Rate for Payer: Healthscope Whirlpool |
$207.60
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$181.65
|
| Rate for Payer: PACE SWMI |
$173.00
|
| Rate for Payer: PHP Medicare Advantage |
$173.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$297.84
|
| Rate for Payer: Priority Health Medicare |
$173.00
|
| Rate for Payer: Priority Health Narrow Network |
$297.84
|
| Rate for Payer: UHC Medicare Advantage |
$178.19
|
|
|
PR DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
64640
|
| Min. Negotiated Rate |
$417.20 |
| Max. Negotiated Rate |
$1,012.74 |
| Rate for Payer: Aetna Commercial |
$536.40
|
| Rate for Payer: Aetna Medicare |
$810.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: ASR ASR |
$578.12
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$462.08
|
| Rate for Payer: BCN Commercial |
$462.08
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$560.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$596.00
|
| Rate for Payer: Healthscope Whirlpool |
$578.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$810.19
|
| Rate for Payer: Mclaren Commercial |
$536.40
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$506.60
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$891.21
|
| Rate for Payer: PHP Medicaid |
$443.17
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.36
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$423.16
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.48
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: VA VA |
$810.19
|
|
|
PR DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
64640
|
| Min. Negotiated Rate |
$417.20 |
| Max. Negotiated Rate |
$596.00 |
| Rate for Payer: Aetna Commercial |
$536.40
|
| Rate for Payer: ASR ASR |
$578.12
|
| Rate for Payer: BCBS Trust/PPO |
$462.08
|
| Rate for Payer: BCN Commercial |
$462.08
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$560.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Healthscope Commercial |
$596.00
|
| Rate for Payer: Healthscope Whirlpool |
$578.12
|
| Rate for Payer: Mclaren Commercial |
$536.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$506.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.48
|
|
|
PR DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 64640
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$720.07 |
| Rate for Payer: Aetna Commercial |
$154.21
|
| Rate for Payer: Aetna Medicare |
$115.08
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$115.08
|
| Rate for Payer: BCBS Trust/PPO |
$720.07
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Medicare Advantage |
$115.08
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$165.72
|
| Rate for Payer: Cofinity Commercial |
$154.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.08
|
| Rate for Payer: Healthscope Commercial |
$138.10
|
| Rate for Payer: Healthscope Whirlpool |
$138.10
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.83
|
| Rate for Payer: PACE SWMI |
$115.08
|
| Rate for Payer: PHP Medicare Advantage |
$115.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.19
|
| Rate for Payer: Priority Health Medicare |
$115.08
|
| Rate for Payer: Priority Health Narrow Network |
$198.19
|
| Rate for Payer: UHC Medicare Advantage |
$118.53
|
|
