|
PR EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT
|
Professional
|
Both
|
$2,170.00
|
|
|
Service Code
|
HCPCS 27638
|
| Min. Negotiated Rate |
$479.04 |
| Max. Negotiated Rate |
$1,612.37 |
| Rate for Payer: Aetna Commercial |
$987.04
|
| Rate for Payer: Aetna Medicare |
$736.60
|
| Rate for Payer: BCBS Complete |
$502.99
|
| Rate for Payer: BCBS MAPPO |
$736.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$1,097.08
|
| Rate for Payer: BCN Medicare Advantage |
$736.60
|
| Rate for Payer: Cash Price |
$1,736.00
|
| Rate for Payer: Cash Price |
$1,736.00
|
| Rate for Payer: Cofinity Commercial |
$1,060.70
|
| Rate for Payer: Cofinity Commercial |
$987.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.60
|
| Rate for Payer: Healthscope Commercial |
$883.92
|
| Rate for Payer: Healthscope Whirlpool |
$883.92
|
| Rate for Payer: Meridian Medicaid |
$502.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$773.43
|
| Rate for Payer: PACE SWMI |
$736.60
|
| Rate for Payer: PHP Medicare Advantage |
$736.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,519.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.41
|
| Rate for Payer: Priority Health Medicare |
$736.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.41
|
| Rate for Payer: UHC Medicare Advantage |
$758.70
|
|
|
PR EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 28104
|
| Min. Negotiated Rate |
$228.98 |
| Max. Negotiated Rate |
$1,143.77 |
| Rate for Payer: Aetna Commercial |
$461.70
|
| Rate for Payer: Aetna Medicare |
$344.55
|
| Rate for Payer: BCBS Complete |
$240.43
|
| Rate for Payer: BCBS MAPPO |
$344.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,143.77
|
| Rate for Payer: BCN Commercial |
$761.85
|
| Rate for Payer: BCN Medicare Advantage |
$344.55
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$496.15
|
| Rate for Payer: Cofinity Commercial |
$461.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.55
|
| Rate for Payer: Healthscope Commercial |
$413.46
|
| Rate for Payer: Healthscope Whirlpool |
$413.46
|
| Rate for Payer: Meridian Medicaid |
$240.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$361.78
|
| Rate for Payer: PACE SWMI |
$344.55
|
| Rate for Payer: PHP Medicare Advantage |
$344.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.22
|
| Rate for Payer: Priority Health Medicare |
$344.55
|
| Rate for Payer: Priority Health Narrow Network |
$538.22
|
| Rate for Payer: UHC Medicare Advantage |
$354.89
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 24116
|
| Min. Negotiated Rate |
$82.41 |
| Max. Negotiated Rate |
$1,321.56 |
| Rate for Payer: Aetna Commercial |
$1,138.45
|
| Rate for Payer: Aetna Medicare |
$849.59
|
| Rate for Payer: BCBS Complete |
$583.51
|
| Rate for Payer: BCBS MAPPO |
$849.59
|
| Rate for Payer: BCBS Trust/PPO |
$82.41
|
| Rate for Payer: BCN Commercial |
$1,264.70
|
| Rate for Payer: BCN Medicare Advantage |
$849.59
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,138.45
|
| Rate for Payer: Cofinity Commercial |
$1,223.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$849.59
|
| Rate for Payer: Healthscope Commercial |
$1,019.51
|
| Rate for Payer: Healthscope Whirlpool |
$1,019.51
|
| Rate for Payer: Meridian Medicaid |
$583.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$892.07
|
| Rate for Payer: PACE SWMI |
$849.59
|
| Rate for Payer: PHP Medicare Advantage |
$849.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,321.56
|
| Rate for Payer: Priority Health Medicare |
$849.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,321.56
|
| Rate for Payer: UHC Medicare Advantage |
$875.08
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA
|
Professional
|
Both
|
$923.00
|
|
|
Service Code
|
HCPCS 23140
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$858.91 |
| Rate for Payer: Aetna Commercial |
$735.37
|
| Rate for Payer: Aetna Medicare |
$548.78
|
| Rate for Payer: BCBS Complete |
$380.20
|
| Rate for Payer: BCBS MAPPO |
$548.78
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$821.96
|
| Rate for Payer: BCN Medicare Advantage |
$548.78
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cash Price |
$738.40
|
| Rate for Payer: Cofinity Commercial |
$790.24
|
| Rate for Payer: Cofinity Commercial |
$735.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.78
|
| Rate for Payer: Healthscope Commercial |
$658.54
|
| Rate for Payer: Healthscope Whirlpool |
$658.54
|
| Rate for Payer: Meridian Medicaid |
$380.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$576.22
|
| Rate for Payer: PACE SWMI |
$548.78
|
| Rate for Payer: PHP Medicare Advantage |
$548.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$858.91
|
| Rate for Payer: Priority Health Medicare |
$548.78
|
| Rate for Payer: Priority Health Narrow Network |
$858.91
|
| Rate for Payer: UHC Medicare Advantage |
$565.24
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 24120
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$859.60 |
| Rate for Payer: Aetna Commercial |
$704.97
|
| Rate for Payer: Aetna Medicare |
$526.10
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$526.10
|
| Rate for Payer: BCBS Trust/PPO |
$114.64
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$526.10
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$757.58
|
| Rate for Payer: Cofinity Commercial |
$704.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.10
|
| Rate for Payer: Healthscope Commercial |
$631.32
|
| Rate for Payer: Healthscope Whirlpool |
$631.32
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.40
|
| Rate for Payer: PACE SWMI |
$526.10
|
| Rate for Payer: PHP Medicare Advantage |
$526.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.19
|
| Rate for Payer: Priority Health Medicare |
$526.10
|
| Rate for Payer: Priority Health Narrow Network |
$824.19
|
| Rate for Payer: UHC Medicare Advantage |
$541.88
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Facility
|
IP
|
$1,228.00
|
|
|
Service Code
|
CPT 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$859.60 |
| Max. Negotiated Rate |
$1,228.00 |
| Rate for Payer: Aetna Commercial |
$1,105.20
|
| Rate for Payer: ASR ASR |
$1,191.16
|
| Rate for Payer: BCBS Trust/PPO |
$952.07
|
| Rate for Payer: BCN Commercial |
$952.07
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.40
|
| Rate for Payer: Healthscope Commercial |
$1,228.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,191.16
|
| Rate for Payer: Mclaren Commercial |
$1,105.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,043.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,080.64
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Professional
|
Both
|
$1,228.00
|
|
|
Service Code
|
HCPCS 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$859.60 |
| Rate for Payer: Aetna Commercial |
$704.97
|
| Rate for Payer: Aetna Medicare |
$526.10
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$526.10
|
| Rate for Payer: BCBS Trust/PPO |
$114.64
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$526.10
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$757.58
|
| Rate for Payer: Cofinity Commercial |
$704.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.10
|
| Rate for Payer: Healthscope Commercial |
$631.32
|
| Rate for Payer: Healthscope Whirlpool |
$631.32
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.40
|
| Rate for Payer: PACE SWMI |
$526.10
|
| Rate for Payer: PHP Medicare Advantage |
$526.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.19
|
| Rate for Payer: Priority Health Medicare |
$526.10
|
| Rate for Payer: Priority Health Narrow Network |
$824.19
|
| Rate for Payer: UHC Medicare Advantage |
$541.88
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN
|
Facility
|
OP
|
$1,228.00
|
|
|
Service Code
|
CPT 24120
|
| Hospital Charge Code |
24120
|
| Min. Negotiated Rate |
$859.60 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$1,105.20
|
| 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 |
$1,191.16
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$952.07
|
| Rate for Payer: BCN Commercial |
$952.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cash Price |
$982.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,228.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,191.16
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$1,105.20
|
| 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 |
$1,043.80
|
| 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 |
$859.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.48
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$871.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,080.64
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 23155
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$1,228.63 |
| Rate for Payer: Aetna Commercial |
$1,055.60
|
| Rate for Payer: Aetna Medicare |
$787.76
|
| Rate for Payer: BCBS Complete |
$542.36
|
| Rate for Payer: BCBS MAPPO |
$787.76
|
| Rate for Payer: BCBS Trust/PPO |
$59.01
|
| Rate for Payer: BCN Commercial |
$1,175.76
|
| Rate for Payer: BCN Medicare Advantage |
$787.76
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$1,134.37
|
| Rate for Payer: Cofinity Commercial |
$1,055.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.76
|
| Rate for Payer: Healthscope Commercial |
$945.31
|
| Rate for Payer: Healthscope Whirlpool |
$945.31
|
| Rate for Payer: Meridian Medicaid |
$542.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$827.15
|
| Rate for Payer: PACE SWMI |
$787.76
|
| Rate for Payer: PHP Medicare Advantage |
$787.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.63
|
| Rate for Payer: Priority Health Medicare |
$787.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,228.63
|
| Rate for Payer: UHC Medicare Advantage |
$811.39
|
|
|
PR EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 23156
|
| Min. Negotiated Rate |
$32.26 |
| Max. Negotiated Rate |
$1,047.86 |
| Rate for Payer: Aetna Commercial |
$899.46
|
| Rate for Payer: Aetna Medicare |
$671.24
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCBS MAPPO |
$671.24
|
| Rate for Payer: BCBS Trust/PPO |
$32.26
|
| Rate for Payer: BCN Commercial |
$1,002.76
|
| Rate for Payer: BCN Medicare Advantage |
$671.24
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$899.46
|
| Rate for Payer: Cofinity Commercial |
$966.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.24
|
| Rate for Payer: Healthscope Commercial |
$805.49
|
| Rate for Payer: Healthscope Whirlpool |
$805.49
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$704.80
|
| Rate for Payer: PACE SWMI |
$671.24
|
| Rate for Payer: PHP Medicare Advantage |
$671.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.86
|
| Rate for Payer: Priority Health Medicare |
$671.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.86
|
| Rate for Payer: UHC Medicare Advantage |
$691.38
|
|
|
PR EXC/CURTG CST/B9 TUM PHALANGES FOOT
|
Professional
|
Both
|
$522.00
|
|
|
Service Code
|
HCPCS 28108
|
| Min. Negotiated Rate |
$186.38 |
| Max. Negotiated Rate |
$630.40 |
| Rate for Payer: Aetna Commercial |
$375.16
|
| Rate for Payer: Aetna Medicare |
$279.97
|
| Rate for Payer: BCBS Complete |
$195.70
|
| Rate for Payer: BCBS MAPPO |
$279.97
|
| Rate for Payer: BCBS Trust/PPO |
$252.00
|
| Rate for Payer: BCN Commercial |
$630.40
|
| Rate for Payer: BCN Medicare Advantage |
$279.97
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cofinity Commercial |
$375.16
|
| Rate for Payer: Cofinity Commercial |
$403.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.97
|
| Rate for Payer: Healthscope Commercial |
$335.96
|
| Rate for Payer: Healthscope Whirlpool |
$335.96
|
| Rate for Payer: Meridian Medicaid |
$195.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$293.97
|
| Rate for Payer: PACE SWMI |
$279.97
|
| Rate for Payer: PHP Medicare Advantage |
$279.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$438.13
|
| Rate for Payer: Priority Health Medicare |
$279.97
|
| Rate for Payer: Priority Health Narrow Network |
$438.13
|
| Rate for Payer: UHC Medicare Advantage |
$288.37
|
|
|
PR EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 28106
|
| Min. Negotiated Rate |
$273.71 |
| Max. Negotiated Rate |
$907.62 |
| Rate for Payer: Aetna Commercial |
$556.37
|
| Rate for Payer: Aetna Medicare |
$415.20
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$415.20
|
| Rate for Payer: BCBS Trust/PPO |
$907.62
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$415.20
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$597.89
|
| Rate for Payer: Cofinity Commercial |
$556.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.20
|
| Rate for Payer: Healthscope Commercial |
$498.24
|
| Rate for Payer: Healthscope Whirlpool |
$498.24
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.96
|
| Rate for Payer: PACE SWMI |
$415.20
|
| Rate for Payer: PHP Medicare Advantage |
$415.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$644.96
|
| Rate for Payer: Priority Health Medicare |
$415.20
|
| Rate for Payer: Priority Health Narrow Network |
$644.96
|
| Rate for Payer: UHC Medicare Advantage |
$427.66
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 25136
|
| Min. Negotiated Rate |
$325.46 |
| Max. Negotiated Rate |
$1,019.62 |
| Rate for Payer: Aetna Commercial |
$659.57
|
| Rate for Payer: Aetna Medicare |
$492.22
|
| Rate for Payer: BCBS Complete |
$341.73
|
| Rate for Payer: BCBS MAPPO |
$492.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,019.62
|
| Rate for Payer: BCN Commercial |
$738.88
|
| Rate for Payer: BCN Medicare Advantage |
$492.22
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cofinity Commercial |
$659.57
|
| Rate for Payer: Cofinity Commercial |
$708.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.22
|
| Rate for Payer: Healthscope Commercial |
$590.66
|
| Rate for Payer: Healthscope Whirlpool |
$590.66
|
| Rate for Payer: Meridian Medicaid |
$341.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$516.83
|
| Rate for Payer: PACE SWMI |
$492.22
|
| Rate for Payer: PHP Medicare Advantage |
$492.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$688.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$772.10
|
| Rate for Payer: Priority Health Medicare |
$492.22
|
| Rate for Payer: Priority Health Narrow Network |
$772.10
|
| Rate for Payer: UHC Medicare Advantage |
$506.99
|
|
|
PR EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 25135
|
| Min. Negotiated Rate |
$366.57 |
| Max. Negotiated Rate |
$1,158.03 |
| Rate for Payer: Aetna Commercial |
$741.52
|
| Rate for Payer: Aetna Medicare |
$553.37
|
| Rate for Payer: BCBS Complete |
$384.90
|
| Rate for Payer: BCBS MAPPO |
$553.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.03
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$553.37
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$796.85
|
| Rate for Payer: Cofinity Commercial |
$741.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.37
|
| Rate for Payer: Healthscope Commercial |
$664.04
|
| Rate for Payer: Healthscope Whirlpool |
$664.04
|
| Rate for Payer: Meridian Medicaid |
$384.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$581.04
|
| Rate for Payer: PACE SWMI |
$553.37
|
| Rate for Payer: PHP Medicare Advantage |
$553.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.08
|
| Rate for Payer: Priority Health Medicare |
$553.37
|
| Rate for Payer: Priority Health Narrow Network |
$867.08
|
| Rate for Payer: UHC Medicare Advantage |
$569.97
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT
|
Professional
|
Both
|
$1,192.00
|
|
|
Service Code
|
HCPCS 25126
|
| Min. Negotiated Rate |
$391.07 |
| Max. Negotiated Rate |
$1,153.28 |
| Rate for Payer: Aetna Commercial |
$794.20
|
| Rate for Payer: Aetna Medicare |
$592.69
|
| Rate for Payer: BCBS Complete |
$410.62
|
| Rate for Payer: BCBS MAPPO |
$592.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.28
|
| Rate for Payer: BCN Commercial |
$887.44
|
| Rate for Payer: BCN Medicare Advantage |
$592.69
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cofinity Commercial |
$794.20
|
| Rate for Payer: Cofinity Commercial |
$853.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.69
|
| Rate for Payer: Healthscope Commercial |
$711.23
|
| Rate for Payer: Healthscope Whirlpool |
$711.23
|
| Rate for Payer: Meridian Medicaid |
$410.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$622.32
|
| Rate for Payer: PACE SWMI |
$592.69
|
| Rate for Payer: PHP Medicare Advantage |
$592.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.34
|
| Rate for Payer: Priority Health Medicare |
$592.69
|
| Rate for Payer: Priority Health Narrow Network |
$927.34
|
| Rate for Payer: UHC Medicare Advantage |
$610.47
|
|
|
PR EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$2,274.00
|
|
|
Service Code
|
HCPCS 25125
|
| Min. Negotiated Rate |
$87.17 |
| Max. Negotiated Rate |
$1,591.80 |
| Rate for Payer: Aetna Commercial |
$788.88
|
| Rate for Payer: Aetna Medicare |
$588.72
|
| Rate for Payer: BCBS Complete |
$407.72
|
| Rate for Payer: BCBS MAPPO |
$588.72
|
| Rate for Payer: BCBS Trust/PPO |
$87.17
|
| Rate for Payer: BCN Commercial |
$881.57
|
| Rate for Payer: BCN Medicare Advantage |
$588.72
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cash Price |
$1,819.20
|
| Rate for Payer: Cofinity Commercial |
$788.88
|
| Rate for Payer: Cofinity Commercial |
$847.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.72
|
| Rate for Payer: Healthscope Commercial |
$706.46
|
| Rate for Payer: Healthscope Whirlpool |
$706.46
|
| Rate for Payer: Meridian Medicaid |
$407.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$618.16
|
| Rate for Payer: PACE SWMI |
$588.72
|
| Rate for Payer: PHP Medicare Advantage |
$588.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$921.22
|
| Rate for Payer: Priority Health Medicare |
$588.72
|
| Rate for Payer: Priority Health Narrow Network |
$921.22
|
| Rate for Payer: UHC Medicare Advantage |
$606.38
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
IP
|
$1,031.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$721.70 |
| Max. Negotiated Rate |
$1,031.00 |
| Rate for Payer: Aetna Commercial |
$927.90
|
| Rate for Payer: ASR ASR |
$1,000.07
|
| Rate for Payer: BCBS Trust/PPO |
$799.33
|
| Rate for Payer: BCN Commercial |
$799.33
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$969.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.80
|
| Rate for Payer: Healthscope Commercial |
$1,031.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,000.07
|
| Rate for Payer: Mclaren Commercial |
$927.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$907.28
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Facility
|
OP
|
$1,031.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
19120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$559.44 |
| Max. Negotiated Rate |
$4,235.21 |
| Rate for Payer: Aetna Commercial |
$927.90
|
| Rate for Payer: Aetna Medicare |
$3,388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,235.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,235.21
|
| Rate for Payer: ASR ASR |
$1,000.07
|
| Rate for Payer: BCBS Complete |
$1,946.16
|
| Rate for Payer: BCBS MAPPO |
$3,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$799.33
|
| Rate for Payer: BCCCP Commercial |
$559.44
|
| Rate for Payer: BCN Commercial |
$799.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,388.17
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$969.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,388.17
|
| Rate for Payer: Healthscope Commercial |
$1,031.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,000.07
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,388.17
|
| Rate for Payer: Mclaren Commercial |
$927.90
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,388.17
|
| Rate for Payer: Meridian Medicaid |
$1,946.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,557.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,896.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.35
|
| Rate for Payer: PACE Medicare |
$3,218.76
|
| Rate for Payer: PACE SWMI |
$3,388.17
|
| Rate for Payer: PHP Commercial |
$3,726.99
|
| Rate for Payer: PHP Medicaid |
$1,853.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,388.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,617.27
|
| Rate for Payer: Priority Health Medicare |
$3,388.17
|
| Rate for Payer: Priority Health Narrow Network |
$2,893.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,388.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$907.28
|
| Rate for Payer: UHC Medicare Advantage |
$3,489.82
|
| Rate for Payer: VA VA |
$3,388.17
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
19120
|
| Min. Negotiated Rate |
$269.66 |
| Max. Negotiated Rate |
$762.83 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna Medicare |
$413.03
|
| Rate for Payer: BCBS Complete |
$283.14
|
| Rate for Payer: BCBS MAPPO |
$413.03
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$762.83
|
| Rate for Payer: BCN Medicare Advantage |
$413.03
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$594.76
|
| Rate for Payer: Cofinity Commercial |
$553.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.03
|
| Rate for Payer: Healthscope Commercial |
$495.64
|
| Rate for Payer: Healthscope Whirlpool |
$495.64
|
| Rate for Payer: Meridian Medicaid |
$283.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.68
|
| Rate for Payer: PACE SWMI |
$413.03
|
| Rate for Payer: PHP Medicare Advantage |
$413.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.45
|
| Rate for Payer: Priority Health Medicare |
$413.03
|
| Rate for Payer: Priority Health Narrow Network |
$515.45
|
| Rate for Payer: UHC Medicare Advantage |
$425.42
|
|
|
PR EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 19120
|
| Min. Negotiated Rate |
$269.66 |
| Max. Negotiated Rate |
$762.83 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna Medicare |
$413.03
|
| Rate for Payer: BCBS Complete |
$283.14
|
| Rate for Payer: BCBS MAPPO |
$413.03
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$762.83
|
| Rate for Payer: BCN Medicare Advantage |
$413.03
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$594.76
|
| Rate for Payer: Cofinity Commercial |
$553.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.03
|
| Rate for Payer: Healthscope Commercial |
$495.64
|
| Rate for Payer: Healthscope Whirlpool |
$495.64
|
| Rate for Payer: Meridian Medicaid |
$283.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$433.68
|
| Rate for Payer: PACE SWMI |
$413.03
|
| Rate for Payer: PHP Medicare Advantage |
$413.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.45
|
| Rate for Payer: Priority Health Medicare |
$413.03
|
| Rate for Payer: Priority Health Narrow Network |
$515.45
|
| Rate for Payer: UHC Medicare Advantage |
$425.42
|
|
|
PR EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS
|
Professional
|
Both
|
$1,383.00
|
|
|
Service Code
|
HCPCS 60200
|
| Min. Negotiated Rate |
$217.13 |
| Max. Negotiated Rate |
$981.75 |
| Rate for Payer: Aetna Commercial |
$886.62
|
| Rate for Payer: Aetna Medicare |
$661.66
|
| Rate for Payer: BCBS Complete |
$451.99
|
| Rate for Payer: BCBS MAPPO |
$661.66
|
| Rate for Payer: BCBS Trust/PPO |
$217.13
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$661.66
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cash Price |
$1,106.40
|
| Rate for Payer: Cofinity Commercial |
$952.79
|
| Rate for Payer: Cofinity Commercial |
$886.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.66
|
| Rate for Payer: Healthscope Commercial |
$793.99
|
| Rate for Payer: Healthscope Whirlpool |
$793.99
|
| Rate for Payer: Meridian Medicaid |
$451.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$694.74
|
| Rate for Payer: PACE SWMI |
$661.66
|
| Rate for Payer: PHP Medicare Advantage |
$661.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.54
|
| Rate for Payer: Priority Health Medicare |
$661.66
|
| Rate for Payer: Priority Health Narrow Network |
$950.54
|
| Rate for Payer: UHC Medicare Advantage |
$681.51
|
|
|
PR EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM
|
Professional
|
Both
|
$3,892.00
|
|
|
Service Code
|
HCPCS 49204
|
| Min. Negotiated Rate |
$624.45 |
| Max. Negotiated Rate |
$2,724.40 |
| Rate for Payer: Aetna Commercial |
$2,023.68
|
| Rate for Payer: Aetna Medicare |
$1,510.21
|
| Rate for Payer: BCBS Complete |
$1,021.41
|
| Rate for Payer: BCBS MAPPO |
$1,510.21
|
| Rate for Payer: BCBS Trust/PPO |
$624.45
|
| Rate for Payer: BCN Commercial |
$2,216.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,510.21
|
| Rate for Payer: Cash Price |
$3,113.60
|
| Rate for Payer: Cash Price |
$3,113.60
|
| Rate for Payer: Cofinity Commercial |
$2,023.68
|
| Rate for Payer: Cofinity Commercial |
$2,174.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,510.21
|
| Rate for Payer: Healthscope Commercial |
$1,812.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,812.25
|
| Rate for Payer: Meridian Medicaid |
$1,021.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,585.72
|
| Rate for Payer: PACE SWMI |
$1,510.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,510.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,724.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,667.04
|
| Rate for Payer: Priority Health Medicare |
$1,510.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,667.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,555.52
|
|
|
PR EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM
|
Professional
|
Both
|
$3,145.00
|
|
|
Service Code
|
HCPCS 49205
|
| Min. Negotiated Rate |
$366.64 |
| Max. Negotiated Rate |
$3,061.58 |
| Rate for Payer: Aetna Commercial |
$2,324.24
|
| Rate for Payer: Aetna Medicare |
$1,734.51
|
| Rate for Payer: BCBS Complete |
$1,171.71
|
| Rate for Payer: BCBS MAPPO |
$1,734.51
|
| Rate for Payer: BCBS Trust/PPO |
$366.64
|
| Rate for Payer: BCN Commercial |
$2,544.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,734.51
|
| Rate for Payer: Cash Price |
$2,516.00
|
| Rate for Payer: Cash Price |
$2,516.00
|
| Rate for Payer: Cofinity Commercial |
$2,497.69
|
| Rate for Payer: Cofinity Commercial |
$2,324.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,734.51
|
| Rate for Payer: Healthscope Commercial |
$2,081.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,081.41
|
| Rate for Payer: Meridian Medicaid |
$1,171.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,821.24
|
| Rate for Payer: PACE SWMI |
$1,734.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,734.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,115.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,201.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,061.58
|
| Rate for Payer: Priority Health Medicare |
$1,734.51
|
| Rate for Payer: Priority Health Narrow Network |
$3,061.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,786.55
|
|
|
PR EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX
|
Professional
|
Both
|
$1,030.00
|
|
|
Service Code
|
HCPCS 42870
|
| Min. Negotiated Rate |
$377.65 |
| Max. Negotiated Rate |
$1,046.00 |
| Rate for Payer: Aetna Commercial |
$764.15
|
| Rate for Payer: Aetna Medicare |
$570.26
|
| Rate for Payer: BCBS Complete |
$396.53
|
| Rate for Payer: BCBS MAPPO |
$570.26
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$570.26
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cofinity Commercial |
$821.17
|
| Rate for Payer: Cofinity Commercial |
$764.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.26
|
| Rate for Payer: Healthscope Commercial |
$684.31
|
| Rate for Payer: Healthscope Whirlpool |
$684.31
|
| Rate for Payer: Meridian Medicaid |
$396.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$598.77
|
| Rate for Payer: PACE SWMI |
$570.26
|
| Rate for Payer: PHP Medicare Advantage |
$570.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.00
|
| Rate for Payer: Priority Health Medicare |
$570.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,046.00
|
| Rate for Payer: UHC Medicare Advantage |
$587.37
|
|
|
PR EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F
|
Professional
|
Both
|
$2,599.00
|
|
|
Service Code
|
HCPCS 26390
|
| Min. Negotiated Rate |
$153.74 |
| Max. Negotiated Rate |
$1,819.30 |
| Rate for Payer: Aetna Commercial |
$1,155.70
|
| Rate for Payer: Aetna Medicare |
$862.46
|
| Rate for Payer: BCBS Complete |
$595.80
|
| Rate for Payer: BCBS MAPPO |
$862.46
|
| Rate for Payer: BCBS Trust/PPO |
$153.74
|
| Rate for Payer: BCN Commercial |
$1,303.31
|
| Rate for Payer: BCN Medicare Advantage |
$862.46
|
| Rate for Payer: Cash Price |
$2,079.20
|
| Rate for Payer: Cash Price |
$2,079.20
|
| Rate for Payer: Cofinity Commercial |
$1,241.94
|
| Rate for Payer: Cofinity Commercial |
$1,155.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.46
|
| Rate for Payer: Healthscope Commercial |
$1,034.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,034.95
|
| Rate for Payer: Meridian Medicaid |
$595.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$905.58
|
| Rate for Payer: PACE SWMI |
$862.46
|
| Rate for Payer: PHP Medicare Advantage |
$862.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,819.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,361.90
|
| Rate for Payer: Priority Health Medicare |
$862.46
|
| Rate for Payer: Priority Health Narrow Network |
$1,361.90
|
| Rate for Payer: UHC Medicare Advantage |
$888.33
|
|
