|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY
|
Professional
|
Both
|
$879.00
|
|
|
Service Code
|
HCPCS 33990
|
| Min. Negotiated Rate |
$224.72 |
| Max. Negotiated Rate |
$1,090.41 |
| Rate for Payer: Aetna Commercial |
$474.60
|
| Rate for Payer: Aetna Medicare |
$354.18
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS MAPPO |
$354.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.41
|
| Rate for Payer: BCN Commercial |
$515.07
|
| Rate for Payer: BCN Medicare Advantage |
$354.18
|
| Rate for Payer: Cash Price |
$703.20
|
| Rate for Payer: Cash Price |
$703.20
|
| Rate for Payer: Cofinity Commercial |
$510.02
|
| Rate for Payer: Cofinity Commercial |
$474.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.18
|
| Rate for Payer: Healthscope Commercial |
$425.02
|
| Rate for Payer: Healthscope Whirlpool |
$425.02
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.89
|
| Rate for Payer: PACE SWMI |
$354.18
|
| Rate for Payer: PHP Medicare Advantage |
$354.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.68
|
| Rate for Payer: Priority Health Medicare |
$354.18
|
| Rate for Payer: Priority Health Narrow Network |
$560.68
|
| Rate for Payer: UHC Medicare Advantage |
$364.81
|
|
|
PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS
|
Professional
|
Both
|
$3,314.00
|
|
|
Service Code
|
HCPCS 33991
|
| Min. Negotiated Rate |
$282.01 |
| Max. Negotiated Rate |
$2,319.80 |
| Rate for Payer: Aetna Commercial |
$599.66
|
| Rate for Payer: Aetna Medicare |
$447.51
|
| Rate for Payer: BCBS Complete |
$296.11
|
| Rate for Payer: BCBS MAPPO |
$447.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$447.51
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cash Price |
$2,651.20
|
| Rate for Payer: Cofinity Commercial |
$644.41
|
| Rate for Payer: Cofinity Commercial |
$599.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.51
|
| Rate for Payer: Healthscope Commercial |
$537.01
|
| Rate for Payer: Healthscope Whirlpool |
$537.01
|
| Rate for Payer: Meridian Medicaid |
$296.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$469.89
|
| Rate for Payer: PACE SWMI |
$447.51
|
| Rate for Payer: PHP Medicare Advantage |
$447.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,319.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$705.90
|
| Rate for Payer: Priority Health Medicare |
$447.51
|
| Rate for Payer: Priority Health Narrow Network |
$705.90
|
| Rate for Payer: UHC Medicare Advantage |
$460.94
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 36571
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$1,860.89 |
| Rate for Payer: Aetna Commercial |
$410.44
|
| Rate for Payer: Aetna Medicare |
$306.30
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCBS MAPPO |
$306.30
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$306.30
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$441.07
|
| Rate for Payer: Cofinity Commercial |
$410.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$367.56
|
| Rate for Payer: Healthscope Whirlpool |
$367.56
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.62
|
| Rate for Payer: PACE SWMI |
$306.30
|
| Rate for Payer: PHP Medicare Advantage |
$306.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.53
|
| Rate for Payer: Priority Health Medicare |
$306.30
|
| Rate for Payer: Priority Health Narrow Network |
$491.53
|
| Rate for Payer: UHC Medicare Advantage |
$315.49
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$1,699.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,189.30 |
| Max. Negotiated Rate |
$1,699.00 |
| Rate for Payer: Aetna Commercial |
$1,529.10
|
| Rate for Payer: ASR ASR |
$1,648.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.23
|
| Rate for Payer: BCN Commercial |
$1,317.23
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,597.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.20
|
| Rate for Payer: Healthscope Commercial |
$1,699.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,648.03
|
| Rate for Payer: Mclaren Commercial |
$1,529.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,444.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,495.12
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$1,699.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36571
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,189.30 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$1,529.10
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$1,648.03
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.23
|
| Rate for Payer: BCN Commercial |
$1,317.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$1,597.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$1,699.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,648.03
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$1,529.10
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,444.15
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,546.09
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,495.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$1,699.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
36571
|
| Min. Negotiated Rate |
$197.88 |
| Max. Negotiated Rate |
$1,860.89 |
| Rate for Payer: Aetna Commercial |
$410.44
|
| Rate for Payer: Aetna Medicare |
$306.30
|
| Rate for Payer: BCBS Complete |
$207.77
|
| Rate for Payer: BCBS MAPPO |
$306.30
|
| Rate for Payer: BCBS Trust/PPO |
$651.39
|
| Rate for Payer: BCN Commercial |
$1,860.89
|
| Rate for Payer: BCN Medicare Advantage |
$306.30
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cash Price |
$1,359.20
|
| Rate for Payer: Cofinity Commercial |
$441.07
|
| Rate for Payer: Cofinity Commercial |
$410.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$367.56
|
| Rate for Payer: Healthscope Whirlpool |
$367.56
|
| Rate for Payer: Meridian Medicaid |
$207.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.62
|
| Rate for Payer: PACE SWMI |
$306.30
|
| Rate for Payer: PHP Medicare Advantage |
$306.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,189.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.53
|
| Rate for Payer: Priority Health Medicare |
$306.30
|
| Rate for Payer: Priority Health Narrow Network |
$491.53
|
| Rate for Payer: UHC Medicare Advantage |
$315.49
|
|
|
PR INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY
|
Professional
|
Both
|
$1,644.00
|
|
|
Service Code
|
HCPCS 19342
|
| Min. Negotiated Rate |
$488.41 |
| Max. Negotiated Rate |
$1,594.65 |
| Rate for Payer: Aetna Commercial |
$1,000.26
|
| Rate for Payer: Aetna Medicare |
$746.46
|
| Rate for Payer: BCBS Complete |
$512.83
|
| Rate for Payer: BCBS MAPPO |
$746.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.65
|
| Rate for Payer: BCN Commercial |
$1,114.67
|
| Rate for Payer: BCN Medicare Advantage |
$746.46
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cash Price |
$1,315.20
|
| Rate for Payer: Cofinity Commercial |
$1,000.26
|
| Rate for Payer: Cofinity Commercial |
$1,074.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.46
|
| Rate for Payer: Healthscope Commercial |
$895.75
|
| Rate for Payer: Healthscope Whirlpool |
$895.75
|
| Rate for Payer: Meridian Medicaid |
$512.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$783.78
|
| Rate for Payer: PACE SWMI |
$746.46
|
| Rate for Payer: PHP Medicare Advantage |
$746.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,150.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$937.58
|
| Rate for Payer: Priority Health Medicare |
$746.46
|
| Rate for Payer: Priority Health Narrow Network |
$937.58
|
| Rate for Payer: UHC Medicare Advantage |
$768.85
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 61886
|
| Min. Negotiated Rate |
$575.74 |
| Max. Negotiated Rate |
$1,804.66 |
| Rate for Payer: Aetna Commercial |
$1,171.23
|
| Rate for Payer: Aetna Medicare |
$874.05
|
| Rate for Payer: BCBS Complete |
$604.53
|
| Rate for Payer: BCBS MAPPO |
$874.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.41
|
| Rate for Payer: BCN Commercial |
$1,804.66
|
| Rate for Payer: BCN Medicare Advantage |
$874.05
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,258.63
|
| Rate for Payer: Cofinity Commercial |
$1,171.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.05
|
| Rate for Payer: Healthscope Commercial |
$1,048.86
|
| Rate for Payer: Healthscope Whirlpool |
$1,048.86
|
| Rate for Payer: Meridian Medicaid |
$604.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$917.75
|
| Rate for Payer: PACE SWMI |
$874.05
|
| Rate for Payer: PHP Medicare Advantage |
$874.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,507.29
|
| Rate for Payer: Priority Health Medicare |
$874.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,507.29
|
| Rate for Payer: UHC Medicare Advantage |
$900.27
|
|
|
PR INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR
|
Professional
|
Both
|
$1,622.00
|
|
|
Service Code
|
HCPCS 61885
|
| Min. Negotiated Rate |
$345.06 |
| Max. Negotiated Rate |
$1,135.40 |
| Rate for Payer: Aetna Commercial |
$703.53
|
| Rate for Payer: Aetna Medicare |
$525.02
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS MAPPO |
$525.02
|
| Rate for Payer: BCBS Trust/PPO |
$810.94
|
| Rate for Payer: BCN Commercial |
$1,084.02
|
| Rate for Payer: BCN Medicare Advantage |
$525.02
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cofinity Commercial |
$756.03
|
| Rate for Payer: Cofinity Commercial |
$703.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.02
|
| Rate for Payer: Healthscope Commercial |
$630.02
|
| Rate for Payer: Healthscope Whirlpool |
$630.02
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.27
|
| Rate for Payer: PACE SWMI |
$525.02
|
| Rate for Payer: PHP Medicare Advantage |
$525.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,135.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$905.40
|
| Rate for Payer: Priority Health Medicare |
$525.02
|
| Rate for Payer: Priority Health Narrow Network |
$905.40
|
| Rate for Payer: UHC Medicare Advantage |
$540.77
|
|
|
PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR
|
Professional
|
Both
|
$1,860.00
|
|
|
Service Code
|
HCPCS 33249
|
| Min. Negotiated Rate |
$571.91 |
| Max. Negotiated Rate |
$1,436.28 |
| Rate for Payer: Aetna Commercial |
$1,202.02
|
| Rate for Payer: Aetna Medicare |
$897.03
|
| Rate for Payer: BCBS Complete |
$600.51
|
| Rate for Payer: BCBS MAPPO |
$897.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$1,319.43
|
| Rate for Payer: BCN Medicare Advantage |
$897.03
|
| Rate for Payer: Cash Price |
$1,488.00
|
| Rate for Payer: Cash Price |
$1,488.00
|
| Rate for Payer: Cofinity Commercial |
$1,202.02
|
| Rate for Payer: Cofinity Commercial |
$1,291.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.03
|
| Rate for Payer: Healthscope Commercial |
$1,076.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,076.44
|
| Rate for Payer: Meridian Medicaid |
$600.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$941.88
|
| Rate for Payer: PACE SWMI |
$897.03
|
| Rate for Payer: PHP Medicare Advantage |
$897.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,436.28
|
| Rate for Payer: Priority Health Medicare |
$897.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,436.28
|
| Rate for Payer: UHC Medicare Advantage |
$923.94
|
|
|
PR INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING
|
Professional
|
Both
|
$2,242.00
|
|
|
Service Code
|
HCPCS 63685
|
| Min. Negotiated Rate |
$218.96 |
| Max. Negotiated Rate |
$1,569.40 |
| Rate for Payer: Aetna Commercial |
$477.71
|
| Rate for Payer: Aetna Medicare |
$356.50
|
| Rate for Payer: BCBS Complete |
$229.91
|
| Rate for Payer: BCBS MAPPO |
$356.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$529.73
|
| Rate for Payer: BCN Medicare Advantage |
$356.50
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cash Price |
$1,793.60
|
| Rate for Payer: Cofinity Commercial |
$513.36
|
| Rate for Payer: Cofinity Commercial |
$477.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.50
|
| Rate for Payer: Healthscope Commercial |
$427.80
|
| Rate for Payer: Healthscope Whirlpool |
$427.80
|
| Rate for Payer: Meridian Medicaid |
$229.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$374.32
|
| Rate for Payer: PACE SWMI |
$356.50
|
| Rate for Payer: PHP Medicare Advantage |
$356.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,569.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.79
|
| Rate for Payer: Priority Health Medicare |
$356.50
|
| Rate for Payer: Priority Health Narrow Network |
$613.79
|
| Rate for Payer: UHC Medicare Advantage |
$367.20
|
|
|
PR INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 33210
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$1,347.69 |
| Rate for Payer: Aetna Commercial |
$213.21
|
| Rate for Payer: Aetna Medicare |
$159.11
|
| Rate for Payer: BCBS Complete |
$105.57
|
| Rate for Payer: BCBS MAPPO |
$159.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.69
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: BCN Medicare Advantage |
$159.11
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$213.21
|
| Rate for Payer: Cofinity Commercial |
$229.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.11
|
| Rate for Payer: Healthscope Commercial |
$190.93
|
| Rate for Payer: Healthscope Whirlpool |
$190.93
|
| Rate for Payer: Meridian Medicaid |
$105.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.07
|
| Rate for Payer: PACE SWMI |
$159.11
|
| Rate for Payer: PHP Medicare Advantage |
$159.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.16
|
| Rate for Payer: Priority Health Medicare |
$159.11
|
| Rate for Payer: Priority Health Narrow Network |
$252.16
|
| Rate for Payer: UHC Medicare Advantage |
$163.88
|
|
|
PR INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH
|
Professional
|
Both
|
$2,672.00
|
|
|
Service Code
|
HCPCS 61215
|
| Min. Negotiated Rate |
$338.67 |
| Max. Negotiated Rate |
$1,870.40 |
| Rate for Payer: Aetna Commercial |
$690.38
|
| Rate for Payer: Aetna Medicare |
$515.21
|
| Rate for Payer: BCBS Complete |
$355.60
|
| Rate for Payer: BCBS MAPPO |
$515.21
|
| Rate for Payer: BCBS Trust/PPO |
$682.56
|
| Rate for Payer: BCN Commercial |
$1,063.68
|
| Rate for Payer: BCN Medicare Advantage |
$515.21
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cash Price |
$2,137.60
|
| Rate for Payer: Cofinity Commercial |
$741.90
|
| Rate for Payer: Cofinity Commercial |
$690.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.21
|
| Rate for Payer: Healthscope Commercial |
$618.25
|
| Rate for Payer: Healthscope Whirlpool |
$618.25
|
| Rate for Payer: Meridian Medicaid |
$355.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$540.97
|
| Rate for Payer: PACE SWMI |
$515.21
|
| Rate for Payer: PHP Medicare Advantage |
$515.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$888.40
|
| Rate for Payer: Priority Health Medicare |
$515.21
|
| Rate for Payer: Priority Health Narrow Network |
$888.40
|
| Rate for Payer: UHC Medicare Advantage |
$530.67
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 51703
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$2,051.39 |
| Rate for Payer: Aetna Commercial |
$100.37
|
| Rate for Payer: Aetna Medicare |
$74.90
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$74.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,051.39
|
| Rate for Payer: BCN Commercial |
$218.93
|
| Rate for Payer: BCN Medicare Advantage |
$74.90
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$107.86
|
| Rate for Payer: Cofinity Commercial |
$100.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.90
|
| Rate for Payer: Healthscope Commercial |
$89.88
|
| Rate for Payer: Healthscope Whirlpool |
$89.88
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.64
|
| Rate for Payer: PACE SWMI |
$74.90
|
| Rate for Payer: PHP Medicare Advantage |
$74.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.59
|
| Rate for Payer: Priority Health Medicare |
$74.90
|
| Rate for Payer: Priority Health Narrow Network |
$121.59
|
| Rate for Payer: UHC Medicare Advantage |
$77.15
|
|
|
PR INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 51702
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$1,962.63 |
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Medicare |
$24.69
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$24.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.63
|
| Rate for Payer: BCN Commercial |
$89.92
|
| Rate for Payer: BCN Medicare Advantage |
$24.69
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$33.08
|
| Rate for Payer: Cofinity Commercial |
$35.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.69
|
| Rate for Payer: Healthscope Commercial |
$29.63
|
| Rate for Payer: Healthscope Whirlpool |
$29.63
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.92
|
| Rate for Payer: PACE SWMI |
$24.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.99
|
| Rate for Payer: Priority Health Medicare |
$24.69
|
| Rate for Payer: Priority Health Narrow Network |
$39.99
|
| Rate for Payer: UHC Medicare Advantage |
$25.43
|
|
|
PR INSJ TESTICULAR PROSTH SEPARATE PROCEDURE
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 54660
|
| Min. Negotiated Rate |
$230.25 |
| Max. Negotiated Rate |
$2,434.41 |
| Rate for Payer: Aetna Commercial |
$467.95
|
| Rate for Payer: Aetna Medicare |
$349.22
|
| Rate for Payer: BCBS Complete |
$241.76
|
| Rate for Payer: BCBS MAPPO |
$349.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,434.41
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$349.22
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$502.88
|
| Rate for Payer: Cofinity Commercial |
$467.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.22
|
| Rate for Payer: Healthscope Commercial |
$419.06
|
| Rate for Payer: Healthscope Whirlpool |
$419.06
|
| Rate for Payer: Meridian Medicaid |
$241.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$366.68
|
| Rate for Payer: PACE SWMI |
$349.22
|
| Rate for Payer: PHP Medicare Advantage |
$349.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.40
|
| Rate for Payer: Priority Health Medicare |
$349.22
|
| Rate for Payer: Priority Health Narrow Network |
$574.40
|
| Rate for Payer: UHC Medicare Advantage |
$359.70
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,378.00
|
|
|
Service Code
|
HCPCS 36561
|
| Hospital Charge Code |
36561
|
| Min. Negotiated Rate |
$208.95 |
| Max. Negotiated Rate |
$2,364.60 |
| Rate for Payer: Aetna Commercial |
$436.26
|
| Rate for Payer: Aetna Medicare |
$325.57
|
| Rate for Payer: BCBS Complete |
$219.40
|
| Rate for Payer: BCBS MAPPO |
$325.57
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$325.57
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$436.26
|
| Rate for Payer: Cofinity Commercial |
$468.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.57
|
| Rate for Payer: Healthscope Commercial |
$390.68
|
| Rate for Payer: Healthscope Whirlpool |
$390.68
|
| Rate for Payer: Meridian Medicaid |
$219.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.85
|
| Rate for Payer: PACE SWMI |
$325.57
|
| Rate for Payer: PHP Medicare Advantage |
$325.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.85
|
| Rate for Payer: Priority Health Medicare |
$325.57
|
| Rate for Payer: Priority Health Narrow Network |
$521.85
|
| Rate for Payer: UHC Medicare Advantage |
$335.34
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
OP
|
$3,378.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,549.81 |
| Max. Negotiated Rate |
$3,541.61 |
| Rate for Payer: Aetna Commercial |
$3,040.20
|
| Rate for Payer: Aetna Medicare |
$2,833.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: ASR ASR |
$3,276.66
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,618.96
|
| Rate for Payer: BCN Commercial |
$2,618.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$3,175.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,378.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,276.66
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,833.29
|
| Rate for Payer: Mclaren Commercial |
$3,040.20
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.30
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,116.62
|
| Rate for Payer: PHP Medicaid |
$1,549.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,073.98
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,398.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,972.64
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Facility
|
IP
|
$3,378.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36561
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,364.60 |
| Max. Negotiated Rate |
$3,378.00 |
| Rate for Payer: Aetna Commercial |
$3,040.20
|
| Rate for Payer: ASR ASR |
$3,276.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,618.96
|
| Rate for Payer: BCN Commercial |
$2,618.96
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$3,175.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.40
|
| Rate for Payer: Healthscope Commercial |
$3,378.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,276.66
|
| Rate for Payer: Mclaren Commercial |
$3,040.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,972.64
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>
|
Professional
|
Both
|
$3,378.00
|
|
|
Service Code
|
HCPCS 36561
|
| Min. Negotiated Rate |
$208.95 |
| Max. Negotiated Rate |
$2,364.60 |
| Rate for Payer: Aetna Commercial |
$436.26
|
| Rate for Payer: Aetna Medicare |
$325.57
|
| Rate for Payer: BCBS Complete |
$219.40
|
| Rate for Payer: BCBS MAPPO |
$325.57
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$325.57
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$468.82
|
| Rate for Payer: Cofinity Commercial |
$436.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.57
|
| Rate for Payer: Healthscope Commercial |
$390.68
|
| Rate for Payer: Healthscope Whirlpool |
$390.68
|
| Rate for Payer: Meridian Medicaid |
$219.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.85
|
| Rate for Payer: PACE SWMI |
$325.57
|
| Rate for Payer: PHP Medicare Advantage |
$325.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.85
|
| Rate for Payer: Priority Health Medicare |
$325.57
|
| Rate for Payer: Priority Health Narrow Network |
$521.85
|
| Rate for Payer: UHC Medicare Advantage |
$335.34
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 36560
|
| Min. Negotiated Rate |
$244.31 |
| Max. Negotiated Rate |
$2,456.30 |
| Rate for Payer: Aetna Commercial |
$508.29
|
| Rate for Payer: Aetna Medicare |
$379.32
|
| Rate for Payer: BCBS Complete |
$256.53
|
| Rate for Payer: BCBS MAPPO |
$379.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,003.31
|
| Rate for Payer: BCN Commercial |
$1,825.70
|
| Rate for Payer: BCN Medicare Advantage |
$379.32
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cofinity Commercial |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$508.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.32
|
| Rate for Payer: Healthscope Commercial |
$455.18
|
| Rate for Payer: Healthscope Whirlpool |
$455.18
|
| Rate for Payer: Meridian Medicaid |
$256.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$398.29
|
| Rate for Payer: PACE SWMI |
$379.32
|
| Rate for Payer: PHP Medicare Advantage |
$379.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,456.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$607.49
|
| Rate for Payer: Priority Health Medicare |
$379.32
|
| Rate for Payer: Priority Health Narrow Network |
$607.49
|
| Rate for Payer: UHC Medicare Advantage |
$390.70
|
|
|
PR INSJ TUNNELED CTR VAD W/SUBQ PUMP
|
Professional
|
Both
|
$3,519.00
|
|
|
Service Code
|
HCPCS 36563
|
| Min. Negotiated Rate |
$228.34 |
| Max. Negotiated Rate |
$2,463.30 |
| Rate for Payer: Aetna Commercial |
$480.31
|
| Rate for Payer: Aetna Medicare |
$358.44
|
| Rate for Payer: BCBS Complete |
$239.76
|
| Rate for Payer: BCBS MAPPO |
$358.44
|
| Rate for Payer: BCBS Trust/PPO |
$742.79
|
| Rate for Payer: BCN Commercial |
$1,661.01
|
| Rate for Payer: BCN Medicare Advantage |
$358.44
|
| Rate for Payer: Cash Price |
$2,815.20
|
| Rate for Payer: Cash Price |
$2,815.20
|
| Rate for Payer: Cofinity Commercial |
$516.15
|
| Rate for Payer: Cofinity Commercial |
$480.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.44
|
| Rate for Payer: Healthscope Commercial |
$430.13
|
| Rate for Payer: Healthscope Whirlpool |
$430.13
|
| Rate for Payer: Meridian Medicaid |
$239.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$376.36
|
| Rate for Payer: PACE SWMI |
$358.44
|
| Rate for Payer: PHP Medicare Advantage |
$358.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,463.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$573.98
|
| Rate for Payer: Priority Health Medicare |
$358.44
|
| Rate for Payer: Priority Health Narrow Network |
$573.98
|
| Rate for Payer: UHC Medicare Advantage |
$369.19
|
|
|
PR INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>
|
Professional
|
Both
|
$1,943.00
|
|
|
Service Code
|
HCPCS 36558
|
| Min. Negotiated Rate |
$162.52 |
| Max. Negotiated Rate |
$1,620.82 |
| Rate for Payer: Aetna Commercial |
$339.88
|
| Rate for Payer: Aetna Medicare |
$253.64
|
| Rate for Payer: BCBS Complete |
$170.65
|
| Rate for Payer: BCBS MAPPO |
$253.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,620.82
|
| Rate for Payer: BCN Commercial |
$1,224.63
|
| Rate for Payer: BCN Medicare Advantage |
$253.64
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cash Price |
$1,554.40
|
| Rate for Payer: Cofinity Commercial |
$365.24
|
| Rate for Payer: Cofinity Commercial |
$339.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.64
|
| Rate for Payer: Healthscope Commercial |
$304.37
|
| Rate for Payer: Healthscope Whirlpool |
$304.37
|
| Rate for Payer: Meridian Medicaid |
$170.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$266.32
|
| Rate for Payer: PACE SWMI |
$253.64
|
| Rate for Payer: PHP Medicare Advantage |
$253.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,360.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$406.95
|
| Rate for Payer: Priority Health Medicare |
$253.64
|
| Rate for Payer: Priority Health Narrow Network |
$406.95
|
| Rate for Payer: UHC Medicare Advantage |
$261.25
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$1,704.00
|
|
|
Service Code
|
HCPCS 36565
|
| Min. Negotiated Rate |
$212.57 |
| Max. Negotiated Rate |
$1,210.95 |
| Rate for Payer: Aetna Commercial |
$442.72
|
| Rate for Payer: Aetna Medicare |
$330.39
|
| Rate for Payer: BCBS Complete |
$223.20
|
| Rate for Payer: BCBS MAPPO |
$330.39
|
| Rate for Payer: BCBS Trust/PPO |
$705.81
|
| Rate for Payer: BCN Commercial |
$1,210.95
|
| Rate for Payer: BCN Medicare Advantage |
$330.39
|
| Rate for Payer: Cash Price |
$1,363.20
|
| Rate for Payer: Cash Price |
$1,363.20
|
| Rate for Payer: Cofinity Commercial |
$442.72
|
| Rate for Payer: Cofinity Commercial |
$475.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.39
|
| Rate for Payer: Healthscope Commercial |
$396.47
|
| Rate for Payer: Healthscope Whirlpool |
$396.47
|
| Rate for Payer: Meridian Medicaid |
$223.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$346.91
|
| Rate for Payer: PACE SWMI |
$330.39
|
| Rate for Payer: PHP Medicare Advantage |
$330.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,192.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.17
|
| Rate for Payer: Priority Health Medicare |
$330.39
|
| Rate for Payer: Priority Health Narrow Network |
$527.17
|
| Rate for Payer: UHC Medicare Advantage |
$340.30
|
|
|
PR INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT
|
Professional
|
Both
|
$2,850.00
|
|
|
Service Code
|
HCPCS 36566
|
| Min. Negotiated Rate |
$224.72 |
| Max. Negotiated Rate |
$6,274.62 |
| Rate for Payer: Aetna Commercial |
$469.83
|
| Rate for Payer: Aetna Medicare |
$350.62
|
| Rate for Payer: BCBS Complete |
$235.96
|
| Rate for Payer: BCBS MAPPO |
$350.62
|
| Rate for Payer: BCBS Trust/PPO |
$907.09
|
| Rate for Payer: BCN Commercial |
$6,274.62
|
| Rate for Payer: BCN Medicare Advantage |
$350.62
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cofinity Commercial |
$469.83
|
| Rate for Payer: Cofinity Commercial |
$504.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.62
|
| Rate for Payer: Healthscope Commercial |
$420.74
|
| Rate for Payer: Healthscope Whirlpool |
$420.74
|
| Rate for Payer: Meridian Medicaid |
$235.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$368.15
|
| Rate for Payer: PACE SWMI |
$350.62
|
| Rate for Payer: PHP Medicare Advantage |
$350.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,995.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.68
|
| Rate for Payer: Priority Health Medicare |
$350.62
|
| Rate for Payer: Priority Health Narrow Network |
$560.68
|
| Rate for Payer: UHC Medicare Advantage |
$361.14
|
|
