|
PR EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE
|
Professional
|
Both
|
$1,413.00
|
|
|
Service Code
|
HCPCS 43270
|
| Min. Negotiated Rate |
$211.74 |
| Max. Negotiated Rate |
$918.45 |
| Rate for Payer: Aetna Commercial |
$283.73
|
| Rate for Payer: Aetna Medicare |
$211.74
|
| Rate for Payer: BCBS Complete |
$565.20
|
| Rate for Payer: BCBS MAPPO |
$211.74
|
| Rate for Payer: BCN Medicare Advantage |
$211.74
|
| Rate for Payer: Cash Price |
$1,130.40
|
| Rate for Payer: Cash Price |
$1,130.40
|
| Rate for Payer: Cofinity Commercial |
$304.91
|
| Rate for Payer: Cofinity Commercial |
$283.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.74
|
| Rate for Payer: Healthscope Commercial |
$254.09
|
| Rate for Payer: Healthscope Whirlpool |
$254.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.33
|
| Rate for Payer: Nomi Health Commercial |
$254.09
|
| Rate for Payer: PACE SWMI |
$211.74
|
| Rate for Payer: PHP Medicare Advantage |
$211.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.45
|
| Rate for Payer: Priority Health Medicare |
$211.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.74
|
| Rate for Payer: UHC Medicare Advantage |
$211.74
|
| Rate for Payer: UHCCP DNSP |
$211.74
|
|
|
PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 43249
|
| Hospital Charge Code |
43249
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,171.30 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: Aetna Commercial |
$1,621.80
|
| Rate for Payer: ASR ASR |
$1,747.94
|
| Rate for Payer: ASR Commercial |
$1,747.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.45
|
| Rate for Payer: BCN Commercial |
$1,397.09
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,693.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Healthscope Commercial |
$1,802.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,747.94
|
| Rate for Payer: Mclaren Commercial |
$1,621.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$1,477.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,585.76
|
|
|
PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 43249
|
| Hospital Charge Code |
43249
|
| Min. Negotiated Rate |
$144.65 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$193.83
|
| Rate for Payer: Aetna Medicare |
$144.65
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$144.65
|
| Rate for Payer: BCN Medicare Advantage |
$144.65
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$208.30
|
| Rate for Payer: Cofinity Commercial |
$193.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.65
|
| Rate for Payer: Healthscope Commercial |
$173.58
|
| Rate for Payer: Healthscope Whirlpool |
$173.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.88
|
| Rate for Payer: Nomi Health Commercial |
$173.58
|
| Rate for Payer: PACE SWMI |
$144.65
|
| Rate for Payer: PHP Medicare Advantage |
$144.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$144.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.65
|
| Rate for Payer: UHC Medicare Advantage |
$144.65
|
| Rate for Payer: UHCCP DNSP |
$144.65
|
|
|
PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 43249
|
| Hospital Charge Code |
43249
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$991.65 |
| Max. Negotiated Rate |
$2,867.66 |
| Rate for Payer: Aetna Commercial |
$1,621.80
|
| Rate for Payer: Aetna Medicare |
$1,850.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: ASR ASR |
$1,747.94
|
| Rate for Payer: ASR Commercial |
$1,747.94
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.66
|
| Rate for Payer: BCN Commercial |
$1,397.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,693.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$1,802.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,747.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,850.10
|
| Rate for Payer: Mclaren Commercial |
$1,621.80
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$1,477.64
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$2,035.11
|
| Rate for Payer: PHP Medicaid |
$991.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,578.91
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,263.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,585.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$2,867.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP DNSP |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 43249
|
| Min. Negotiated Rate |
$144.65 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$193.83
|
| Rate for Payer: Aetna Medicare |
$144.65
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$144.65
|
| Rate for Payer: BCN Medicare Advantage |
$144.65
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$208.30
|
| Rate for Payer: Cofinity Commercial |
$193.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.65
|
| Rate for Payer: Healthscope Commercial |
$173.58
|
| Rate for Payer: Healthscope Whirlpool |
$173.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.88
|
| Rate for Payer: Nomi Health Commercial |
$173.58
|
| Rate for Payer: PACE SWMI |
$144.65
|
| Rate for Payer: PHP Medicare Advantage |
$144.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$144.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.65
|
| Rate for Payer: UHC Medicare Advantage |
$144.65
|
| Rate for Payer: UHCCP DNSP |
$144.65
|
|
|
PR EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 43244
|
| Min. Negotiated Rate |
$230.04 |
| Max. Negotiated Rate |
$739.05 |
| Rate for Payer: Aetna Commercial |
$308.25
|
| Rate for Payer: Aetna Medicare |
$230.04
|
| Rate for Payer: BCBS Complete |
$454.80
|
| Rate for Payer: BCBS MAPPO |
$230.04
|
| Rate for Payer: BCN Medicare Advantage |
$230.04
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$331.26
|
| Rate for Payer: Cofinity Commercial |
$308.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.04
|
| Rate for Payer: Healthscope Commercial |
$276.05
|
| Rate for Payer: Healthscope Whirlpool |
$276.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.54
|
| Rate for Payer: Nomi Health Commercial |
$276.05
|
| Rate for Payer: PACE SWMI |
$230.04
|
| Rate for Payer: PHP Medicare Advantage |
$230.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.05
|
| Rate for Payer: Priority Health Medicare |
$230.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.04
|
| Rate for Payer: UHC Medicare Advantage |
$230.04
|
| Rate for Payer: UHCCP DNSP |
$230.04
|
|
|
PR EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD
|
Professional
|
Both
|
$587.00
|
|
|
Service Code
|
HCPCS 43257
|
| Min. Negotiated Rate |
$218.63 |
| Max. Negotiated Rate |
$381.55 |
| Rate for Payer: Aetna Commercial |
$292.96
|
| Rate for Payer: Aetna Medicare |
$218.63
|
| Rate for Payer: BCBS Complete |
$234.80
|
| Rate for Payer: BCBS MAPPO |
$218.63
|
| Rate for Payer: BCN Medicare Advantage |
$218.63
|
| Rate for Payer: Cash Price |
$469.60
|
| Rate for Payer: Cash Price |
$469.60
|
| Rate for Payer: Cofinity Commercial |
$314.83
|
| Rate for Payer: Cofinity Commercial |
$292.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.63
|
| Rate for Payer: Healthscope Commercial |
$262.36
|
| Rate for Payer: Healthscope Whirlpool |
$262.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.56
|
| Rate for Payer: Nomi Health Commercial |
$262.36
|
| Rate for Payer: PACE SWMI |
$218.63
|
| Rate for Payer: PHP Medicare Advantage |
$218.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.55
|
| Rate for Payer: Priority Health Medicare |
$218.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.63
|
| Rate for Payer: UHC Medicare Advantage |
$218.63
|
| Rate for Payer: UHCCP DNSP |
$218.63
|
|
|
PR EGD DILATION GASTRIC/DUODENAL STRICTURE
|
Professional
|
Both
|
$1,013.00
|
|
|
Service Code
|
HCPCS 43245
|
| Min. Negotiated Rate |
$167.26 |
| Max. Negotiated Rate |
$658.45 |
| Rate for Payer: Aetna Commercial |
$224.13
|
| Rate for Payer: Aetna Medicare |
$167.26
|
| Rate for Payer: BCBS Complete |
$405.20
|
| Rate for Payer: BCBS MAPPO |
$167.26
|
| Rate for Payer: BCN Medicare Advantage |
$167.26
|
| Rate for Payer: Cash Price |
$810.40
|
| Rate for Payer: Cash Price |
$810.40
|
| Rate for Payer: Cofinity Commercial |
$240.85
|
| Rate for Payer: Cofinity Commercial |
$224.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.26
|
| Rate for Payer: Healthscope Commercial |
$200.71
|
| Rate for Payer: Healthscope Whirlpool |
$200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.62
|
| Rate for Payer: Nomi Health Commercial |
$200.71
|
| Rate for Payer: PACE SWMI |
$167.26
|
| Rate for Payer: PHP Medicare Advantage |
$167.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.45
|
| Rate for Payer: Priority Health Medicare |
$167.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.26
|
| Rate for Payer: UHC Medicare Advantage |
$167.26
|
| Rate for Payer: UHCCP DNSP |
$167.26
|
|
|
PR EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 43266
|
| Min. Negotiated Rate |
$205.46 |
| Max. Negotiated Rate |
$449.15 |
| Rate for Payer: Aetna Commercial |
$275.32
|
| Rate for Payer: Aetna Medicare |
$205.46
|
| Rate for Payer: BCBS Complete |
$276.40
|
| Rate for Payer: BCBS MAPPO |
$205.46
|
| Rate for Payer: BCN Medicare Advantage |
$205.46
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$295.86
|
| Rate for Payer: Cofinity Commercial |
$275.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.46
|
| Rate for Payer: Healthscope Commercial |
$246.55
|
| Rate for Payer: Healthscope Whirlpool |
$246.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.73
|
| Rate for Payer: Nomi Health Commercial |
$246.55
|
| Rate for Payer: PACE SWMI |
$205.46
|
| Rate for Payer: PHP Medicare Advantage |
$205.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health Medicare |
$205.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.46
|
| Rate for Payer: UHC Medicare Advantage |
$205.46
|
| Rate for Payer: UHCCP DNSP |
$205.46
|
|
|
PR EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 43233
|
| Min. Negotiated Rate |
$217.23 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Commercial |
$291.09
|
| Rate for Payer: Aetna Medicare |
$217.23
|
| Rate for Payer: BCBS Complete |
$415.60
|
| Rate for Payer: BCBS MAPPO |
$217.23
|
| Rate for Payer: BCN Medicare Advantage |
$217.23
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cofinity Commercial |
$312.81
|
| Rate for Payer: Cofinity Commercial |
$291.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.23
|
| Rate for Payer: Healthscope Commercial |
$260.68
|
| Rate for Payer: Healthscope Whirlpool |
$260.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.09
|
| Rate for Payer: Nomi Health Commercial |
$260.68
|
| Rate for Payer: PACE SWMI |
$217.23
|
| Rate for Payer: PHP Medicare Advantage |
$217.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.35
|
| Rate for Payer: Priority Health Medicare |
$217.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.23
|
| Rate for Payer: UHC Medicare Advantage |
$217.23
|
| Rate for Payer: UHCCP DNSP |
$217.23
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 43247
|
| Min. Negotiated Rate |
$166.46 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Aetna Commercial |
$223.06
|
| Rate for Payer: Aetna Medicare |
$166.46
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS MAPPO |
$166.46
|
| Rate for Payer: BCN Medicare Advantage |
$166.46
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Cofinity Commercial |
$223.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$199.75
|
| Rate for Payer: Healthscope Whirlpool |
$199.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.78
|
| Rate for Payer: Nomi Health Commercial |
$199.75
|
| Rate for Payer: PACE SWMI |
$166.46
|
| Rate for Payer: PHP Medicare Advantage |
$166.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health Medicare |
$166.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.46
|
| Rate for Payer: UHC Medicare Advantage |
$166.46
|
| Rate for Payer: UHCCP DNSP |
$166.46
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 43247
|
| Hospital Charge Code |
43247
|
| Min. Negotiated Rate |
$166.46 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Aetna Commercial |
$223.06
|
| Rate for Payer: Aetna Medicare |
$166.46
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: BCBS MAPPO |
$166.46
|
| Rate for Payer: BCN Medicare Advantage |
$166.46
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$239.70
|
| Rate for Payer: Cofinity Commercial |
$223.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$199.75
|
| Rate for Payer: Healthscope Whirlpool |
$199.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.78
|
| Rate for Payer: Nomi Health Commercial |
$199.75
|
| Rate for Payer: PACE SWMI |
$166.46
|
| Rate for Payer: PHP Medicare Advantage |
$166.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health Medicare |
$166.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.46
|
| Rate for Payer: UHC Medicare Advantage |
$166.46
|
| Rate for Payer: UHCCP DNSP |
$166.46
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
43247
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$1,417.29 |
| Rate for Payer: Aetna Commercial |
$887.40
|
| Rate for Payer: Aetna Medicare |
$914.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: ASR ASR |
$956.42
|
| Rate for Payer: ASR Commercial |
$956.42
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCBS Trust/PPO |
$807.44
|
| Rate for Payer: BCN Commercial |
$764.45
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$926.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$986.00
|
| Rate for Payer: Healthscope Whirlpool |
$956.42
|
| Rate for Payer: Humana Choice PPO Medicare |
$914.38
|
| Rate for Payer: Mclaren Commercial |
$887.40
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$808.52
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,005.82
|
| Rate for Payer: PHP Medicaid |
$490.11
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$863.93
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health Narrow Network |
$691.19
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$867.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,417.29
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP DNSP |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
43247
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$640.90 |
| Max. Negotiated Rate |
$986.00 |
| Rate for Payer: Aetna Commercial |
$887.40
|
| Rate for Payer: ASR ASR |
$956.42
|
| Rate for Payer: ASR Commercial |
$956.42
|
| Rate for Payer: BCBS Trust/PPO |
$803.49
|
| Rate for Payer: BCN Commercial |
$764.45
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Cofinity Commercial |
$926.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$788.80
|
| Rate for Payer: Healthscope Commercial |
$986.00
|
| Rate for Payer: Healthscope Whirlpool |
$956.42
|
| Rate for Payer: Mclaren Commercial |
$887.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.10
|
| Rate for Payer: Nomi Health Commercial |
$808.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$867.68
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43250
|
| Hospital Charge Code |
43250
|
| Min. Negotiated Rate |
$161.39 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$216.26
|
| Rate for Payer: Aetna Medicare |
$161.39
|
| Rate for Payer: BCBS Complete |
$441.60
|
| Rate for Payer: BCBS MAPPO |
$161.39
|
| Rate for Payer: BCN Medicare Advantage |
$161.39
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$232.40
|
| Rate for Payer: Cofinity Commercial |
$216.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.39
|
| Rate for Payer: Healthscope Commercial |
$193.67
|
| Rate for Payer: Healthscope Whirlpool |
$193.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.46
|
| Rate for Payer: Nomi Health Commercial |
$193.67
|
| Rate for Payer: PACE SWMI |
$161.39
|
| Rate for Payer: PHP Medicare Advantage |
$161.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$161.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.39
|
| Rate for Payer: UHC Medicare Advantage |
$161.39
|
| Rate for Payer: UHCCP DNSP |
$161.39
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$1,104.00
|
|
|
Service Code
|
CPT 43250
|
| Hospital Charge Code |
43250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$717.60 |
| Max. Negotiated Rate |
$2,867.66 |
| Rate for Payer: Aetna Commercial |
$993.60
|
| Rate for Payer: Aetna Medicare |
$1,850.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: ASR ASR |
$1,070.88
|
| Rate for Payer: ASR Commercial |
$1,070.88
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCBS Trust/PPO |
$904.07
|
| Rate for Payer: BCN Commercial |
$855.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$1,037.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$1,104.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,070.88
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,850.10
|
| Rate for Payer: Mclaren Commercial |
$993.60
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$938.40
|
| Rate for Payer: Nomi Health Commercial |
$905.28
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$2,035.11
|
| Rate for Payer: PHP Medicaid |
$991.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$967.32
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health Narrow Network |
$773.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$971.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$2,867.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP DNSP |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: VA VA |
$1,850.10
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43250
|
| Min. Negotiated Rate |
$161.39 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$216.26
|
| Rate for Payer: Aetna Medicare |
$161.39
|
| Rate for Payer: BCBS Complete |
$441.60
|
| Rate for Payer: BCBS MAPPO |
$161.39
|
| Rate for Payer: BCN Medicare Advantage |
$161.39
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$232.40
|
| Rate for Payer: Cofinity Commercial |
$216.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.39
|
| Rate for Payer: Healthscope Commercial |
$193.67
|
| Rate for Payer: Healthscope Whirlpool |
$193.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.46
|
| Rate for Payer: Nomi Health Commercial |
$193.67
|
| Rate for Payer: PACE SWMI |
$161.39
|
| Rate for Payer: PHP Medicare Advantage |
$161.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health Medicare |
$161.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.39
|
| Rate for Payer: UHC Medicare Advantage |
$161.39
|
| Rate for Payer: UHCCP DNSP |
$161.39
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
IP
|
$1,104.00
|
|
|
Service Code
|
CPT 43250
|
| Hospital Charge Code |
43250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$717.60 |
| Max. Negotiated Rate |
$1,104.00 |
| Rate for Payer: Aetna Commercial |
$993.60
|
| Rate for Payer: ASR ASR |
$1,070.88
|
| Rate for Payer: ASR Commercial |
$1,070.88
|
| Rate for Payer: BCBS Trust/PPO |
$899.65
|
| Rate for Payer: BCN Commercial |
$855.93
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$1,037.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.20
|
| Rate for Payer: Healthscope Commercial |
$1,104.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,070.88
|
| Rate for Payer: Mclaren Commercial |
$993.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$938.40
|
| Rate for Payer: Nomi Health Commercial |
$905.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$971.52
|
|
|
PR EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 43243
|
| Min. Negotiated Rate |
$224.75 |
| Max. Negotiated Rate |
$782.60 |
| Rate for Payer: Aetna Commercial |
$301.17
|
| Rate for Payer: Aetna Medicare |
$224.75
|
| Rate for Payer: BCBS Complete |
$481.60
|
| Rate for Payer: BCBS MAPPO |
$224.75
|
| Rate for Payer: BCN Medicare Advantage |
$224.75
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$323.64
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.75
|
| Rate for Payer: Healthscope Commercial |
$269.70
|
| Rate for Payer: Healthscope Whirlpool |
$269.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.99
|
| Rate for Payer: Nomi Health Commercial |
$269.70
|
| Rate for Payer: PACE SWMI |
$224.75
|
| Rate for Payer: PHP Medicare Advantage |
$224.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health Medicare |
$224.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.75
|
| Rate for Payer: UHC Medicare Advantage |
$224.75
|
| Rate for Payer: UHCCP DNSP |
$224.75
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Min. Negotiated Rate |
$156.41 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$156.41
|
| Rate for Payer: BCBS Complete |
$353.60
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Healthscope Commercial |
$187.69
|
| Rate for Payer: Healthscope Whirlpool |
$187.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health Medicare |
$156.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
| Rate for Payer: UHCCP DNSP |
$156.41
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
OP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$1,417.29 |
| Rate for Payer: Aetna Commercial |
$795.60
|
| Rate for Payer: Aetna Medicare |
$914.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: ASR ASR |
$857.48
|
| Rate for Payer: ASR Commercial |
$857.48
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCBS Trust/PPO |
$723.91
|
| Rate for Payer: BCN Commercial |
$685.37
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$830.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$884.00
|
| Rate for Payer: Healthscope Whirlpool |
$857.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$914.38
|
| Rate for Payer: Mclaren Commercial |
$795.60
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: Nomi Health Commercial |
$724.88
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,005.82
|
| Rate for Payer: PHP Medicaid |
$490.11
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.56
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health Narrow Network |
$619.68
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,417.29
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP DNSP |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: VA VA |
$914.38
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
IP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$574.60 |
| Max. Negotiated Rate |
$884.00 |
| Rate for Payer: Aetna Commercial |
$795.60
|
| Rate for Payer: ASR ASR |
$857.48
|
| Rate for Payer: ASR Commercial |
$857.48
|
| Rate for Payer: BCBS Trust/PPO |
$720.37
|
| Rate for Payer: BCN Commercial |
$685.37
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$830.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Healthscope Commercial |
$884.00
|
| Rate for Payer: Healthscope Whirlpool |
$857.48
|
| Rate for Payer: Mclaren Commercial |
$795.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: Nomi Health Commercial |
$724.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.92
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Hospital Charge Code |
43248
|
| Min. Negotiated Rate |
$156.41 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$156.41
|
| Rate for Payer: BCBS Complete |
$353.60
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Healthscope Commercial |
$187.69
|
| Rate for Payer: Healthscope Whirlpool |
$187.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health Medicare |
$156.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
| Rate for Payer: UHCCP DNSP |
$156.41
|
|
|
PR EGD INTRALUMINAL TUBE/CATHETER INSERTION
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 43241
|
| Min. Negotiated Rate |
$134.61 |
| Max. Negotiated Rate |
$567.45 |
| Rate for Payer: Aetna Commercial |
$180.38
|
| Rate for Payer: Aetna Medicare |
$134.61
|
| Rate for Payer: BCBS Complete |
$349.20
|
| Rate for Payer: BCBS MAPPO |
$134.61
|
| Rate for Payer: BCN Medicare Advantage |
$134.61
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$193.84
|
| Rate for Payer: Cofinity Commercial |
$180.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.61
|
| Rate for Payer: Healthscope Commercial |
$161.53
|
| Rate for Payer: Healthscope Whirlpool |
$161.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.34
|
| Rate for Payer: Nomi Health Commercial |
$161.53
|
| Rate for Payer: PACE SWMI |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health Medicare |
$134.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.61
|
| Rate for Payer: UHC Medicare Advantage |
$134.61
|
| Rate for Payer: UHCCP DNSP |
$134.61
|
|
|
PR EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 43242
|
| Min. Negotiated Rate |
$246.65 |
| Max. Negotiated Rate |
$671.45 |
| Rate for Payer: Aetna Commercial |
$330.51
|
| Rate for Payer: Aetna Medicare |
$246.65
|
| Rate for Payer: BCBS Complete |
$413.20
|
| Rate for Payer: BCBS MAPPO |
$246.65
|
| Rate for Payer: BCN Medicare Advantage |
$246.65
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$355.18
|
| Rate for Payer: Cofinity Commercial |
$330.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.65
|
| Rate for Payer: Healthscope Commercial |
$295.98
|
| Rate for Payer: Healthscope Whirlpool |
$295.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.98
|
| Rate for Payer: Nomi Health Commercial |
$295.98
|
| Rate for Payer: PACE SWMI |
$246.65
|
| Rate for Payer: PHP Medicare Advantage |
$246.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.45
|
| Rate for Payer: Priority Health Medicare |
$246.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.65
|
| Rate for Payer: UHC Medicare Advantage |
$246.65
|
| Rate for Payer: UHCCP DNSP |
$246.65
|
|
