|
HC APHERESIS
|
Facility
|
IP
|
$2,505.38
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,753.77 |
| Max. Negotiated Rate |
$2,505.38 |
| Rate for Payer: Aetna Commercial |
$2,254.84
|
| Rate for Payer: ASR ASR |
$2,430.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.42
|
| Rate for Payer: BCN Commercial |
$1,942.42
|
| Rate for Payer: Cash Price |
$2,004.30
|
| Rate for Payer: Cofinity Commercial |
$2,355.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.30
|
| Rate for Payer: Healthscope Commercial |
$2,505.38
|
| Rate for Payer: Healthscope Whirlpool |
$2,430.22
|
| Rate for Payer: Mclaren Commercial |
$2,254.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,129.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,753.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,204.73
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
IP
|
$129.14
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$90.40 |
| Max. Negotiated Rate |
$129.14 |
| Rate for Payer: Aetna Commercial |
$116.23
|
| Rate for Payer: ASR ASR |
$125.27
|
| Rate for Payer: BCBS Trust/PPO |
$100.12
|
| Rate for Payer: BCN Commercial |
$100.12
|
| Rate for Payer: Cash Price |
$103.31
|
| Rate for Payer: Cofinity Commercial |
$121.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.31
|
| Rate for Payer: Healthscope Commercial |
$129.14
|
| Rate for Payer: Healthscope Whirlpool |
$125.27
|
| Rate for Payer: Mclaren Commercial |
$116.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.64
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
OP
|
$129.14
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.66 |
| Max. Negotiated Rate |
$129.14 |
| Rate for Payer: Aetna Commercial |
$116.23
|
| Rate for Payer: ASR ASR |
$125.27
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Trust/PPO |
$100.12
|
| Rate for Payer: BCN Commercial |
$100.12
|
| Rate for Payer: Cash Price |
$103.31
|
| Rate for Payer: Cofinity Commercial |
$121.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.31
|
| Rate for Payer: Healthscope Commercial |
$129.14
|
| Rate for Payer: Healthscope Whirlpool |
$125.27
|
| Rate for Payer: Mclaren Commercial |
$116.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.52
|
| Rate for Payer: Priority Health Narrow Network |
$91.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$113.64
|
|
|
HC APNEALINK PLUS
|
Facility
|
OP
|
$733.10
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$733.10 |
| Rate for Payer: Aetna Commercial |
$659.79
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: ASR ASR |
$711.11
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$568.37
|
| Rate for Payer: BCN Commercial |
$568.37
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$586.48
|
| Rate for Payer: Cash Price |
$586.48
|
| Rate for Payer: Cofinity Commercial |
$689.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$733.10
|
| Rate for Payer: Healthscope Whirlpool |
$711.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$138.85
|
| Rate for Payer: Mclaren Commercial |
$659.79
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$623.14
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicaid |
$75.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.72
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$273.38
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.13
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: VA VA |
$138.85
|
|
|
HC APNEALINK PLUS
|
Facility
|
IP
|
$733.10
|
|
|
Service Code
|
CPT 95806
|
| Hospital Charge Code |
92000014
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$513.17 |
| Max. Negotiated Rate |
$733.10 |
| Rate for Payer: Aetna Commercial |
$659.79
|
| Rate for Payer: ASR ASR |
$711.11
|
| Rate for Payer: BCBS Trust/PPO |
$568.37
|
| Rate for Payer: BCN Commercial |
$568.37
|
| Rate for Payer: Cash Price |
$586.48
|
| Rate for Payer: Cofinity Commercial |
$689.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.48
|
| Rate for Payer: Healthscope Commercial |
$733.10
|
| Rate for Payer: Healthscope Whirlpool |
$711.11
|
| Rate for Payer: Mclaren Commercial |
$659.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$623.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$645.13
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: ASR ASR |
$66.93
|
| Rate for Payer: BCBS Complete |
$12.11
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$53.50
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Healthscope Whirlpool |
$66.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.09
|
| Rate for Payer: Mclaren Commercial |
$62.10
|
| Rate for Payer: Mclaren Medicaid |
$11.54
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Medicaid |
$11.54
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.15
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.12
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
| Rate for Payer: UHC Medicare Advantage |
$21.72
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$62.10
|
| Rate for Payer: ASR ASR |
$66.93
|
| Rate for Payer: BCBS Trust/PPO |
$53.50
|
| Rate for Payer: BCN Commercial |
$53.50
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$64.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Healthscope Whirlpool |
$66.93
|
| Rate for Payer: Mclaren Commercial |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Complete |
$12.11
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.09
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Mclaren Medicaid |
$11.54
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Medicaid |
$11.54
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.15
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.12
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
| Rate for Payer: UHC Medicare Advantage |
$21.72
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$49.98 |
| Rate for Payer: Aetna Commercial |
$44.98
|
| Rate for Payer: ASR ASR |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.75
|
| Rate for Payer: BCN Commercial |
$38.75
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$46.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Mclaren Commercial |
$44.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.98
|
|
|
HC APOLIPOPROTEIN B LMPP
|
Facility
|
OP
|
$38.76
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100637
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$34.88
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.36
|
| Rate for Payer: ASR ASR |
$37.60
|
| Rate for Payer: BCBS Complete |
$12.11
|
| Rate for Payer: BCBS MAPPO |
$21.09
|
| Rate for Payer: BCBS Trust/PPO |
$30.05
|
| Rate for Payer: BCN Commercial |
$30.05
|
| Rate for Payer: BCN Medicare Advantage |
$21.09
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$36.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.09
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Healthscope Whirlpool |
$37.60
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.09
|
| Rate for Payer: Mclaren Commercial |
$34.88
|
| Rate for Payer: Mclaren Medicaid |
$11.54
|
| Rate for Payer: Mclaren Medicare |
$21.09
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.95
|
| Rate for Payer: PACE Medicare |
$20.04
|
| Rate for Payer: PACE SWMI |
$21.09
|
| Rate for Payer: PHP Commercial |
$23.20
|
| Rate for Payer: PHP Medicaid |
$11.54
|
| Rate for Payer: PHP Medicare Advantage |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.15
|
| Rate for Payer: Priority Health Medicare |
$21.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.12
|
| Rate for Payer: Railroad Medicare Medicare |
$21.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.11
|
| Rate for Payer: UHC Medicare Advantage |
$21.72
|
| Rate for Payer: VA VA |
$21.09
|
|
|
HC APOLIPOPROTEIN B LMPP
|
Facility
|
IP
|
$38.76
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100637
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.13 |
| Max. Negotiated Rate |
$38.76 |
| Rate for Payer: Aetna Commercial |
$34.88
|
| Rate for Payer: ASR ASR |
$37.60
|
| Rate for Payer: BCBS Trust/PPO |
$30.05
|
| Rate for Payer: BCN Commercial |
$30.05
|
| Rate for Payer: Cash Price |
$31.01
|
| Rate for Payer: Cofinity Commercial |
$36.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.01
|
| Rate for Payer: Healthscope Commercial |
$38.76
|
| Rate for Payer: Healthscope Whirlpool |
$37.60
|
| Rate for Payer: Mclaren Commercial |
$34.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$34.11
|
|
|
HC APPLE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200072
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.86
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC APPLE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200072
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$24.89 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: ASR ASR |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.30
|
| Rate for Payer: BCN Commercial |
$19.30
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$23.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$24.89
|
| Rate for Payer: Healthscope Whirlpool |
$24.14
|
| Rate for Payer: Mclaren Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.90
|
|
|
HC APPLIANCE BELT
|
Facility
|
IP
|
$24.42
|
|
| Hospital Charge Code |
27000027
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.09 |
| Max. Negotiated Rate |
$24.42 |
| Rate for Payer: Aetna Commercial |
$21.98
|
| Rate for Payer: ASR ASR |
$23.69
|
| Rate for Payer: BCBS Trust/PPO |
$18.93
|
| Rate for Payer: BCN Commercial |
$18.93
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Healthscope Commercial |
$24.42
|
| Rate for Payer: Healthscope Whirlpool |
$23.69
|
| Rate for Payer: Mclaren Commercial |
$21.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.49
|
|
|
HC APPLIANCE BELT
|
Facility
|
OP
|
$24.42
|
|
| Hospital Charge Code |
27000027
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$24.42 |
| Rate for Payer: Aetna Commercial |
$21.98
|
| Rate for Payer: ASR ASR |
$23.69
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS Trust/PPO |
$18.93
|
| Rate for Payer: BCN Commercial |
$18.93
|
| Rate for Payer: Cash Price |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$22.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.54
|
| Rate for Payer: Healthscope Commercial |
$24.42
|
| Rate for Payer: Healthscope Whirlpool |
$23.69
|
| Rate for Payer: Mclaren Commercial |
$21.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.22
|
| Rate for Payer: Priority Health Narrow Network |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.49
|
|
|
HC APPLICATION OF TOPICAL FLUORIDE VARNISH BY PHYS/QHP
|
Facility
|
OP
|
$34.80
|
|
|
Service Code
|
CPT 99188
|
| Hospital Charge Code |
51000097
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$34.80 |
| Rate for Payer: Aetna Commercial |
$31.32
|
| Rate for Payer: ASR ASR |
$33.76
|
| Rate for Payer: BCBS Complete |
$13.92
|
| Rate for Payer: BCBS Trust/PPO |
$26.98
|
| Rate for Payer: BCN Commercial |
$26.98
|
| Rate for Payer: Cash Price |
$27.84
|
| Rate for Payer: Cofinity Commercial |
$32.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.84
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Healthscope Whirlpool |
$33.76
|
| Rate for Payer: Mclaren Commercial |
$31.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.67
|
| Rate for Payer: Priority Health Narrow Network |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.62
|
|
|
HC APPLICATION OF TOPICAL FLUORIDE VARNISH BY PHYS/QHP
|
Facility
|
IP
|
$34.80
|
|
|
Service Code
|
CPT 99188
|
| Hospital Charge Code |
51000097
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$34.80 |
| Rate for Payer: Aetna Commercial |
$31.32
|
| Rate for Payer: ASR ASR |
$33.76
|
| Rate for Payer: BCBS Trust/PPO |
$26.98
|
| Rate for Payer: BCN Commercial |
$26.98
|
| Rate for Payer: Cash Price |
$27.84
|
| Rate for Payer: Cofinity Commercial |
$32.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.84
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Healthscope Whirlpool |
$33.76
|
| Rate for Payer: Mclaren Commercial |
$31.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.62
|
|
|
HC APPLICATION ON-BODY INJECTOR
|
Facility
|
OP
|
$146.85
|
|
|
Service Code
|
CPT 96377
|
| Hospital Charge Code |
76100069
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$23.09 |
| Max. Negotiated Rate |
$146.85 |
| Rate for Payer: Aetna Commercial |
$132.16
|
| Rate for Payer: Aetna Medicare |
$42.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.78
|
| Rate for Payer: ASR ASR |
$142.44
|
| Rate for Payer: BCBS Complete |
$24.25
|
| Rate for Payer: BCBS MAPPO |
$42.22
|
| Rate for Payer: BCBS Trust/PPO |
$113.85
|
| Rate for Payer: BCN Commercial |
$113.85
|
| Rate for Payer: BCN Medicare Advantage |
$42.22
|
| Rate for Payer: Cash Price |
$117.48
|
| Rate for Payer: Cash Price |
$117.48
|
| Rate for Payer: Cofinity Commercial |
$138.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.22
|
| Rate for Payer: Healthscope Commercial |
$146.85
|
| Rate for Payer: Healthscope Whirlpool |
$142.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$42.22
|
| Rate for Payer: Mclaren Commercial |
$132.16
|
| Rate for Payer: Mclaren Medicaid |
$23.09
|
| Rate for Payer: Mclaren Medicare |
$42.22
|
| Rate for Payer: Meridian Medicaid |
$24.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.82
|
| Rate for Payer: PACE Medicare |
$40.11
|
| Rate for Payer: PACE SWMI |
$42.22
|
| Rate for Payer: PHP Commercial |
$46.44
|
| Rate for Payer: PHP Medicaid |
$23.09
|
| Rate for Payer: PHP Medicare Advantage |
$42.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.63
|
| Rate for Payer: Priority Health Medicare |
$42.22
|
| Rate for Payer: Priority Health Narrow Network |
$104.26
|
| Rate for Payer: Railroad Medicare Medicare |
$42.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.23
|
| Rate for Payer: UHC Medicare Advantage |
$43.49
|
| Rate for Payer: VA VA |
$42.22
|
|
|
HC APPLICATION ON-BODY INJECTOR
|
Facility
|
IP
|
$146.85
|
|
|
Service Code
|
CPT 96377
|
| Hospital Charge Code |
76100069
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.80 |
| Max. Negotiated Rate |
$146.85 |
| Rate for Payer: Aetna Commercial |
$132.16
|
| Rate for Payer: ASR ASR |
$142.44
|
| Rate for Payer: BCBS Trust/PPO |
$113.85
|
| Rate for Payer: BCN Commercial |
$113.85
|
| Rate for Payer: Cash Price |
$117.48
|
| Rate for Payer: Cofinity Commercial |
$138.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.48
|
| Rate for Payer: Healthscope Commercial |
$146.85
|
| Rate for Payer: Healthscope Whirlpool |
$142.44
|
| Rate for Payer: Mclaren Commercial |
$132.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.23
|
|
|
HC APPLY HC SKIN SUB 1ST 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$1,909.32
|
|
|
Service Code
|
CPT 15277
|
| Hospital Charge Code |
76100063
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,336.52 |
| Max. Negotiated Rate |
$1,909.32 |
| Rate for Payer: Aetna Commercial |
$1,718.39
|
| Rate for Payer: ASR ASR |
$1,852.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
| Rate for Payer: BCN Commercial |
$1,480.30
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cofinity Commercial |
$1,794.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,527.46
|
| Rate for Payer: Healthscope Commercial |
$1,909.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,852.04
|
| Rate for Payer: Mclaren Commercial |
$1,718.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,622.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,680.20
|
|
|
HC APPLY HC SKIN SUB 1ST 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$1,909.32
|
|
|
Service Code
|
CPT 15277
|
| Hospital Charge Code |
76100063
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$886.68 |
| Max. Negotiated Rate |
$2,026.22 |
| Rate for Payer: Aetna Commercial |
$1,718.39
|
| Rate for Payer: Aetna Medicare |
$1,620.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: ASR ASR |
$1,852.04
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.30
|
| Rate for Payer: BCN Commercial |
$1,480.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cofinity Commercial |
$1,794.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,527.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$1,909.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,852.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,620.98
|
| Rate for Payer: Mclaren Commercial |
$1,718.39
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,622.92
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,783.08
|
| Rate for Payer: PHP Medicaid |
$886.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,737.48
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,355.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,680.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
HC APPLY HC SKIN SUB 1ST 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$2,520.30
|
|
|
Service Code
|
CPT 15273
|
| Hospital Charge Code |
76100059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,764.21 |
| Max. Negotiated Rate |
$2,520.30 |
| Rate for Payer: Aetna Commercial |
$2,268.27
|
| Rate for Payer: ASR ASR |
$2,444.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.99
|
| Rate for Payer: BCN Commercial |
$1,953.99
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$2,369.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,016.24
|
| Rate for Payer: Healthscope Commercial |
$2,520.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,444.69
|
| Rate for Payer: Mclaren Commercial |
$2,268.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,142.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,217.86
|
|
|
HC APPLY HC SKIN SUB 1ST 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$2,520.30
|
|
|
Service Code
|
CPT 15273
|
| Hospital Charge Code |
76100059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,744.36 |
| Max. Negotiated Rate |
$3,986.20 |
| Rate for Payer: Aetna Commercial |
$2,268.27
|
| Rate for Payer: Aetna Medicare |
$3,188.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,986.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,986.20
|
| Rate for Payer: ASR ASR |
$2,444.69
|
| Rate for Payer: BCBS Complete |
$1,831.74
|
| Rate for Payer: BCBS MAPPO |
$3,188.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.99
|
| Rate for Payer: BCN Commercial |
$1,953.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,188.96
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$2,369.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,016.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,188.96
|
| Rate for Payer: Healthscope Commercial |
$2,520.30
|
| Rate for Payer: Healthscope Whirlpool |
$2,444.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,188.96
|
| Rate for Payer: Mclaren Commercial |
$2,268.27
|
| Rate for Payer: Mclaren Medicaid |
$1,744.36
|
| Rate for Payer: Mclaren Medicare |
$3,188.96
|
| Rate for Payer: Meridian Medicaid |
$1,831.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,348.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,667.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,142.26
|
| Rate for Payer: PACE Medicare |
$3,029.51
|
| Rate for Payer: PACE SWMI |
$3,188.96
|
| Rate for Payer: PHP Commercial |
$3,507.86
|
| Rate for Payer: PHP Medicaid |
$1,744.36
|
| Rate for Payer: PHP Medicare Advantage |
$3,188.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,744.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,293.47
|
| Rate for Payer: Priority Health Medicare |
$3,188.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,789.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,188.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,217.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,284.63
|
| Rate for Payer: VA VA |
$3,188.96
|
|
|
HC APPLY HC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$2,553.43
|
|
|
Service Code
|
CPT 15275
|
| Hospital Charge Code |
76100061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,787.40 |
| Max. Negotiated Rate |
$2,553.43 |
| Rate for Payer: Aetna Commercial |
$2,298.09
|
| Rate for Payer: ASR ASR |
$2,476.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.67
|
| Rate for Payer: BCN Commercial |
$1,979.67
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$2,400.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Healthscope Commercial |
$2,553.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,476.83
|
| Rate for Payer: Mclaren Commercial |
$2,298.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,247.02
|
|
|
HC APPLY HC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$2,553.43
|
|
|
Service Code
|
CPT 15275
|
| Hospital Charge Code |
76100061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$886.68 |
| Max. Negotiated Rate |
$2,553.43 |
| Rate for Payer: Aetna Commercial |
$2,298.09
|
| Rate for Payer: Aetna Medicare |
$1,620.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: ASR ASR |
$2,476.83
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.67
|
| Rate for Payer: BCN Commercial |
$1,979.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$2,400.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$2,553.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,476.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,620.98
|
| Rate for Payer: Mclaren Commercial |
$2,298.09
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,783.08
|
| Rate for Payer: PHP Medicaid |
$886.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,323.62
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,812.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,247.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
