|
PR INCISION BONE CORTEX SHOULDER AREA
|
Professional
|
Both
|
$1,359.00
|
|
|
Service Code
|
HCPCS 23035
|
| Min. Negotiated Rate |
$543.60 |
| Max. Negotiated Rate |
$947.04 |
| Rate for Payer: Aetna Commercial |
$881.28
|
| Rate for Payer: Aetna Medicare |
$657.67
|
| Rate for Payer: BCBS Complete |
$543.60
|
| Rate for Payer: BCBS MAPPO |
$657.67
|
| Rate for Payer: BCN Medicare Advantage |
$657.67
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cofinity Commercial |
$947.04
|
| Rate for Payer: Cofinity Commercial |
$881.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.67
|
| Rate for Payer: Healthscope Commercial |
$789.20
|
| Rate for Payer: Healthscope Whirlpool |
$789.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.55
|
| Rate for Payer: Nomi Health Commercial |
$789.20
|
| Rate for Payer: PACE SWMI |
$657.67
|
| Rate for Payer: PHP Medicare Advantage |
$657.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$883.35
|
| Rate for Payer: Priority Health Medicare |
$657.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.67
|
| Rate for Payer: UHC Medicare Advantage |
$657.67
|
| Rate for Payer: UHCCP DNSP |
$657.67
|
|
|
PR INCISION DEEP BONE CORTEX FOREARM&/WRIST
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 25035
|
| Min. Negotiated Rate |
$571.26 |
| Max. Negotiated Rate |
$1,060.80 |
| Rate for Payer: Aetna Commercial |
$765.49
|
| Rate for Payer: Aetna Medicare |
$571.26
|
| Rate for Payer: BCBS Complete |
$652.80
|
| Rate for Payer: BCBS MAPPO |
$571.26
|
| Rate for Payer: BCN Medicare Advantage |
$571.26
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$822.61
|
| Rate for Payer: Cofinity Commercial |
$765.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.26
|
| Rate for Payer: Healthscope Commercial |
$685.51
|
| Rate for Payer: Healthscope Whirlpool |
$685.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.82
|
| Rate for Payer: Nomi Health Commercial |
$685.51
|
| Rate for Payer: PACE SWMI |
$571.26
|
| Rate for Payer: PHP Medicare Advantage |
$571.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,060.80
|
| Rate for Payer: Priority Health Medicare |
$571.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.26
|
| Rate for Payer: UHC Medicare Advantage |
$571.26
|
| Rate for Payer: UHCCP DNSP |
$571.26
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 10061
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Aetna Commercial |
$232.41
|
| Rate for Payer: Aetna Medicare |
$173.44
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$173.44
|
| Rate for Payer: BCN Medicare Advantage |
$173.44
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$249.75
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.44
|
| Rate for Payer: Healthscope Commercial |
$208.13
|
| Rate for Payer: Healthscope Whirlpool |
$208.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.11
|
| Rate for Payer: Nomi Health Commercial |
$208.13
|
| Rate for Payer: PACE SWMI |
$173.44
|
| Rate for Payer: PHP Medicare Advantage |
$173.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$173.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.44
|
| Rate for Payer: UHC Medicare Advantage |
$173.44
|
| Rate for Payer: UHCCP DNSP |
$173.44
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
10061
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Aetna Commercial |
$232.41
|
| Rate for Payer: Aetna Medicare |
$173.44
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$173.44
|
| Rate for Payer: BCN Medicare Advantage |
$173.44
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$249.75
|
| Rate for Payer: Cofinity Commercial |
$232.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.44
|
| Rate for Payer: Healthscope Commercial |
$208.13
|
| Rate for Payer: Healthscope Whirlpool |
$208.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.11
|
| Rate for Payer: Nomi Health Commercial |
$208.13
|
| Rate for Payer: PACE SWMI |
$173.44
|
| Rate for Payer: PHP Medicare Advantage |
$173.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$173.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.44
|
| Rate for Payer: UHC Medicare Advantage |
$173.44
|
| Rate for Payer: UHCCP DNSP |
$173.44
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
10061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$330.30
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$355.99
|
| Rate for Payer: ASR Commercial |
$355.99
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$300.54
|
| Rate for Payer: BCN Commercial |
$284.54
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$344.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$367.00
|
| Rate for Payer: Healthscope Whirlpool |
$355.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$330.30
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.95
|
| Rate for Payer: Nomi Health Commercial |
$300.94
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.57
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$257.27
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
10061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$238.55 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna Commercial |
$330.30
|
| Rate for Payer: ASR ASR |
$355.99
|
| Rate for Payer: ASR Commercial |
$355.99
|
| Rate for Payer: BCBS Trust/PPO |
$299.07
|
| Rate for Payer: BCN Commercial |
$284.54
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$344.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.60
|
| Rate for Payer: Healthscope Commercial |
$367.00
|
| Rate for Payer: Healthscope Whirlpool |
$355.99
|
| Rate for Payer: Mclaren Commercial |
$330.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.95
|
| Rate for Payer: Nomi Health Commercial |
$300.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.96
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 10060
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$144.13 |
| Rate for Payer: Aetna Commercial |
$134.12
|
| Rate for Payer: Aetna Medicare |
$100.09
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$100.09
|
| Rate for Payer: BCN Medicare Advantage |
$100.09
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$144.13
|
| Rate for Payer: Cofinity Commercial |
$134.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.09
|
| Rate for Payer: Healthscope Commercial |
$120.11
|
| Rate for Payer: Healthscope Whirlpool |
$120.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.09
|
| Rate for Payer: Nomi Health Commercial |
$120.11
|
| Rate for Payer: PACE SWMI |
$100.09
|
| Rate for Payer: PHP Medicare Advantage |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$100.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.09
|
| Rate for Payer: UHC Medicare Advantage |
$100.09
|
| Rate for Payer: UHCCP DNSP |
$100.09
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Trust/PPO |
$149.94
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
10060
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$165.60
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$178.48
|
| Rate for Payer: ASR Commercial |
$178.48
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$150.68
|
| Rate for Payer: BCN Commercial |
$142.66
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$172.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$184.00
|
| Rate for Payer: Healthscope Whirlpool |
$178.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$165.60
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.40
|
| Rate for Payer: Nomi Health Commercial |
$150.88
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.22
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$128.98
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
10060
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$144.13 |
| Rate for Payer: Aetna Commercial |
$134.12
|
| Rate for Payer: Aetna Medicare |
$100.09
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS MAPPO |
$100.09
|
| Rate for Payer: BCN Medicare Advantage |
$100.09
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$144.13
|
| Rate for Payer: Cofinity Commercial |
$134.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.09
|
| Rate for Payer: Healthscope Commercial |
$120.11
|
| Rate for Payer: Healthscope Whirlpool |
$120.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.09
|
| Rate for Payer: Nomi Health Commercial |
$120.11
|
| Rate for Payer: PACE SWMI |
$100.09
|
| Rate for Payer: PHP Medicare Advantage |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Medicare |
$100.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.09
|
| Rate for Payer: UHC Medicare Advantage |
$100.09
|
| Rate for Payer: UHCCP DNSP |
$100.09
|
|
|
PR INCISION&DRAINAGE BURSA FOOT
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 28001
|
| Min. Negotiated Rate |
$91.98 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$123.25
|
| Rate for Payer: Aetna Medicare |
$91.98
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$91.98
|
| Rate for Payer: BCN Medicare Advantage |
$91.98
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$132.45
|
| Rate for Payer: Cofinity Commercial |
$123.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.98
|
| Rate for Payer: Healthscope Commercial |
$110.38
|
| Rate for Payer: Healthscope Whirlpool |
$110.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.58
|
| Rate for Payer: Nomi Health Commercial |
$110.38
|
| Rate for Payer: PACE SWMI |
$91.98
|
| Rate for Payer: PHP Medicare Advantage |
$91.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$91.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.98
|
| Rate for Payer: UHC Medicare Advantage |
$91.98
|
| Rate for Payer: UHCCP DNSP |
$91.98
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$437.45 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$605.70
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$652.81
|
| Rate for Payer: ASR Commercial |
$652.81
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$551.12
|
| Rate for Payer: BCN Commercial |
$521.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$632.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$673.00
|
| Rate for Payer: Healthscope Whirlpool |
$652.81
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$605.70
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: Nomi Health Commercial |
$551.86
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.68
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$471.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
10180
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$437.45 |
| Max. Negotiated Rate |
$673.00 |
| Rate for Payer: Aetna Commercial |
$605.70
|
| Rate for Payer: ASR ASR |
$652.81
|
| Rate for Payer: ASR Commercial |
$652.81
|
| Rate for Payer: BCBS Trust/PPO |
$548.43
|
| Rate for Payer: BCN Commercial |
$521.78
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$632.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.40
|
| Rate for Payer: Healthscope Commercial |
$673.00
|
| Rate for Payer: Healthscope Whirlpool |
$652.81
|
| Rate for Payer: Mclaren Commercial |
$605.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.05
|
| Rate for Payer: Nomi Health Commercial |
$551.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$592.24
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 10180
|
| Hospital Charge Code |
10180
|
| Min. Negotiated Rate |
$171.33 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Commercial |
$229.58
|
| Rate for Payer: Aetna Medicare |
$171.33
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: BCBS MAPPO |
$171.33
|
| Rate for Payer: BCN Medicare Advantage |
$171.33
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Cofinity Commercial |
$229.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.33
|
| Rate for Payer: Healthscope Commercial |
$205.60
|
| Rate for Payer: Healthscope Whirlpool |
$205.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.90
|
| Rate for Payer: Nomi Health Commercial |
$205.60
|
| Rate for Payer: PACE SWMI |
$171.33
|
| Rate for Payer: PHP Medicare Advantage |
$171.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health Medicare |
$171.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.33
|
| Rate for Payer: UHC Medicare Advantage |
$171.33
|
| Rate for Payer: UHCCP DNSP |
$171.33
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 10180
|
| Min. Negotiated Rate |
$171.33 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Commercial |
$229.58
|
| Rate for Payer: Aetna Medicare |
$171.33
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: BCBS MAPPO |
$171.33
|
| Rate for Payer: BCN Medicare Advantage |
$171.33
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Cofinity Commercial |
$229.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.33
|
| Rate for Payer: Healthscope Commercial |
$205.60
|
| Rate for Payer: Healthscope Whirlpool |
$205.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.90
|
| Rate for Payer: Nomi Health Commercial |
$205.60
|
| Rate for Payer: PACE SWMI |
$171.33
|
| Rate for Payer: PHP Medicare Advantage |
$171.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health Medicare |
$171.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.33
|
| Rate for Payer: UHC Medicare Advantage |
$171.33
|
| Rate for Payer: UHCCP DNSP |
$171.33
|
|
|
PR INCISION & DRAINAGE FOREARM&/WRIST BURSA
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 25031
|
| Min. Negotiated Rate |
$291.60 |
| Max. Negotiated Rate |
$514.99 |
| Rate for Payer: Aetna Commercial |
$479.22
|
| Rate for Payer: Aetna Medicare |
$357.63
|
| Rate for Payer: BCBS Complete |
$291.60
|
| Rate for Payer: BCBS MAPPO |
$357.63
|
| Rate for Payer: BCN Medicare Advantage |
$357.63
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$514.99
|
| Rate for Payer: Cofinity Commercial |
$479.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.63
|
| Rate for Payer: Healthscope Commercial |
$429.16
|
| Rate for Payer: Healthscope Whirlpool |
$429.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.51
|
| Rate for Payer: Nomi Health Commercial |
$429.16
|
| Rate for Payer: PACE SWMI |
$357.63
|
| Rate for Payer: PHP Medicare Advantage |
$357.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.85
|
| Rate for Payer: Priority Health Medicare |
$357.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.63
|
| Rate for Payer: UHC Medicare Advantage |
$357.63
|
| Rate for Payer: UHCCP DNSP |
$357.63
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 27603
|
| Min. Negotiated Rate |
$371.50 |
| Max. Negotiated Rate |
$741.00 |
| Rate for Payer: Aetna Commercial |
$497.81
|
| Rate for Payer: Aetna Medicare |
$371.50
|
| Rate for Payer: BCBS Complete |
$456.00
|
| Rate for Payer: BCBS MAPPO |
$371.50
|
| Rate for Payer: BCN Medicare Advantage |
$371.50
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$534.96
|
| Rate for Payer: Cofinity Commercial |
$497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.50
|
| Rate for Payer: Healthscope Commercial |
$445.80
|
| Rate for Payer: Healthscope Whirlpool |
$445.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.07
|
| Rate for Payer: Nomi Health Commercial |
$445.80
|
| Rate for Payer: PACE SWMI |
$371.50
|
| Rate for Payer: PHP Medicare Advantage |
$371.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health Medicare |
$371.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.50
|
| Rate for Payer: UHC Medicare Advantage |
$371.50
|
| Rate for Payer: UHCCP DNSP |
$371.50
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 27604
|
| Min. Negotiated Rate |
$319.47 |
| Max. Negotiated Rate |
$577.20 |
| Rate for Payer: Aetna Commercial |
$428.09
|
| Rate for Payer: Aetna Medicare |
$319.47
|
| Rate for Payer: BCBS Complete |
$355.20
|
| Rate for Payer: BCBS MAPPO |
$319.47
|
| Rate for Payer: BCN Medicare Advantage |
$319.47
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$460.04
|
| Rate for Payer: Cofinity Commercial |
$428.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.47
|
| Rate for Payer: Healthscope Commercial |
$383.36
|
| Rate for Payer: Healthscope Whirlpool |
$383.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.44
|
| Rate for Payer: Nomi Health Commercial |
$383.36
|
| Rate for Payer: PACE SWMI |
$319.47
|
| Rate for Payer: PHP Medicare Advantage |
$319.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.20
|
| Rate for Payer: Priority Health Medicare |
$319.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.47
|
| Rate for Payer: UHC Medicare Advantage |
$319.47
|
| Rate for Payer: UHCCP DNSP |
$319.47
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 10081
|
| Min. Negotiated Rate |
$164.08 |
| Max. Negotiated Rate |
$295.10 |
| Rate for Payer: Aetna Commercial |
$219.87
|
| Rate for Payer: Aetna Medicare |
$164.08
|
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: BCBS MAPPO |
$164.08
|
| Rate for Payer: BCN Medicare Advantage |
$164.08
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Commercial |
$236.28
|
| Rate for Payer: Cofinity Commercial |
$219.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.08
|
| Rate for Payer: Healthscope Commercial |
$196.90
|
| Rate for Payer: Healthscope Whirlpool |
$196.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.28
|
| Rate for Payer: Nomi Health Commercial |
$196.90
|
| Rate for Payer: PACE SWMI |
$164.08
|
| Rate for Payer: PHP Medicare Advantage |
$164.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.10
|
| Rate for Payer: Priority Health Medicare |
$164.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.08
|
| Rate for Payer: UHC Medicare Advantage |
$164.08
|
| Rate for Payer: UHCCP DNSP |
$164.08
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 10080
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$203.45 |
| Rate for Payer: Aetna Commercial |
$132.94
|
| Rate for Payer: Aetna Medicare |
$99.21
|
| Rate for Payer: BCBS Complete |
$125.20
|
| Rate for Payer: BCBS MAPPO |
$99.21
|
| Rate for Payer: BCN Medicare Advantage |
$99.21
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$142.86
|
| Rate for Payer: Cofinity Commercial |
$132.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.21
|
| Rate for Payer: Healthscope Commercial |
$119.05
|
| Rate for Payer: Healthscope Whirlpool |
$119.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.17
|
| Rate for Payer: Nomi Health Commercial |
$119.05
|
| Rate for Payer: PACE SWMI |
$99.21
|
| Rate for Payer: PHP Medicare Advantage |
$99.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.45
|
| Rate for Payer: Priority Health Medicare |
$99.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.21
|
| Rate for Payer: UHC Medicare Advantage |
$99.21
|
| Rate for Payer: UHCCP DNSP |
$99.21
|
|
|
PR INCISION&DRAINAGE UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$742.00
|
|
|
Service Code
|
HCPCS 23931
|
| Min. Negotiated Rate |
$153.83 |
| Max. Negotiated Rate |
$482.30 |
| Rate for Payer: Aetna Commercial |
$206.13
|
| Rate for Payer: Aetna Medicare |
$153.83
|
| Rate for Payer: BCBS Complete |
$296.80
|
| Rate for Payer: BCBS MAPPO |
$153.83
|
| Rate for Payer: BCN Medicare Advantage |
$153.83
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cash Price |
$593.60
|
| Rate for Payer: Cofinity Commercial |
$221.52
|
| Rate for Payer: Cofinity Commercial |
$206.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.83
|
| Rate for Payer: Healthscope Commercial |
$184.60
|
| Rate for Payer: Healthscope Whirlpool |
$184.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.52
|
| Rate for Payer: Nomi Health Commercial |
$184.60
|
| Rate for Payer: PACE SWMI |
$153.83
|
| Rate for Payer: PHP Medicare Advantage |
$153.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$482.30
|
| Rate for Payer: Priority Health Medicare |
$153.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.83
|
| Rate for Payer: UHC Medicare Advantage |
$153.83
|
| Rate for Payer: UHCCP DNSP |
$153.83
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
25000
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$1,175.00 |
| Rate for Payer: Aetna Commercial |
$1,057.50
|
| Rate for Payer: ASR ASR |
$1,139.75
|
| Rate for Payer: ASR Commercial |
$1,139.75
|
| Rate for Payer: BCBS Trust/PPO |
$957.51
|
| Rate for Payer: BCN Commercial |
$910.98
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Healthscope Commercial |
$1,175.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.75
|
| Rate for Payer: Mclaren Commercial |
$1,057.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.00
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25000
|
| Hospital Charge Code |
25000
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$447.25
|
| Rate for Payer: Aetna Medicare |
$333.77
|
| Rate for Payer: BCBS Complete |
$470.00
|
| Rate for Payer: BCBS MAPPO |
$333.77
|
| Rate for Payer: BCN Medicare Advantage |
$333.77
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$480.63
|
| Rate for Payer: Cofinity Commercial |
$447.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.77
|
| Rate for Payer: Healthscope Commercial |
$400.52
|
| Rate for Payer: Healthscope Whirlpool |
$400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.46
|
| Rate for Payer: Nomi Health Commercial |
$400.52
|
| Rate for Payer: PACE SWMI |
$333.77
|
| Rate for Payer: PHP Medicare Advantage |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health Medicare |
$333.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.77
|
| Rate for Payer: UHC Medicare Advantage |
$333.77
|
| Rate for Payer: UHCCP DNSP |
$333.77
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
25000
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$2,419.32 |
| Rate for Payer: Aetna Commercial |
$1,057.50
|
| Rate for Payer: Aetna Medicare |
$1,560.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: ASR ASR |
$1,139.75
|
| Rate for Payer: ASR Commercial |
$1,139.75
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCBS Trust/PPO |
$962.21
|
| Rate for Payer: BCN Commercial |
$910.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$1,175.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,560.85
|
| Rate for Payer: Mclaren Commercial |
$1,057.50
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$1,716.93
|
| Rate for Payer: PHP Medicaid |
$836.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.54
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health Narrow Network |
$823.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,419.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP DNSP |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: VA VA |
$1,560.85
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25000
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$447.25
|
| Rate for Payer: Aetna Medicare |
$333.77
|
| Rate for Payer: BCBS Complete |
$470.00
|
| Rate for Payer: BCBS MAPPO |
$333.77
|
| Rate for Payer: BCN Medicare Advantage |
$333.77
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$480.63
|
| Rate for Payer: Cofinity Commercial |
$447.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.77
|
| Rate for Payer: Healthscope Commercial |
$400.52
|
| Rate for Payer: Healthscope Whirlpool |
$400.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.46
|
| Rate for Payer: Nomi Health Commercial |
$400.52
|
| Rate for Payer: PACE SWMI |
$333.77
|
| Rate for Payer: PHP Medicare Advantage |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health Medicare |
$333.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.77
|
| Rate for Payer: UHC Medicare Advantage |
$333.77
|
| Rate for Payer: UHCCP DNSP |
$333.77
|
|
