|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
IP
|
$864.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$561.60 |
| Max. Negotiated Rate |
$864.00 |
| Rate for Payer: Aetna Commercial |
$777.60
|
| Rate for Payer: ASR ASR |
$838.08
|
| Rate for Payer: ASR Commercial |
$838.08
|
| Rate for Payer: BCBS Trust/PPO |
$704.07
|
| Rate for Payer: BCN Commercial |
$669.86
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$812.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.20
|
| Rate for Payer: Healthscope Commercial |
$864.00
|
| Rate for Payer: Healthscope Whirlpool |
$838.08
|
| Rate for Payer: Mclaren Commercial |
$777.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.40
|
| Rate for Payer: Nomi Health Commercial |
$708.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.32
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 49550
|
| Hospital Charge Code |
49550
|
| Min. Negotiated Rate |
$345.60 |
| Max. Negotiated Rate |
$812.40 |
| Rate for Payer: Aetna Commercial |
$755.99
|
| Rate for Payer: Aetna Medicare |
$564.17
|
| Rate for Payer: BCBS Complete |
$345.60
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$812.40
|
| Rate for Payer: Cofinity Commercial |
$755.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Healthscope Commercial |
$677.00
|
| Rate for Payer: Healthscope Whirlpool |
$677.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Nomi Health Commercial |
$677.00
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP DNSP |
$564.17
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 49550
|
| Min. Negotiated Rate |
$345.60 |
| Max. Negotiated Rate |
$812.40 |
| Rate for Payer: Aetna Commercial |
$755.99
|
| Rate for Payer: Aetna Medicare |
$564.17
|
| Rate for Payer: BCBS Complete |
$345.60
|
| Rate for Payer: BCBS MAPPO |
$564.17
|
| Rate for Payer: BCN Medicare Advantage |
$564.17
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$812.40
|
| Rate for Payer: Cofinity Commercial |
$755.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.17
|
| Rate for Payer: Healthscope Commercial |
$677.00
|
| Rate for Payer: Healthscope Whirlpool |
$677.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.38
|
| Rate for Payer: Nomi Health Commercial |
$677.00
|
| Rate for Payer: PACE SWMI |
$564.17
|
| Rate for Payer: PHP Medicare Advantage |
$564.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health Medicare |
$564.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.17
|
| Rate for Payer: UHC Medicare Advantage |
$564.17
|
| Rate for Payer: UHCCP DNSP |
$564.17
|
|
|
PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$864.00
|
|
|
Service Code
|
CPT 49550
|
| Hospital Charge Code |
49550
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$561.60 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$777.60
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$838.08
|
| Rate for Payer: ASR Commercial |
$838.08
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$707.53
|
| Rate for Payer: BCN Commercial |
$669.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$812.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$864.00
|
| Rate for Payer: Healthscope Whirlpool |
$838.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$777.60
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.40
|
| Rate for Payer: Nomi Health Commercial |
$708.48
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$757.04
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$605.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR RPR 1ST INCAL/VNT HERNIA INCARCERATED
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 49561
|
| Min. Negotiated Rate |
$897.20 |
| Max. Negotiated Rate |
$1,457.95 |
| Rate for Payer: Aetna Medicare |
$1,121.50
|
| Rate for Payer: BCBS Complete |
$897.20
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49507
|
| Hospital Charge Code |
49507
|
| Min. Negotiated Rate |
$572.41 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$767.03
|
| Rate for Payer: Aetna Medicare |
$572.41
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$572.41
|
| Rate for Payer: BCN Medicare Advantage |
$572.41
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$824.27
|
| Rate for Payer: Cofinity Commercial |
$767.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.41
|
| Rate for Payer: Healthscope Commercial |
$686.89
|
| Rate for Payer: Healthscope Whirlpool |
$686.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.03
|
| Rate for Payer: Nomi Health Commercial |
$686.89
|
| Rate for Payer: PACE SWMI |
$572.41
|
| Rate for Payer: PHP Medicare Advantage |
$572.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$572.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.41
|
| Rate for Payer: UHC Medicare Advantage |
$572.41
|
| Rate for Payer: UHCCP DNSP |
$572.41
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$1,498.50
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$1,615.05
|
| Rate for Payer: ASR Commercial |
$1,615.05
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.47
|
| Rate for Payer: BCN Commercial |
$1,290.87
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,565.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,665.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,615.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$1,498.50
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$1,365.30
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,458.87
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,167.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,465.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49507
|
| Min. Negotiated Rate |
$572.41 |
| Max. Negotiated Rate |
$1,082.25 |
| Rate for Payer: Aetna Commercial |
$767.03
|
| Rate for Payer: Aetna Medicare |
$572.41
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$572.41
|
| Rate for Payer: BCN Medicare Advantage |
$572.41
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$824.27
|
| Rate for Payer: Cofinity Commercial |
$767.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.41
|
| Rate for Payer: Healthscope Commercial |
$686.89
|
| Rate for Payer: Healthscope Whirlpool |
$686.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.03
|
| Rate for Payer: Nomi Health Commercial |
$686.89
|
| Rate for Payer: PACE SWMI |
$572.41
|
| Rate for Payer: PHP Medicare Advantage |
$572.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$572.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.41
|
| Rate for Payer: UHC Medicare Advantage |
$572.41
|
| Rate for Payer: UHCCP DNSP |
$572.41
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 49507
|
| Hospital Charge Code |
49507
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,082.25 |
| Max. Negotiated Rate |
$1,665.00 |
| Rate for Payer: Aetna Commercial |
$1,498.50
|
| Rate for Payer: ASR ASR |
$1,615.05
|
| Rate for Payer: ASR Commercial |
$1,615.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,356.81
|
| Rate for Payer: BCN Commercial |
$1,290.87
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,565.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,332.00
|
| Rate for Payer: Healthscope Commercial |
$1,665.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,615.05
|
| Rate for Payer: Mclaren Commercial |
$1,498.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,415.25
|
| Rate for Payer: Nomi Health Commercial |
$1,365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,465.20
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 49505
|
| Min. Negotiated Rate |
$509.49 |
| Max. Negotiated Rate |
$1,097.20 |
| Rate for Payer: Aetna Commercial |
$682.72
|
| Rate for Payer: Aetna Medicare |
$509.49
|
| Rate for Payer: BCBS Complete |
$675.20
|
| Rate for Payer: BCBS MAPPO |
$509.49
|
| Rate for Payer: BCN Medicare Advantage |
$509.49
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$733.67
|
| Rate for Payer: Cofinity Commercial |
$682.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.49
|
| Rate for Payer: Healthscope Commercial |
$611.39
|
| Rate for Payer: Healthscope Whirlpool |
$611.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.96
|
| Rate for Payer: Nomi Health Commercial |
$611.39
|
| Rate for Payer: PACE SWMI |
$509.49
|
| Rate for Payer: PHP Medicare Advantage |
$509.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health Medicare |
$509.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.49
|
| Rate for Payer: UHC Medicare Advantage |
$509.49
|
| Rate for Payer: UHCCP DNSP |
$509.49
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 49505
|
| Hospital Charge Code |
49505
|
| Min. Negotiated Rate |
$509.49 |
| Max. Negotiated Rate |
$1,097.20 |
| Rate for Payer: Aetna Commercial |
$682.72
|
| Rate for Payer: Aetna Medicare |
$509.49
|
| Rate for Payer: BCBS Complete |
$675.20
|
| Rate for Payer: BCBS MAPPO |
$509.49
|
| Rate for Payer: BCN Medicare Advantage |
$509.49
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$733.67
|
| Rate for Payer: Cofinity Commercial |
$682.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.49
|
| Rate for Payer: Healthscope Commercial |
$611.39
|
| Rate for Payer: Healthscope Whirlpool |
$611.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.96
|
| Rate for Payer: Nomi Health Commercial |
$611.39
|
| Rate for Payer: PACE SWMI |
$509.49
|
| Rate for Payer: PHP Medicare Advantage |
$509.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health Medicare |
$509.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.49
|
| Rate for Payer: UHC Medicare Advantage |
$509.49
|
| Rate for Payer: UHCCP DNSP |
$509.49
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
IP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,097.20 |
| Max. Negotiated Rate |
$1,688.00 |
| Rate for Payer: Aetna Commercial |
$1,519.20
|
| Rate for Payer: ASR ASR |
$1,637.36
|
| Rate for Payer: ASR Commercial |
$1,637.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,375.55
|
| Rate for Payer: BCN Commercial |
$1,308.71
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,586.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Healthscope Commercial |
$1,688.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,637.36
|
| Rate for Payer: Mclaren Commercial |
$1,519.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: Nomi Health Commercial |
$1,384.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,485.44
|
|
|
PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE
|
Facility
|
OP
|
$1,688.00
|
|
|
Service Code
|
CPT 49505
|
| Hospital Charge Code |
49505
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,097.20 |
| Max. Negotiated Rate |
$5,334.82 |
| Rate for Payer: Aetna Commercial |
$1,519.20
|
| Rate for Payer: Aetna Medicare |
$3,441.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: ASR ASR |
$1,637.36
|
| Rate for Payer: ASR Commercial |
$1,637.36
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,382.30
|
| Rate for Payer: BCN Commercial |
$1,308.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$1,586.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$1,688.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,637.36
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,441.82
|
| Rate for Payer: Mclaren Commercial |
$1,519.20
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,434.80
|
| Rate for Payer: Nomi Health Commercial |
$1,384.16
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,786.00
|
| Rate for Payer: PHP Medicaid |
$1,844.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,479.03
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,183.29
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,485.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$5,334.82
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP DNSP |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: VA VA |
$3,441.82
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 49501
|
| Min. Negotiated Rate |
$592.06 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$793.36
|
| Rate for Payer: Aetna Medicare |
$592.06
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$592.06
|
| Rate for Payer: BCN Medicare Advantage |
$592.06
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Cofinity Commercial |
$793.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.06
|
| Rate for Payer: Healthscope Commercial |
$710.47
|
| Rate for Payer: Healthscope Whirlpool |
$710.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.66
|
| Rate for Payer: Nomi Health Commercial |
$710.47
|
| Rate for Payer: PACE SWMI |
$592.06
|
| Rate for Payer: PHP Medicare Advantage |
$592.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$592.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$592.06
|
| Rate for Payer: UHC Medicare Advantage |
$592.06
|
| Rate for Payer: UHCCP DNSP |
$592.06
|
|
|
PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,362.00
|
|
|
Service Code
|
HCPCS 49500
|
| Min. Negotiated Rate |
$404.10 |
| Max. Negotiated Rate |
$885.30 |
| Rate for Payer: Aetna Commercial |
$541.49
|
| Rate for Payer: Aetna Medicare |
$404.10
|
| Rate for Payer: BCBS Complete |
$544.80
|
| Rate for Payer: BCBS MAPPO |
$404.10
|
| Rate for Payer: BCN Medicare Advantage |
$404.10
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cofinity Commercial |
$581.90
|
| Rate for Payer: Cofinity Commercial |
$541.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.10
|
| Rate for Payer: Healthscope Commercial |
$484.92
|
| Rate for Payer: Healthscope Whirlpool |
$484.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.31
|
| Rate for Payer: Nomi Health Commercial |
$484.92
|
| Rate for Payer: PACE SWMI |
$404.10
|
| Rate for Payer: PHP Medicare Advantage |
$404.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.30
|
| Rate for Payer: Priority Health Medicare |
$404.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.10
|
| Rate for Payer: UHC Medicare Advantage |
$404.10
|
| Rate for Payer: UHCCP DNSP |
$404.10
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER
|
Professional
|
Both
|
$1,799.00
|
|
|
Service Code
|
HCPCS 49496
|
| Min. Negotiated Rate |
$600.19 |
| Max. Negotiated Rate |
$1,169.35 |
| Rate for Payer: Aetna Commercial |
$804.25
|
| Rate for Payer: Aetna Medicare |
$600.19
|
| Rate for Payer: BCBS Complete |
$719.60
|
| Rate for Payer: BCBS MAPPO |
$600.19
|
| Rate for Payer: BCN Medicare Advantage |
$600.19
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cash Price |
$1,439.20
|
| Rate for Payer: Cofinity Commercial |
$864.27
|
| Rate for Payer: Cofinity Commercial |
$804.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.19
|
| Rate for Payer: Healthscope Commercial |
$720.23
|
| Rate for Payer: Healthscope Whirlpool |
$720.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.20
|
| Rate for Payer: Nomi Health Commercial |
$720.23
|
| Rate for Payer: PACE SWMI |
$600.19
|
| Rate for Payer: PHP Medicare Advantage |
$600.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.35
|
| Rate for Payer: Priority Health Medicare |
$600.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.19
|
| Rate for Payer: UHC Medicare Advantage |
$600.19
|
| Rate for Payer: UHCCP DNSP |
$600.19
|
|
|
PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC
|
Professional
|
Both
|
$1,514.00
|
|
|
Service Code
|
HCPCS 49495
|
| Min. Negotiated Rate |
$399.00 |
| Max. Negotiated Rate |
$984.10 |
| Rate for Payer: Aetna Commercial |
$534.66
|
| Rate for Payer: Aetna Medicare |
$399.00
|
| Rate for Payer: BCBS Complete |
$605.60
|
| Rate for Payer: BCBS MAPPO |
$399.00
|
| Rate for Payer: BCN Medicare Advantage |
$399.00
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cash Price |
$1,211.20
|
| Rate for Payer: Cofinity Commercial |
$574.56
|
| Rate for Payer: Cofinity Commercial |
$534.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.00
|
| Rate for Payer: Healthscope Commercial |
$478.80
|
| Rate for Payer: Healthscope Whirlpool |
$478.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.95
|
| Rate for Payer: Nomi Health Commercial |
$478.80
|
| Rate for Payer: PACE SWMI |
$399.00
|
| Rate for Payer: PHP Medicare Advantage |
$399.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.10
|
| Rate for Payer: Priority Health Medicare |
$399.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.00
|
| Rate for Payer: UHC Medicare Advantage |
$399.00
|
| Rate for Payer: UHCCP DNSP |
$399.00
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED
|
Professional
|
Both
|
$1,899.00
|
|
|
Service Code
|
HCPCS 49492
|
| Min. Negotiated Rate |
$759.60 |
| Max. Negotiated Rate |
$1,346.20 |
| Rate for Payer: Aetna Commercial |
$1,252.71
|
| Rate for Payer: Aetna Medicare |
$934.86
|
| Rate for Payer: BCBS Complete |
$759.60
|
| Rate for Payer: BCBS MAPPO |
$934.86
|
| Rate for Payer: BCN Medicare Advantage |
$934.86
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cofinity Commercial |
$1,346.20
|
| Rate for Payer: Cofinity Commercial |
$1,252.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.86
|
| Rate for Payer: Healthscope Commercial |
$1,121.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,121.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.60
|
| Rate for Payer: Nomi Health Commercial |
$1,121.83
|
| Rate for Payer: PACE SWMI |
$934.86
|
| Rate for Payer: PHP Medicare Advantage |
$934.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.35
|
| Rate for Payer: Priority Health Medicare |
$934.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.86
|
| Rate for Payer: UHC Medicare Advantage |
$934.86
|
| Rate for Payer: UHCCP DNSP |
$934.86
|
|
|
PR RPR 1ST INGUN HRNA PRETERM INFT RDC
|
Professional
|
Both
|
$1,665.00
|
|
|
Service Code
|
HCPCS 49491
|
| Min. Negotiated Rate |
$666.00 |
| Max. Negotiated Rate |
$1,119.34 |
| Rate for Payer: Aetna Commercial |
$1,041.61
|
| Rate for Payer: Aetna Medicare |
$777.32
|
| Rate for Payer: BCBS Complete |
$666.00
|
| Rate for Payer: BCBS MAPPO |
$777.32
|
| Rate for Payer: BCN Medicare Advantage |
$777.32
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cash Price |
$1,332.00
|
| Rate for Payer: Cofinity Commercial |
$1,119.34
|
| Rate for Payer: Cofinity Commercial |
$1,041.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.32
|
| Rate for Payer: Healthscope Commercial |
$932.78
|
| Rate for Payer: Healthscope Whirlpool |
$932.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$816.19
|
| Rate for Payer: Nomi Health Commercial |
$932.78
|
| Rate for Payer: PACE SWMI |
$777.32
|
| Rate for Payer: PHP Medicare Advantage |
$777.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.25
|
| Rate for Payer: Priority Health Medicare |
$777.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.32
|
| Rate for Payer: UHC Medicare Advantage |
$777.32
|
| Rate for Payer: UHCCP DNSP |
$777.32
|
|
|
PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB
|
Professional
|
Both
|
$1,302.00
|
|
|
Service Code
|
HCPCS 33218
|
| Min. Negotiated Rate |
$368.12 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$493.28
|
| Rate for Payer: Aetna Medicare |
$368.12
|
| Rate for Payer: BCBS Complete |
$520.80
|
| Rate for Payer: BCBS MAPPO |
$368.12
|
| Rate for Payer: BCN Medicare Advantage |
$368.12
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cofinity Commercial |
$530.09
|
| Rate for Payer: Cofinity Commercial |
$493.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.12
|
| Rate for Payer: Healthscope Commercial |
$441.74
|
| Rate for Payer: Healthscope Whirlpool |
$441.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.53
|
| Rate for Payer: Nomi Health Commercial |
$441.74
|
| Rate for Payer: PACE SWMI |
$368.12
|
| Rate for Payer: PHP Medicare Advantage |
$368.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health Medicare |
$368.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$368.12
|
| Rate for Payer: UHC Medicare Advantage |
$368.12
|
| Rate for Payer: UHCCP DNSP |
$368.12
|
|
|
PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 33220
|
| Min. Negotiated Rate |
$361.79 |
| Max. Negotiated Rate |
$865.80 |
| Rate for Payer: Aetna Commercial |
$484.80
|
| Rate for Payer: Aetna Medicare |
$361.79
|
| Rate for Payer: BCBS Complete |
$532.80
|
| Rate for Payer: BCBS MAPPO |
$361.79
|
| Rate for Payer: BCN Medicare Advantage |
$361.79
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cofinity Commercial |
$520.98
|
| Rate for Payer: Cofinity Commercial |
$484.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.79
|
| Rate for Payer: Healthscope Commercial |
$434.15
|
| Rate for Payer: Healthscope Whirlpool |
$434.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.88
|
| Rate for Payer: Nomi Health Commercial |
$434.15
|
| Rate for Payer: PACE SWMI |
$361.79
|
| Rate for Payer: PHP Medicare Advantage |
$361.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.80
|
| Rate for Payer: Priority Health Medicare |
$361.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.79
|
| Rate for Payer: UHC Medicare Advantage |
$361.79
|
| Rate for Payer: UHCCP DNSP |
$361.79
|
|
|
PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,565.00
|
|
|
Service Code
|
HCPCS 49596
|
| Min. Negotiated Rate |
$626.00 |
| Max. Negotiated Rate |
$1,444.00 |
| Rate for Payer: Aetna Commercial |
$1,343.73
|
| Rate for Payer: Aetna Medicare |
$1,002.78
|
| Rate for Payer: BCBS Complete |
$626.00
|
| Rate for Payer: BCBS MAPPO |
$1,002.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,002.78
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,444.00
|
| Rate for Payer: Cofinity Commercial |
$1,343.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,002.78
|
| Rate for Payer: Healthscope Commercial |
$1,203.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,203.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,052.92
|
| Rate for Payer: Nomi Health Commercial |
$1,203.34
|
| Rate for Payer: PACE SWMI |
$1,002.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,002.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.25
|
| Rate for Payer: Priority Health Medicare |
$1,002.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,002.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,002.78
|
| Rate for Payer: UHCCP DNSP |
$1,002.78
|
|
|
PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 49595
|
| Min. Negotiated Rate |
$634.40 |
| Max. Negotiated Rate |
$1,086.52 |
| Rate for Payer: Aetna Commercial |
$1,011.07
|
| Rate for Payer: Aetna Medicare |
$754.53
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$754.53
|
| Rate for Payer: BCN Medicare Advantage |
$754.53
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$1,086.52
|
| Rate for Payer: Cofinity Commercial |
$1,011.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$754.53
|
| Rate for Payer: Healthscope Commercial |
$905.44
|
| Rate for Payer: Healthscope Whirlpool |
$905.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$792.26
|
| Rate for Payer: Nomi Health Commercial |
$905.44
|
| Rate for Payer: PACE SWMI |
$754.53
|
| Rate for Payer: PHP Medicare Advantage |
$754.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$754.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$754.53
|
| Rate for Payer: UHC Medicare Advantage |
$754.53
|
| Rate for Payer: UHCCP DNSP |
$754.53
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Professional
|
Both
|
$1,855.00
|
|
|
Service Code
|
HCPCS 49594
|
| Min. Negotiated Rate |
$728.48 |
| Max. Negotiated Rate |
$1,205.75 |
| Rate for Payer: Aetna Commercial |
$976.16
|
| Rate for Payer: Aetna Medicare |
$728.48
|
| Rate for Payer: BCBS Complete |
$742.00
|
| Rate for Payer: BCBS MAPPO |
$728.48
|
| Rate for Payer: BCN Medicare Advantage |
$728.48
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$976.16
|
| Rate for Payer: Cofinity Commercial |
$1,049.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.48
|
| Rate for Payer: Healthscope Commercial |
$874.18
|
| Rate for Payer: Healthscope Whirlpool |
$874.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.90
|
| Rate for Payer: Nomi Health Commercial |
$874.18
|
| Rate for Payer: PACE SWMI |
$728.48
|
| Rate for Payer: PHP Medicare Advantage |
$728.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health Medicare |
$728.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.48
|
| Rate for Payer: UHC Medicare Advantage |
$728.48
|
| Rate for Payer: UHCCP DNSP |
$728.48
|
|
|
PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED
|
Facility
|
OP
|
$1,855.00
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
49594
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,205.75 |
| Max. Negotiated Rate |
$8,819.70 |
| Rate for Payer: Aetna Commercial |
$1,669.50
|
| Rate for Payer: Aetna Medicare |
$5,690.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: ASR ASR |
$1,799.35
|
| Rate for Payer: ASR Commercial |
$1,799.35
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,519.06
|
| Rate for Payer: BCN Commercial |
$1,438.18
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cash Price |
$1,484.00
|
| Rate for Payer: Cofinity Commercial |
$1,743.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$1,855.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,799.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,690.13
|
| Rate for Payer: Mclaren Commercial |
$1,669.50
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,576.75
|
| Rate for Payer: Nomi Health Commercial |
$1,521.10
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,259.14
|
| Rate for Payer: PHP Medicaid |
$3,049.91
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,625.35
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,300.36
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,632.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$8,819.70
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP DNSP |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: VA VA |
$5,690.13
|
|
