|
IFUSE SYST SI JT 3D 7.0X35MM
|
Facility
|
OP
|
$17,430.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270693647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,614.50 |
| Max. Negotiated Rate |
$8,715.00 |
| Rate for Payer: Aetna Commercial |
$5,229.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,229.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,444.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,444.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,486.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,444.65
|
| Rate for Payer: Cigna Commercial |
$8,715.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,218.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,614.50
|
|
|
IFUSE SYST SI JT 3D 7.0X35MM
|
Facility
|
IP
|
$17,430.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270693647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,614.50 |
| Max. Negotiated Rate |
$4,218.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,486.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,218.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,614.50
|
|
|
IFUSE TORQ 10X35MM IMPLANT
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270703479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 10X35MM IMPLANT
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270703479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
iFUSE-TORQ 10X40MM
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270702582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
iFUSE-TORQ 10X40MM
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270702582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
iFUSE-TORQ 10X45MM
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270702467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
iFUSE-TORQ 10X45MM
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270702467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
iFUSE-TORQ 10X55MM
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270702466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
iFUSE-TORQ 10X55MM
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270702466
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 11.5X40MM
|
Facility
|
OP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 11.5X40MM
|
Facility
|
IP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 11.5X45MM IMPLANT
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270703478
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 11.5X45MM IMPLANT
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270703478
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 11.5X55MM
|
Facility
|
IP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE TORQ 11.5X55MM
|
Facility
|
OP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704542
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE-TORQ IMPLANT 10MMX50MM
|
Facility
|
IP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE-TORQ IMPLANT 10MMX50MM
|
Facility
|
OP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE-TORQ IMPLANT 11.5X50MM
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270702633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: Aetna Commercial |
$4,837.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IFUSE-TORQ IMPLANT 11.5X50MM
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270702633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IgA
|
Facility
|
IP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.85 |
| Max. Negotiated Rate |
$56.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
|
|
IgA
|
Facility
|
OP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.27
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
|
IGA
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86671
|
| Hospital Charge Code |
3035174B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
IGA
|
Facility
|
OP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.27
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
|
IGA
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86671
|
| Hospital Charge Code |
3035174B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$39.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.88
|
| Rate for Payer: Cigna Commercial |
$12.25
|
| Rate for Payer: Cigna Medicare Advantage |
$6.12
|
| Rate for Payer: Clover Medicare Advantage |
$11.64
|
| Rate for Payer: EmblemHealth Commercial |
$36.75
|
| Rate for Payer: Humana Medicare Advantage |
$12.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.74
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.25
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.25
|
|