|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
3401065
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
5100783
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
1500109
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
3401058
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
100126
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
2300909
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
395096366
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$221.80
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
5700261
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$33.27 |
| Max. Negotiated Rate |
$33.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.27
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
93500041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
100124
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
2011453
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
100119
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
2300909
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
3401058
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
1500109
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
74308240
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
4501036
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
3401065
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
8200516
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
3401060
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
100127
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
100124
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
73050920
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
3401031
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|
|
INF THERAPEUTIC EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
73237022
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$13.87 |
| Max. Negotiated Rate |
$802.00 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare Advantage |
$99.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.63
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.14
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$802.00
|
|