|
HC CHROMIUM
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
30100165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health SBD |
$39.20
|
|
|
HC CHROMIUM
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
30100165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$21.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.35
|
| Rate for Payer: BCBS Complete |
$11.41
|
| Rate for Payer: BCBS MAPPO |
$20.28
|
| Rate for Payer: BCBS Trust/PPO |
$17.95
|
| Rate for Payer: BCN Commercial |
$17.95
|
| Rate for Payer: BCN Medicare Advantage |
$20.28
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.28
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$10.87
|
| Rate for Payer: Mclaren Medicare |
$20.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.29
|
| Rate for Payer: Meridian Medicaid |
$11.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$30.42
|
| Rate for Payer: PACE Medicare |
$19.27
|
| Rate for Payer: PACE SWMI |
$20.28
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$20.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.28
|
| Rate for Payer: Priority Health Medicare |
$20.28
|
| Rate for Payer: Priority Health Narrow Network |
$16.22
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: Railroad Medicare Medicare |
$20.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.34
|
| Rate for Payer: UHC Core |
$43.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.28
|
| Rate for Payer: UHC Exchange |
$43.85
|
| Rate for Payer: UHC Medicare Advantage |
$20.28
|
| Rate for Payer: UHCCP Medicaid |
$11.42
|
| Rate for Payer: VA VA |
$20.28
|
|
|
HC CHROMOGRANIN A
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$11.71
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$18.42
|
| Rate for Payer: BCN Commercial |
$18.42
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Cofinity Commercial |
$42.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Mclaren Medicaid |
$11.15
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$31.22
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.41
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$17.13
|
| Rate for Payer: Priority Health SBD |
$38.67
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.81
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$11.72
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CHROMOGRANIN A
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.67 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.90
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$42.97
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health SBD |
$38.67
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
OP
|
$2,448.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$182.78 |
| Max. Negotiated Rate |
$3,480.00 |
| Rate for Payer: Aetna Commercial |
$2,080.80
|
| Rate for Payer: Aetna Medicare |
$1,206.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,591.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,450.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,450.00
|
| Rate for Payer: BCBS Complete |
$652.85
|
| Rate for Payer: BCBS MAPPO |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.15
|
| Rate for Payer: BCN Commercial |
$1,369.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,713.60
|
| Rate for Payer: Cofinity Commercial |
$2,105.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,713.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,958.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthscope Commercial |
$2,203.20
|
| Rate for Payer: Mclaren Medicaid |
$621.76
|
| Rate for Payer: Mclaren Medicare |
$1,160.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,218.00
|
| Rate for Payer: Meridian Medicaid |
$652.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,080.80
|
| Rate for Payer: Nomi Health Commercial |
$3,480.00
|
| Rate for Payer: PACE Medicare |
$1,102.00
|
| Rate for Payer: PACE SWMI |
$1,160.00
|
| Rate for Payer: PHP Commercial |
$2,080.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,160.00
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$928.00
|
| Rate for Payer: Priority Health SBD |
$1,542.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,392.00
|
| Rate for Payer: UHC Core |
$182.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,160.00
|
| Rate for Payer: UHC Exchange |
$182.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.00
|
| Rate for Payer: UHCCP Medicaid |
$653.08
|
| Rate for Payer: VA VA |
$1,160.00
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
IP
|
$2,448.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,542.24 |
| Max. Negotiated Rate |
$2,203.20 |
| Rate for Payer: Aetna Commercial |
$2,080.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,591.20
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,713.60
|
| Rate for Payer: Cofinity Commercial |
$2,105.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,713.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,958.40
|
| Rate for Payer: Healthscope Commercial |
$2,203.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,080.80
|
| Rate for Payer: PHP Commercial |
$2,080.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health SBD |
$1,542.24
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
OP
|
$1,649.34
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$182.78 |
| Max. Negotiated Rate |
$3,480.00 |
| Rate for Payer: Aetna Commercial |
$1,401.94
|
| Rate for Payer: Aetna Medicare |
$1,206.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,072.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,450.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,450.00
|
| Rate for Payer: BCBS Complete |
$652.85
|
| Rate for Payer: BCBS MAPPO |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.15
|
| Rate for Payer: BCN Commercial |
$1,369.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cofinity Commercial |
$1,418.43
|
| Rate for Payer: Cofinity Commercial |
$1,154.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,154.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,319.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthscope Commercial |
$1,484.41
|
| Rate for Payer: Mclaren Medicaid |
$621.76
|
| Rate for Payer: Mclaren Medicare |
$1,160.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,218.00
|
| Rate for Payer: Meridian Medicaid |
$652.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,401.94
|
| Rate for Payer: Nomi Health Commercial |
$3,480.00
|
| Rate for Payer: PACE Medicare |
$1,102.00
|
| Rate for Payer: PACE SWMI |
$1,160.00
|
| Rate for Payer: PHP Commercial |
$1,401.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,160.00
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$928.00
|
| Rate for Payer: Priority Health SBD |
$1,039.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,392.00
|
| Rate for Payer: UHC Core |
$182.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,160.00
|
| Rate for Payer: UHC Exchange |
$182.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.00
|
| Rate for Payer: UHCCP Medicaid |
$653.08
|
| Rate for Payer: VA VA |
$1,160.00
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
IP
|
$1,649.34
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,039.08 |
| Max. Negotiated Rate |
$1,484.41 |
| Rate for Payer: Aetna Commercial |
$1,401.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,072.07
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cofinity Commercial |
$1,154.54
|
| Rate for Payer: Cofinity Commercial |
$1,418.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,154.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,319.47
|
| Rate for Payer: Healthscope Commercial |
$1,484.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,401.94
|
| Rate for Payer: PHP Commercial |
$1,401.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.07
|
| Rate for Payer: Priority Health SBD |
$1,039.08
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.94 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.94 |
| Max. Negotiated Rate |
$50.20 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$34.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.84
|
| Rate for Payer: BCBS Complete |
$18.84
|
| Rate for Payer: BCBS MAPPO |
$33.47
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: BCN Medicare Advantage |
$33.47
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.47
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$17.94
|
| Rate for Payer: Mclaren Medicare |
$33.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.14
|
| Rate for Payer: Meridian Medicaid |
$18.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$50.20
|
| Rate for Payer: PACE Medicare |
$31.80
|
| Rate for Payer: PACE SWMI |
$33.47
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$33.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.47
|
| Rate for Payer: Priority Health Medicare |
$33.47
|
| Rate for Payer: Priority Health Narrow Network |
$26.78
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: Railroad Medicare Medicare |
$33.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.47
|
| Rate for Payer: UHC Medicare Advantage |
$33.47
|
| Rate for Payer: UHCCP Medicaid |
$18.84
|
| Rate for Payer: VA VA |
$33.47
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
OP
|
$207.04
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$260.49 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: Aetna Medicare |
$180.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.08
|
| Rate for Payer: BCBS Complete |
$97.74
|
| Rate for Payer: BCBS MAPPO |
$173.66
|
| Rate for Payer: BCBS Trust/PPO |
$153.73
|
| Rate for Payer: BCN Commercial |
$153.73
|
| Rate for Payer: BCN Medicare Advantage |
$173.66
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$178.05
|
| Rate for Payer: Cofinity Commercial |
$144.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.66
|
| Rate for Payer: Healthscope Commercial |
$186.34
|
| Rate for Payer: Mclaren Medicaid |
$93.08
|
| Rate for Payer: Mclaren Medicare |
$173.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.34
|
| Rate for Payer: Meridian Medicaid |
$97.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$260.49
|
| Rate for Payer: PACE Medicare |
$164.98
|
| Rate for Payer: PACE SWMI |
$173.66
|
| Rate for Payer: PHP Commercial |
$175.98
|
| Rate for Payer: PHP Medicare Advantage |
$173.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.66
|
| Rate for Payer: Priority Health Medicare |
$173.66
|
| Rate for Payer: Priority Health Narrow Network |
$138.93
|
| Rate for Payer: Priority Health SBD |
$130.44
|
| Rate for Payer: Railroad Medicare Medicare |
$173.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.66
|
| Rate for Payer: UHC Medicare Advantage |
$173.66
|
| Rate for Payer: UHCCP Medicaid |
$97.77
|
| Rate for Payer: VA VA |
$173.66
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
IP
|
$207.04
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$130.44 |
| Max. Negotiated Rate |
$186.34 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.58
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$144.93
|
| Rate for Payer: Cofinity Commercial |
$178.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Healthscope Commercial |
$186.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: PHP Commercial |
$175.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.58
|
| Rate for Payer: Priority Health SBD |
$130.44
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
OP
|
$375.58
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$338.02 |
| Rate for Payer: Aetna Commercial |
$319.24
|
| Rate for Payer: Aetna Medicare |
$196.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.71
|
| Rate for Payer: BCBS Complete |
$106.13
|
| Rate for Payer: BCBS MAPPO |
$188.57
|
| Rate for Payer: BCBS Trust/PPO |
$166.93
|
| Rate for Payer: BCN Commercial |
$166.93
|
| Rate for Payer: BCN Medicare Advantage |
$188.57
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cofinity Commercial |
$323.00
|
| Rate for Payer: Cofinity Commercial |
$262.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.57
|
| Rate for Payer: Healthscope Commercial |
$338.02
|
| Rate for Payer: Mclaren Medicaid |
$101.07
|
| Rate for Payer: Mclaren Medicare |
$188.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.00
|
| Rate for Payer: Meridian Medicaid |
$106.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.24
|
| Rate for Payer: Nomi Health Commercial |
$282.86
|
| Rate for Payer: PACE Medicare |
$179.14
|
| Rate for Payer: PACE SWMI |
$188.57
|
| Rate for Payer: PHP Commercial |
$319.24
|
| Rate for Payer: PHP Medicare Advantage |
$188.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.57
|
| Rate for Payer: Priority Health Medicare |
$188.57
|
| Rate for Payer: Priority Health Narrow Network |
$150.86
|
| Rate for Payer: Priority Health SBD |
$236.62
|
| Rate for Payer: Railroad Medicare Medicare |
$188.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.57
|
| Rate for Payer: UHC Medicare Advantage |
$188.57
|
| Rate for Payer: UHCCP Medicaid |
$106.16
|
| Rate for Payer: VA VA |
$188.57
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
IP
|
$375.58
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$236.62 |
| Max. Negotiated Rate |
$338.02 |
| Rate for Payer: Aetna Commercial |
$319.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.13
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cofinity Commercial |
$262.91
|
| Rate for Payer: Cofinity Commercial |
$323.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.46
|
| Rate for Payer: Healthscope Commercial |
$338.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.24
|
| Rate for Payer: PHP Commercial |
$319.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health SBD |
$236.62
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
OP
|
$221.61
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.44 |
| Max. Negotiated Rate |
$199.45 |
| Rate for Payer: Aetna Commercial |
$188.37
|
| Rate for Payer: Aetna Medicare |
$121.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.61
|
| Rate for Payer: BCBS Complete |
$65.56
|
| Rate for Payer: BCBS MAPPO |
$116.49
|
| Rate for Payer: BCBS Trust/PPO |
$103.12
|
| Rate for Payer: BCN Commercial |
$103.12
|
| Rate for Payer: BCN Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$190.58
|
| Rate for Payer: Cofinity Commercial |
$155.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$155.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.49
|
| Rate for Payer: Healthscope Commercial |
$199.45
|
| Rate for Payer: Mclaren Medicaid |
$62.44
|
| Rate for Payer: Mclaren Medicare |
$116.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.31
|
| Rate for Payer: Meridian Medicaid |
$65.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$174.74
|
| Rate for Payer: PACE Medicare |
$110.67
|
| Rate for Payer: PACE SWMI |
$116.49
|
| Rate for Payer: PHP Commercial |
$188.37
|
| Rate for Payer: PHP Medicare Advantage |
$116.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.49
|
| Rate for Payer: Priority Health Medicare |
$116.49
|
| Rate for Payer: Priority Health Narrow Network |
$93.19
|
| Rate for Payer: Priority Health SBD |
$139.61
|
| Rate for Payer: Railroad Medicare Medicare |
$116.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.49
|
| Rate for Payer: UHC Medicare Advantage |
$116.49
|
| Rate for Payer: UHCCP Medicaid |
$65.58
|
| Rate for Payer: VA VA |
$116.49
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
IP
|
$221.61
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$139.61 |
| Max. Negotiated Rate |
$199.45 |
| Rate for Payer: Aetna Commercial |
$188.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.05
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$190.58
|
| Rate for Payer: Cofinity Commercial |
$155.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$155.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Healthscope Commercial |
$199.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: PHP Commercial |
$188.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.05
|
| Rate for Payer: Priority Health SBD |
$139.61
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.51 |
| Max. Negotiated Rate |
$206.44 |
| Rate for Payer: Aetna Commercial |
$194.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.10
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$160.57
|
| Rate for Payer: Cofinity Commercial |
$197.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: PHP Commercial |
$194.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health SBD |
$144.51
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$215.62 |
| Rate for Payer: Aetna Commercial |
$194.97
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: BCBS Complete |
$80.90
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$127.25
|
| Rate for Payer: BCN Commercial |
$127.25
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$197.27
|
| Rate for Payer: Cofinity Commercial |
$160.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Mclaren Medicaid |
$77.05
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: Meridian Medicaid |
$80.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: Nomi Health Commercial |
$215.62
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$194.97
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.75
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$115.00
|
| Rate for Payer: Priority Health SBD |
$144.51
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$143.75
|
| Rate for Payer: UHCCP Medicaid |
$80.93
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$215.62 |
| Rate for Payer: Aetna Commercial |
$199.86
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: BCBS Complete |
$80.90
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$127.25
|
| Rate for Payer: BCN Commercial |
$127.25
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$202.21
|
| Rate for Payer: Cofinity Commercial |
$164.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$211.62
|
| Rate for Payer: Mclaren Medicaid |
$77.05
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: Meridian Medicaid |
$80.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: Nomi Health Commercial |
$215.62
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$199.86
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.75
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$115.00
|
| Rate for Payer: Priority Health SBD |
$148.13
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$143.75
|
| Rate for Payer: UHCCP Medicaid |
$80.93
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$148.13 |
| Max. Negotiated Rate |
$211.62 |
| Rate for Payer: Aetna Commercial |
$199.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.83
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$164.59
|
| Rate for Payer: Cofinity Commercial |
$202.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$164.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Healthscope Commercial |
$211.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: PHP Commercial |
$199.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health SBD |
$148.13
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.33 |
| Max. Negotiated Rate |
$184.75 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.43
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$143.70
|
| Rate for Payer: Cofinity Commercial |
$176.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Healthscope Commercial |
$184.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: PHP Commercial |
$174.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health SBD |
$129.33
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.26 |
| Max. Negotiated Rate |
$188.24 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna Medicare |
$130.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.86
|
| Rate for Payer: BCBS Complete |
$70.63
|
| Rate for Payer: BCBS MAPPO |
$125.49
|
| Rate for Payer: BCBS Trust/PPO |
$111.09
|
| Rate for Payer: BCN Commercial |
$111.09
|
| Rate for Payer: BCN Medicare Advantage |
$125.49
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$176.54
|
| Rate for Payer: Cofinity Commercial |
$143.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.49
|
| Rate for Payer: Healthscope Commercial |
$184.75
|
| Rate for Payer: Mclaren Medicaid |
$67.26
|
| Rate for Payer: Mclaren Medicare |
$125.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.76
|
| Rate for Payer: Meridian Medicaid |
$70.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: Nomi Health Commercial |
$188.24
|
| Rate for Payer: PACE Medicare |
$119.22
|
| Rate for Payer: PACE SWMI |
$125.49
|
| Rate for Payer: PHP Commercial |
$174.49
|
| Rate for Payer: PHP Medicare Advantage |
$125.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.24
|
| Rate for Payer: Priority Health Medicare |
$125.49
|
| Rate for Payer: Priority Health Narrow Network |
$102.59
|
| Rate for Payer: Priority Health SBD |
$129.33
|
| Rate for Payer: Railroad Medicare Medicare |
$125.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.49
|
| Rate for Payer: UHC Medicare Advantage |
$125.49
|
| Rate for Payer: UHCCP Medicaid |
$70.65
|
| Rate for Payer: VA VA |
$125.49
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.56 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$156.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.88
|
| Rate for Payer: BCBS Complete |
$84.59
|
| Rate for Payer: BCBS MAPPO |
$150.30
|
| Rate for Payer: BCBS Trust/PPO |
$133.06
|
| Rate for Payer: BCN Commercial |
$133.06
|
| Rate for Payer: BCN Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Cofinity Commercial |
$213.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.30
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Mclaren Medicaid |
$80.56
|
| Rate for Payer: Mclaren Medicare |
$150.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.82
|
| Rate for Payer: Meridian Medicaid |
$84.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$225.45
|
| Rate for Payer: PACE Medicare |
$142.78
|
| Rate for Payer: PACE SWMI |
$150.30
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$150.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.30
|
| Rate for Payer: Priority Health Medicare |
$150.30
|
| Rate for Payer: Priority Health Narrow Network |
$120.24
|
| Rate for Payer: Priority Health SBD |
$192.05
|
| Rate for Payer: Railroad Medicare Medicare |
$150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.30
|
| Rate for Payer: UHC Medicare Advantage |
$150.30
|
| Rate for Payer: UHCCP Medicaid |
$84.62
|
| Rate for Payer: VA VA |
$150.30
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$192.05 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$213.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health SBD |
$192.05
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,105.88 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna Medicare |
$1,382.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,797.05
|
| Rate for Payer: BCBS Complete |
$1,105.88
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$1,935.28
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,935.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health SBD |
$1,741.75
|
|
