|
HC CHROMOGRANIN A
|
Facility
|
IP
|
$60.18
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.70 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: BCBS Trust/PPO |
$46.51
|
| Rate for Payer: BCN Commercial |
$46.51
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.15
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.96
|
| Rate for Payer: UHC Core |
$50.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.14
|
|
|
HC CHROMOGRANIN A
|
Facility
|
OP
|
$60.18
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$16.13
|
| Rate for Payer: BCBS MAPPO |
$15.04
|
| Rate for Payer: BCBS Trust/PPO |
$46.79
|
| Rate for Payer: BCN Commercial |
$46.79
|
| Rate for Payer: BCN Medicare Advantage |
$15.04
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.04
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.14
|
| Rate for Payer: Mclaren Medicaid |
$15.36
|
| Rate for Payer: Meridian Medicaid |
$16.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.15
|
| Rate for Payer: PACE Senior Care Partners |
$14.29
|
| Rate for Payer: PACE SWMI |
$15.04
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: PHP Medicare Advantage |
$15.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.36
|
| Rate for Payer: Priority Health Medicare |
$15.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.70
|
| Rate for Payer: Railroad Medicare Medicare |
$15.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.96
|
| Rate for Payer: UHC Core |
$50.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.04
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: VA VA |
$15.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.14
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
OP
|
$2,400.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$570.00 |
| Max. Negotiated Rate |
$2,160.00 |
| Rate for Payer: Aetna Commercial |
$2,040.00
|
| Rate for Payer: Aetna Medicare |
$624.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$750.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$750.00
|
| Rate for Payer: BCBS Complete |
$898.88
|
| Rate for Payer: BCBS MAPPO |
$600.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.00
|
| Rate for Payer: BCN Commercial |
$1,866.00
|
| Rate for Payer: BCN Medicare Advantage |
$600.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,064.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.00
|
| Rate for Payer: Healthscope Commercial |
$2,160.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.00
|
| Rate for Payer: Mclaren Medicaid |
$856.08
|
| Rate for Payer: Meridian Medicaid |
$898.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$630.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$690.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,040.00
|
| Rate for Payer: PACE Senior Care Partners |
$570.00
|
| Rate for Payer: PACE SWMI |
$600.00
|
| Rate for Payer: PHP Commercial |
$2,040.00
|
| Rate for Payer: PHP Medicare Advantage |
$600.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,088.00
|
| Rate for Payer: Priority Health Medicare |
$600.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,463.76
|
| Rate for Payer: Railroad Medicare Medicare |
$600.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,112.00
|
| Rate for Payer: UHC Core |
$2,004.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.00
|
| Rate for Payer: UHC Medicare Advantage |
$618.00
|
| Rate for Payer: VA VA |
$600.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.00
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
IP
|
$2,400.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,463.76 |
| Max. Negotiated Rate |
$2,160.00 |
| Rate for Payer: Aetna Commercial |
$2,040.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.72
|
| Rate for Payer: BCN Commercial |
$1,854.72
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,064.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.00
|
| Rate for Payer: Healthscope Commercial |
$2,160.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,040.00
|
| Rate for Payer: PHP Commercial |
$2,040.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,088.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,463.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,112.00
|
| Rate for Payer: UHC Core |
$2,004.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.00
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
IP
|
$1,617.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$986.21 |
| Max. Negotiated Rate |
$1,455.30 |
| Rate for Payer: Aetna Commercial |
$1,374.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,249.62
|
| Rate for Payer: BCN Commercial |
$1,249.62
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,390.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,293.60
|
| Rate for Payer: Healthscope Commercial |
$1,455.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,212.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,374.45
|
| Rate for Payer: PHP Commercial |
$1,374.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$986.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,422.96
|
| Rate for Payer: UHC Core |
$1,350.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,212.75
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
OP
|
$1,617.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$384.04 |
| Max. Negotiated Rate |
$1,455.30 |
| Rate for Payer: Aetna Commercial |
$1,374.45
|
| Rate for Payer: Aetna Medicare |
$420.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$505.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$505.31
|
| Rate for Payer: BCBS Complete |
$898.88
|
| Rate for Payer: BCBS MAPPO |
$404.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.22
|
| Rate for Payer: BCN Commercial |
$1,257.22
|
| Rate for Payer: BCN Medicare Advantage |
$404.25
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,390.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,293.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.25
|
| Rate for Payer: Healthscope Commercial |
$1,455.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,212.75
|
| Rate for Payer: Mclaren Medicaid |
$856.08
|
| Rate for Payer: Meridian Medicaid |
$898.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$424.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,374.45
|
| Rate for Payer: PACE Senior Care Partners |
$384.04
|
| Rate for Payer: PACE SWMI |
$404.25
|
| Rate for Payer: PHP Commercial |
$1,374.45
|
| Rate for Payer: PHP Medicare Advantage |
$404.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$856.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,406.79
|
| Rate for Payer: Priority Health Medicare |
$404.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$986.21
|
| Rate for Payer: Railroad Medicare Medicare |
$404.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,422.96
|
| Rate for Payer: UHC Core |
$1,350.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.25
|
| Rate for Payer: UHC Medicare Advantage |
$416.38
|
| Rate for Payer: VA VA |
$404.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,212.75
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.77 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$27.59
|
| Rate for Payer: BCN Commercial |
$27.59
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$25.94
|
| Rate for Payer: BCBS MAPPO |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.92
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Mclaren Medicaid |
$24.70
|
| Rate for Payer: Meridian Medicaid |
$25.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Senior Care Partners |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.92
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.19
|
| Rate for Payer: VA VA |
$8.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
IP
|
$202.98
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$123.80 |
| Max. Negotiated Rate |
$182.68 |
| Rate for Payer: Aetna Commercial |
$172.53
|
| Rate for Payer: BCBS Trust/PPO |
$156.86
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cofinity Commercial |
$174.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.38
|
| Rate for Payer: Healthscope Commercial |
$182.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.53
|
| Rate for Payer: PHP Commercial |
$172.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.62
|
| Rate for Payer: UHC Core |
$169.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.24
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
OP
|
$202.98
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.21 |
| Max. Negotiated Rate |
$182.68 |
| Rate for Payer: Aetna Commercial |
$172.53
|
| Rate for Payer: Aetna Medicare |
$52.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.43
|
| Rate for Payer: BCBS Complete |
$134.57
|
| Rate for Payer: BCBS MAPPO |
$50.74
|
| Rate for Payer: BCBS Trust/PPO |
$157.82
|
| Rate for Payer: BCN Commercial |
$157.82
|
| Rate for Payer: BCN Medicare Advantage |
$50.74
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cofinity Commercial |
$174.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.74
|
| Rate for Payer: Healthscope Commercial |
$182.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.24
|
| Rate for Payer: Mclaren Medicaid |
$128.16
|
| Rate for Payer: Meridian Medicaid |
$134.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.53
|
| Rate for Payer: PACE Senior Care Partners |
$48.21
|
| Rate for Payer: PACE SWMI |
$50.74
|
| Rate for Payer: PHP Commercial |
$172.53
|
| Rate for Payer: PHP Medicare Advantage |
$50.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.59
|
| Rate for Payer: Priority Health Medicare |
$50.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.80
|
| Rate for Payer: Railroad Medicare Medicare |
$50.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.62
|
| Rate for Payer: UHC Core |
$169.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.74
|
| Rate for Payer: UHC Medicare Advantage |
$52.27
|
| Rate for Payer: VA VA |
$50.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.24
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
IP
|
$368.22
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$224.58 |
| Max. Negotiated Rate |
$331.40 |
| Rate for Payer: Aetna Commercial |
$312.99
|
| Rate for Payer: BCBS Trust/PPO |
$284.56
|
| Rate for Payer: BCN Commercial |
$284.56
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cofinity Commercial |
$316.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.58
|
| Rate for Payer: Healthscope Commercial |
$331.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.99
|
| Rate for Payer: PHP Commercial |
$312.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.03
|
| Rate for Payer: UHC Core |
$307.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.16
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
OP
|
$368.22
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.45 |
| Max. Negotiated Rate |
$331.40 |
| Rate for Payer: Aetna Commercial |
$312.99
|
| Rate for Payer: Aetna Medicare |
$95.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.07
|
| Rate for Payer: BCBS Complete |
$146.12
|
| Rate for Payer: BCBS MAPPO |
$92.06
|
| Rate for Payer: BCBS Trust/PPO |
$286.29
|
| Rate for Payer: BCN Commercial |
$286.29
|
| Rate for Payer: BCN Medicare Advantage |
$92.06
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cofinity Commercial |
$316.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.06
|
| Rate for Payer: Healthscope Commercial |
$331.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.16
|
| Rate for Payer: Mclaren Medicaid |
$139.16
|
| Rate for Payer: Meridian Medicaid |
$146.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.99
|
| Rate for Payer: PACE Senior Care Partners |
$87.45
|
| Rate for Payer: PACE SWMI |
$92.06
|
| Rate for Payer: PHP Commercial |
$312.99
|
| Rate for Payer: PHP Medicare Advantage |
$92.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.35
|
| Rate for Payer: Priority Health Medicare |
$92.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.58
|
| Rate for Payer: Railroad Medicare Medicare |
$92.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.03
|
| Rate for Payer: UHC Core |
$307.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.06
|
| Rate for Payer: UHC Medicare Advantage |
$94.82
|
| Rate for Payer: VA VA |
$92.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.16
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
OP
|
$217.26
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Aetna Commercial |
$184.67
|
| Rate for Payer: Aetna Medicare |
$56.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.89
|
| Rate for Payer: BCBS Complete |
$90.27
|
| Rate for Payer: BCBS MAPPO |
$54.32
|
| Rate for Payer: BCBS Trust/PPO |
$168.92
|
| Rate for Payer: BCN Commercial |
$168.92
|
| Rate for Payer: BCN Medicare Advantage |
$54.32
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$186.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.32
|
| Rate for Payer: Healthscope Commercial |
$195.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.94
|
| Rate for Payer: Mclaren Medicaid |
$85.97
|
| Rate for Payer: Meridian Medicaid |
$90.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.67
|
| Rate for Payer: PACE Senior Care Partners |
$51.60
|
| Rate for Payer: PACE SWMI |
$54.32
|
| Rate for Payer: PHP Commercial |
$184.67
|
| Rate for Payer: PHP Medicare Advantage |
$54.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.02
|
| Rate for Payer: Priority Health Medicare |
$54.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.51
|
| Rate for Payer: Railroad Medicare Medicare |
$54.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.19
|
| Rate for Payer: UHC Core |
$181.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.32
|
| Rate for Payer: UHC Medicare Advantage |
$55.94
|
| Rate for Payer: VA VA |
$54.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.94
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
IP
|
$217.26
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.51 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Aetna Commercial |
$184.67
|
| Rate for Payer: BCBS Trust/PPO |
$167.90
|
| Rate for Payer: BCN Commercial |
$167.90
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$186.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Healthscope Commercial |
$195.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.67
|
| Rate for Payer: PHP Commercial |
$184.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.19
|
| Rate for Payer: UHC Core |
$181.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.94
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$224.88
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$53.41 |
| Max. Negotiated Rate |
$202.39 |
| Rate for Payer: Aetna Commercial |
$191.15
|
| Rate for Payer: Aetna Medicare |
$58.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.28
|
| Rate for Payer: BCBS Complete |
$111.39
|
| Rate for Payer: BCBS MAPPO |
$56.22
|
| Rate for Payer: BCBS Trust/PPO |
$174.84
|
| Rate for Payer: BCN Commercial |
$174.84
|
| Rate for Payer: BCN Medicare Advantage |
$56.22
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cofinity Commercial |
$193.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.22
|
| Rate for Payer: Healthscope Commercial |
$202.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.66
|
| Rate for Payer: Mclaren Medicaid |
$106.09
|
| Rate for Payer: Meridian Medicaid |
$111.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.15
|
| Rate for Payer: PACE Senior Care Partners |
$53.41
|
| Rate for Payer: PACE SWMI |
$56.22
|
| Rate for Payer: PHP Commercial |
$191.15
|
| Rate for Payer: PHP Medicare Advantage |
$56.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.65
|
| Rate for Payer: Priority Health Medicare |
$56.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.15
|
| Rate for Payer: Railroad Medicare Medicare |
$56.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.89
|
| Rate for Payer: UHC Core |
$187.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.22
|
| Rate for Payer: UHC Medicare Advantage |
$57.91
|
| Rate for Payer: VA VA |
$56.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.66
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$224.88
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$137.15 |
| Max. Negotiated Rate |
$202.39 |
| Rate for Payer: Aetna Commercial |
$191.15
|
| Rate for Payer: BCBS Trust/PPO |
$173.79
|
| Rate for Payer: BCN Commercial |
$173.79
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cofinity Commercial |
$193.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.90
|
| Rate for Payer: Healthscope Commercial |
$202.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.15
|
| Rate for Payer: PHP Commercial |
$191.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.89
|
| Rate for Payer: UHC Core |
$187.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.66
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$225.75
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$137.68 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna Commercial |
$191.89
|
| Rate for Payer: BCBS Trust/PPO |
$174.46
|
| Rate for Payer: BCN Commercial |
$174.46
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cofinity Commercial |
$194.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.60
|
| Rate for Payer: Healthscope Commercial |
$203.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.89
|
| Rate for Payer: PHP Commercial |
$191.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.66
|
| Rate for Payer: UHC Core |
$188.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.31
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$225.75
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$53.62 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna Commercial |
$191.89
|
| Rate for Payer: Aetna Medicare |
$58.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.55
|
| Rate for Payer: BCBS Complete |
$111.39
|
| Rate for Payer: BCBS MAPPO |
$56.44
|
| Rate for Payer: BCBS Trust/PPO |
$175.52
|
| Rate for Payer: BCN Commercial |
$175.52
|
| Rate for Payer: BCN Medicare Advantage |
$56.44
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cofinity Commercial |
$194.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.44
|
| Rate for Payer: Healthscope Commercial |
$203.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.31
|
| Rate for Payer: Mclaren Medicaid |
$106.09
|
| Rate for Payer: Meridian Medicaid |
$111.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.89
|
| Rate for Payer: PACE Senior Care Partners |
$53.62
|
| Rate for Payer: PACE SWMI |
$56.44
|
| Rate for Payer: PHP Commercial |
$191.89
|
| Rate for Payer: PHP Medicare Advantage |
$56.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$196.40
|
| Rate for Payer: Priority Health Medicare |
$56.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.68
|
| Rate for Payer: Railroad Medicare Medicare |
$56.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.66
|
| Rate for Payer: UHC Core |
$188.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.44
|
| Rate for Payer: UHC Medicare Advantage |
$58.13
|
| Rate for Payer: VA VA |
$56.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.31
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna Medicare |
$51.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.16
|
| Rate for Payer: BCBS Complete |
$97.24
|
| Rate for Payer: BCBS MAPPO |
$49.72
|
| Rate for Payer: BCBS Trust/PPO |
$154.64
|
| Rate for Payer: BCN Commercial |
$154.64
|
| Rate for Payer: BCN Medicare Advantage |
$49.72
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.72
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Mclaren Medicaid |
$92.61
|
| Rate for Payer: Meridian Medicaid |
$97.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.06
|
| Rate for Payer: PACE Senior Care Partners |
$47.24
|
| Rate for Payer: PACE SWMI |
$49.72
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: PHP Medicare Advantage |
$49.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.04
|
| Rate for Payer: Priority Health Medicare |
$49.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.31
|
| Rate for Payer: Railroad Medicare Medicare |
$49.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.03
|
| Rate for Payer: UHC Core |
$166.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$51.22
|
| Rate for Payer: VA VA |
$49.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$121.31 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: BCBS Trust/PPO |
$153.71
|
| Rate for Payer: BCN Commercial |
$153.71
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.06
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.03
|
| Rate for Payer: UHC Core |
$166.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$182.27 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: BCBS Trust/PPO |
$230.96
|
| Rate for Payer: BCN Commercial |
$230.96
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.00
|
| Rate for Payer: UHC Core |
$249.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna Medicare |
$77.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.39
|
| Rate for Payer: BCBS Complete |
$116.47
|
| Rate for Payer: BCBS MAPPO |
$74.72
|
| Rate for Payer: BCBS Trust/PPO |
$232.36
|
| Rate for Payer: BCN Commercial |
$232.36
|
| Rate for Payer: BCN Medicare Advantage |
$74.72
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.72
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Mclaren Medicaid |
$110.92
|
| Rate for Payer: Meridian Medicaid |
$116.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Senior Care Partners |
$70.98
|
| Rate for Payer: PACE SWMI |
$74.72
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.01
|
| Rate for Payer: Priority Health Medicare |
$74.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.27
|
| Rate for Payer: Railroad Medicare Medicare |
$74.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.00
|
| Rate for Payer: UHC Core |
$249.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.72
|
| Rate for Payer: UHC Medicare Advantage |
$76.96
|
| Rate for Payer: VA VA |
$74.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC CIRCUMCISION
|
Facility
|
IP
|
$2,710.48
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,653.12 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.66
|
| Rate for Payer: BCN Commercial |
$2,094.66
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,358.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,653.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,385.22
|
| Rate for Payer: UHC Core |
$2,263.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,710.48
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$643.74 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna Medicare |
$704.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$847.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$847.02
|
| Rate for Payer: BCBS Complete |
$1,084.19
|
| Rate for Payer: BCBS MAPPO |
$677.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,107.40
|
| Rate for Payer: BCN Commercial |
$2,107.40
|
| Rate for Payer: BCN Medicare Advantage |
$677.62
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.62
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$711.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$779.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PACE Senior Care Partners |
$643.74
|
| Rate for Payer: PACE SWMI |
$677.62
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: PHP Medicare Advantage |
$677.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,358.12
|
| Rate for Payer: Priority Health Medicare |
$677.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,653.12
|
| Rate for Payer: Railroad Medicare Medicare |
$677.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,385.22
|
| Rate for Payer: UHC Core |
$2,263.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$677.62
|
| Rate for Payer: UHC Medicare Advantage |
$697.95
|
| Rate for Payer: VA VA |
$677.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$632.18 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: Aetna Medicare |
$692.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$831.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$831.82
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$665.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,069.57
|
| Rate for Payer: BCN Commercial |
$2,069.57
|
| Rate for Payer: BCN Medicare Advantage |
$665.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,289.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.46
|
| Rate for Payer: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$698.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$765.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PACE Senior Care Partners |
$632.18
|
| Rate for Payer: PACE SWMI |
$665.46
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| Rate for Payer: PHP Medicare Advantage |
$665.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,315.78
|
| Rate for Payer: Priority Health Medicare |
$665.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,623.44
|
| Rate for Payer: Railroad Medicare Medicare |
$665.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.40
|
| Rate for Payer: UHC Core |
$2,222.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.46
|
| Rate for Payer: UHC Medicare Advantage |
$685.42
|
| Rate for Payer: VA VA |
$665.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
