|
HC CYSTOMETROGRAM W/VP & UP
|
Facility
|
OP
|
$1,737.79
|
|
|
Service Code
|
CPT 51729
|
| Hospital Charge Code |
76100345
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$412.73 |
| Max. Negotiated Rate |
$1,564.01 |
| Rate for Payer: Aetna Commercial |
$1,477.12
|
| Rate for Payer: Aetna Medicare |
$451.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$543.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$543.06
|
| Rate for Payer: BCBS Complete |
$470.52
|
| Rate for Payer: BCBS MAPPO |
$434.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,351.13
|
| Rate for Payer: BCN Commercial |
$1,351.13
|
| Rate for Payer: BCN Medicare Advantage |
$434.45
|
| Rate for Payer: Cash Price |
$1,390.23
|
| Rate for Payer: Cash Price |
$1,390.23
|
| Rate for Payer: Cofinity Commercial |
$1,494.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.45
|
| Rate for Payer: Healthscope Commercial |
$1,564.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,303.34
|
| Rate for Payer: Mclaren Medicaid |
$448.11
|
| Rate for Payer: Meridian Medicaid |
$470.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$456.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$499.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,477.12
|
| Rate for Payer: PACE Senior Care Partners |
$412.73
|
| Rate for Payer: PACE SWMI |
$434.45
|
| Rate for Payer: PHP Commercial |
$1,477.12
|
| Rate for Payer: PHP Medicare Advantage |
$434.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,511.88
|
| Rate for Payer: Priority Health Medicare |
$434.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.88
|
| Rate for Payer: Railroad Medicare Medicare |
$434.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,529.26
|
| Rate for Payer: UHC Core |
$1,451.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.45
|
| Rate for Payer: UHC Medicare Advantage |
$447.48
|
| Rate for Payer: VA VA |
$434.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,303.34
|
|
|
HC CYSTOMETROGRAM W/VP & UP
|
Facility
|
IP
|
$1,737.79
|
|
|
Service Code
|
CPT 51729
|
| Hospital Charge Code |
76100345
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,059.88 |
| Max. Negotiated Rate |
$1,564.01 |
| Rate for Payer: Aetna Commercial |
$1,477.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.96
|
| Rate for Payer: BCN Commercial |
$1,342.96
|
| Rate for Payer: Cash Price |
$1,390.23
|
| Rate for Payer: Cofinity Commercial |
$1,494.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.23
|
| Rate for Payer: Healthscope Commercial |
$1,564.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,303.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,477.12
|
| Rate for Payer: PHP Commercial |
$1,477.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,511.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,529.26
|
| Rate for Payer: UHC Core |
$1,451.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,303.34
|
|
|
HC CYSTOSCOPY DIL URETHRAL STRICTURE
|
Facility
|
IP
|
$2,661.82
|
|
|
Service Code
|
CPT 52281
|
| Hospital Charge Code |
76100194
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,623.44 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.05
|
| Rate for Payer: BCN Commercial |
$2,057.05
|
| 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: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| 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 Narrow/Tiered Network |
$1,623.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.40
|
| Rate for Payer: UHC Core |
$2,222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC CYSTOSCOPY DIL URETHRAL STRICTURE
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 52281
|
| Hospital Charge Code |
76100194
|
|
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
|
|
|
HC CYSTOSCOPY REMV CALCULUS, COMPLICATED
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 52315
|
| Hospital Charge Code |
76100253
|
|
Hospital Revenue Code
|
761
|
| 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 |
$1,402.94
|
| 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: 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: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| 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 Choice Medicaid |
$1,336.13
|
| 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 CYSTOSCOPY REMV CALCULUS, COMPLICATED
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 52315
|
| Hospital Charge Code |
76100253
|
|
Hospital Revenue Code
|
761
|
| 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 CYSTOSCOPY REMV CALCULUS SIMPLE
|
Facility
|
IP
|
$2,661.82
|
|
|
Service Code
|
CPT 52310
|
| Hospital Charge Code |
76100195
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,623.44 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.05
|
| Rate for Payer: BCN Commercial |
$2,057.05
|
| 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: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| 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 Narrow/Tiered Network |
$1,623.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.40
|
| Rate for Payer: UHC Core |
$2,222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC CYSTOSCOPY REMV CALCULUS SIMPLE
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 52310
|
| Hospital Charge Code |
76100195
|
|
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
|
|
|
HC CYSTO TX FEMALE URETHRAL SYNDROME
|
Facility
|
OP
|
$851.50
|
|
|
Service Code
|
CPT 52285
|
| Hospital Charge Code |
76100272
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.23 |
| Max. Negotiated Rate |
$766.35 |
| Rate for Payer: Aetna Commercial |
$723.78
|
| Rate for Payer: Aetna Medicare |
$221.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$266.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$266.09
|
| Rate for Payer: BCBS Complete |
$470.52
|
| Rate for Payer: BCBS MAPPO |
$212.88
|
| Rate for Payer: BCBS Trust/PPO |
$662.04
|
| Rate for Payer: BCN Commercial |
$662.04
|
| Rate for Payer: BCN Medicare Advantage |
$212.88
|
| Rate for Payer: Cash Price |
$681.20
|
| Rate for Payer: Cash Price |
$681.20
|
| Rate for Payer: Cofinity Commercial |
$732.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.88
|
| Rate for Payer: Healthscope Commercial |
$766.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$638.62
|
| Rate for Payer: Mclaren Medicaid |
$448.11
|
| Rate for Payer: Meridian Medicaid |
$470.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$223.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.78
|
| Rate for Payer: PACE Senior Care Partners |
$202.23
|
| Rate for Payer: PACE SWMI |
$212.88
|
| Rate for Payer: PHP Commercial |
$723.78
|
| Rate for Payer: PHP Medicare Advantage |
$212.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.80
|
| Rate for Payer: Priority Health Medicare |
$212.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.33
|
| Rate for Payer: Railroad Medicare Medicare |
$212.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.32
|
| Rate for Payer: UHC Core |
$711.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.88
|
| Rate for Payer: UHC Medicare Advantage |
$219.26
|
| Rate for Payer: VA VA |
$212.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$638.62
|
|
|
HC CYSTO TX FEMALE URETHRAL SYNDROME
|
Facility
|
IP
|
$851.50
|
|
|
Service Code
|
CPT 52285
|
| Hospital Charge Code |
76100272
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$519.33 |
| Max. Negotiated Rate |
$766.35 |
| Rate for Payer: Aetna Commercial |
$723.78
|
| Rate for Payer: BCBS Trust/PPO |
$658.04
|
| Rate for Payer: BCN Commercial |
$658.04
|
| Rate for Payer: Cash Price |
$681.20
|
| Rate for Payer: Cofinity Commercial |
$732.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.20
|
| Rate for Payer: Healthscope Commercial |
$766.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$638.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.78
|
| Rate for Payer: PHP Commercial |
$723.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.32
|
| Rate for Payer: UHC Core |
$711.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$638.62
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
|
OP
|
$977.70
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$879.93 |
| Rate for Payer: Aetna Commercial |
$831.04
|
| Rate for Payer: Aetna Medicare |
$254.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$305.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$305.53
|
| Rate for Payer: BCBS Complete |
$470.52
|
| Rate for Payer: BCBS MAPPO |
$244.42
|
| Rate for Payer: BCBS Trust/PPO |
$760.16
|
| Rate for Payer: BCN Commercial |
$760.16
|
| Rate for Payer: BCN Medicare Advantage |
$244.42
|
| Rate for Payer: Cash Price |
$782.16
|
| Rate for Payer: Cash Price |
$782.16
|
| Rate for Payer: Cofinity Commercial |
$840.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.42
|
| Rate for Payer: Healthscope Commercial |
$879.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$733.28
|
| Rate for Payer: Mclaren Medicaid |
$448.11
|
| Rate for Payer: Meridian Medicaid |
$470.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$256.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$281.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.04
|
| Rate for Payer: PACE Senior Care Partners |
$232.20
|
| Rate for Payer: PACE SWMI |
$244.42
|
| Rate for Payer: PHP Commercial |
$831.04
|
| Rate for Payer: PHP Medicare Advantage |
$244.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.60
|
| Rate for Payer: Priority Health Medicare |
$244.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$596.30
|
| Rate for Payer: Railroad Medicare Medicare |
$244.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$860.38
|
| Rate for Payer: UHC Core |
$816.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.42
|
| Rate for Payer: UHC Medicare Advantage |
$251.76
|
| Rate for Payer: VA VA |
$244.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$733.28
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
|
IP
|
$977.70
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$596.30 |
| Max. Negotiated Rate |
$879.93 |
| Rate for Payer: Aetna Commercial |
$831.04
|
| Rate for Payer: BCBS Trust/PPO |
$755.57
|
| Rate for Payer: BCN Commercial |
$755.57
|
| Rate for Payer: Cash Price |
$782.16
|
| Rate for Payer: Cofinity Commercial |
$840.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.16
|
| Rate for Payer: Healthscope Commercial |
$879.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$733.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.04
|
| Rate for Payer: PHP Commercial |
$831.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$850.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$596.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$860.38
|
| Rate for Payer: UHC Core |
$816.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$733.28
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
OP
|
$2,981.15
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$708.02 |
| Max. Negotiated Rate |
$2,683.04 |
| Rate for Payer: Aetna Commercial |
$2,533.98
|
| Rate for Payer: Aetna Medicare |
$775.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$931.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$931.61
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$745.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.84
|
| Rate for Payer: BCN Commercial |
$2,317.84
|
| Rate for Payer: BCN Medicare Advantage |
$745.29
|
| Rate for Payer: Cash Price |
$2,384.92
|
| Rate for Payer: Cash Price |
$2,384.92
|
| Rate for Payer: Cofinity Commercial |
$2,563.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,384.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.29
|
| Rate for Payer: Healthscope Commercial |
$2,683.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,235.86
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$782.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$857.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,533.98
|
| Rate for Payer: PACE Senior Care Partners |
$708.02
|
| Rate for Payer: PACE SWMI |
$745.29
|
| Rate for Payer: PHP Commercial |
$2,533.98
|
| Rate for Payer: PHP Medicare Advantage |
$745.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,086.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,593.60
|
| Rate for Payer: Priority Health Medicare |
$745.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,818.20
|
| Rate for Payer: Railroad Medicare Medicare |
$745.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,623.41
|
| Rate for Payer: UHC Core |
$2,489.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$745.29
|
| Rate for Payer: UHC Medicare Advantage |
$767.65
|
| Rate for Payer: VA VA |
$745.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,235.86
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
IP
|
$2,981.15
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,818.20 |
| Max. Negotiated Rate |
$2,683.04 |
| Rate for Payer: Aetna Commercial |
$2,533.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,303.83
|
| Rate for Payer: BCN Commercial |
$2,303.83
|
| Rate for Payer: Cash Price |
$2,384.92
|
| Rate for Payer: Cofinity Commercial |
$2,563.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,384.92
|
| Rate for Payer: Healthscope Commercial |
$2,683.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,235.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,533.98
|
| Rate for Payer: PHP Commercial |
$2,533.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,086.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,593.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,818.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,623.41
|
| Rate for Payer: UHC Core |
$2,489.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,235.86
|
|
|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| 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 CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| 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 |
$1,402.94
|
| 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: 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: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| 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 Choice Medicaid |
$1,336.13
|
| 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 CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
OP
|
$4,617.85
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,096.74 |
| Max. Negotiated Rate |
$4,156.06 |
| Rate for Payer: Aetna Commercial |
$3,925.17
|
| Rate for Payer: Aetna Medicare |
$1,200.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,443.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,443.08
|
| Rate for Payer: BCBS Complete |
$2,401.24
|
| Rate for Payer: BCBS MAPPO |
$1,154.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,590.38
|
| Rate for Payer: BCN Commercial |
$3,590.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,154.46
|
| Rate for Payer: Cash Price |
$3,694.28
|
| Rate for Payer: Cash Price |
$3,694.28
|
| Rate for Payer: Cofinity Commercial |
$3,971.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,694.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,154.46
|
| Rate for Payer: Healthscope Commercial |
$4,156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,463.39
|
| Rate for Payer: Mclaren Medicaid |
$2,286.89
|
| Rate for Payer: Meridian Medicaid |
$2,401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,212.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,327.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,925.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,096.74
|
| Rate for Payer: PACE SWMI |
$1,154.46
|
| Rate for Payer: PHP Commercial |
$3,925.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,154.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,286.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,232.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,017.53
|
| Rate for Payer: Priority Health Medicare |
$1,154.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,816.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,154.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,063.71
|
| Rate for Payer: UHC Core |
$3,855.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,154.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.10
|
| Rate for Payer: VA VA |
$1,154.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,463.39
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
IP
|
$4,617.85
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,816.43 |
| Max. Negotiated Rate |
$4,156.06 |
| Rate for Payer: Aetna Commercial |
$3,925.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,568.67
|
| Rate for Payer: BCN Commercial |
$3,568.67
|
| Rate for Payer: Cash Price |
$3,694.28
|
| Rate for Payer: Cofinity Commercial |
$3,971.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,694.28
|
| Rate for Payer: Healthscope Commercial |
$4,156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,463.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,925.17
|
| Rate for Payer: PHP Commercial |
$3,925.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,232.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,017.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,816.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,063.71
|
| Rate for Payer: UHC Core |
$3,855.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,463.39
|
|
|
HC CYTO DNA PROBE
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.80
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$101.51
|
| Rate for Payer: BCN Commercial |
$101.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.98
|
| Rate for Payer: PACE Senior Care Partners |
$31.01
|
| Rate for Payer: PACE SWMI |
$32.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$32.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.59
|
| Rate for Payer: Priority Health Medicare |
$32.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.63
|
| Rate for Payer: Railroad Medicare Medicare |
$32.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.64
|
| Rate for Payer: UHC Medicare Advantage |
$33.62
|
| Rate for Payer: VA VA |
$32.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CYTO DNA PROBE
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$79.63 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: BCBS Trust/PPO |
$100.90
|
| Rate for Payer: BCN Commercial |
$100.90
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.98
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$80.89
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.45
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.79
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.45 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$80.40
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: Aetna Medicare |
$68.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.19
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$65.75
|
| Rate for Payer: BCBS Trust/PPO |
$204.48
|
| Rate for Payer: BCN Commercial |
$204.48
|
| Rate for Payer: BCN Medicare Advantage |
$65.75
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.25
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PACE Senior Care Partners |
$62.46
|
| Rate for Payer: PACE SWMI |
$65.75
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: PHP Medicare Advantage |
$65.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Medicare |
$65.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.40
|
| Rate for Payer: Railroad Medicare Medicare |
$65.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.44
|
| Rate for Payer: UHC Core |
$219.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.75
|
| Rate for Payer: UHC Medicare Advantage |
$67.72
|
| Rate for Payer: VA VA |
$65.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.25
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: BCBS Trust/PPO |
$203.25
|
| Rate for Payer: BCN Commercial |
$203.25
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.44
|
| Rate for Payer: UHC Core |
$219.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.25
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$145.16 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Aetna Commercial |
$202.30
|
| Rate for Payer: BCBS Trust/PPO |
$183.93
|
| Rate for Payer: BCN Commercial |
$183.93
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$204.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.40
|
| Rate for Payer: Healthscope Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.30
|
| Rate for Payer: PHP Commercial |
$202.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.44
|
| Rate for Payer: UHC Core |
$198.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.50
|
|
