|
HC CYSTO TX FEMALE URETHRAL SYNDROME
|
Facility
|
OP
|
$885.90
|
|
|
Service Code
|
CPT 52285
|
| Hospital Charge Code |
76100272
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.18 |
| Max. Negotiated Rate |
$797.31 |
| Rate for Payer: Aetna Commercial |
$753.01
|
| Rate for Payer: Aetna Medicare |
$230.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.84
|
| Rate for Payer: BCBS Complete |
$163.98
|
| Rate for Payer: BCBS MAPPO |
$221.47
|
| Rate for Payer: BCBS Trust/PPO |
$728.30
|
| Rate for Payer: BCN Commercial |
$728.30
|
| Rate for Payer: BCN Medicare Advantage |
$221.47
|
| Rate for Payer: Cash Price |
$708.72
|
| Rate for Payer: Cofinity Commercial |
$761.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.47
|
| Rate for Payer: Healthscope Commercial |
$797.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.42
|
| Rate for Payer: Mclaren Medicaid |
$156.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.55
|
| Rate for Payer: Meridian Medicaid |
$163.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$243.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$753.01
|
| Rate for Payer: Nomi Health Commercial |
$726.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$664.42
|
| Rate for Payer: PACE Senior Care Partners |
$210.40
|
| Rate for Payer: PACE SWMI |
$221.47
|
| Rate for Payer: PHP Commercial |
$753.01
|
| Rate for Payer: PHP Medicare Advantage |
$221.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$770.73
|
| Rate for Payer: Priority Health Medicare |
$223.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$616.59
|
| Rate for Payer: Railroad Medicare Medicare |
$221.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.59
|
| Rate for Payer: UHC Core |
$739.73
|
| Rate for Payer: UHC Exchange |
$221.47
|
| Rate for Payer: UHC Medicaid |
$156.18
|
| Rate for Payer: UHC Medicare Advantage |
$221.47
|
| Rate for Payer: UHCCP Medicaid |
$156.18
|
| Rate for Payer: VA VA |
$221.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.42
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
|
IP
|
$1,017.20
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$707.97 |
| Max. Negotiated Rate |
$915.48 |
| Rate for Payer: Aetna Commercial |
$864.62
|
| Rate for Payer: BCBS Trust/PPO |
$840.11
|
| Rate for Payer: BCN Commercial |
$840.11
|
| Rate for Payer: Cash Price |
$813.76
|
| Rate for Payer: Cofinity Commercial |
$874.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.76
|
| Rate for Payer: Healthscope Commercial |
$915.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.62
|
| Rate for Payer: Nomi Health Commercial |
$834.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.90
|
| Rate for Payer: PHP Commercial |
$864.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$884.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$707.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$895.14
|
| Rate for Payer: UHC Core |
$849.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.90
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
|
OP
|
$1,017.20
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.33 |
| Max. Negotiated Rate |
$915.48 |
| Rate for Payer: Aetna Commercial |
$864.62
|
| Rate for Payer: Aetna Medicare |
$264.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$317.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$317.88
|
| Rate for Payer: BCBS Complete |
$188.28
|
| Rate for Payer: BCBS MAPPO |
$254.30
|
| Rate for Payer: BCBS Trust/PPO |
$836.24
|
| Rate for Payer: BCN Commercial |
$836.24
|
| Rate for Payer: BCN Medicare Advantage |
$254.30
|
| Rate for Payer: Cash Price |
$813.76
|
| Rate for Payer: Cofinity Commercial |
$874.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.30
|
| Rate for Payer: Healthscope Commercial |
$915.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.90
|
| Rate for Payer: Mclaren Medicaid |
$179.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.01
|
| Rate for Payer: Meridian Medicaid |
$188.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$279.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.62
|
| Rate for Payer: Nomi Health Commercial |
$834.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.90
|
| Rate for Payer: PACE Senior Care Partners |
$241.59
|
| Rate for Payer: PACE SWMI |
$254.30
|
| Rate for Payer: PHP Commercial |
$864.62
|
| Rate for Payer: PHP Medicare Advantage |
$254.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$884.96
|
| Rate for Payer: Priority Health Medicare |
$256.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$707.97
|
| Rate for Payer: Railroad Medicare Medicare |
$254.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$895.14
|
| Rate for Payer: UHC Core |
$849.36
|
| Rate for Payer: UHC Exchange |
$254.30
|
| Rate for Payer: UHC Medicaid |
$179.33
|
| Rate for Payer: UHC Medicare Advantage |
$254.30
|
| Rate for Payer: UHCCP Medicaid |
$179.33
|
| Rate for Payer: VA VA |
$254.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.90
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
OP
|
$3,101.59
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$546.81 |
| Max. Negotiated Rate |
$2,791.43 |
| Rate for Payer: Aetna Commercial |
$2,636.35
|
| Rate for Payer: Aetna Medicare |
$806.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$969.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$969.25
|
| Rate for Payer: BCBS Complete |
$574.10
|
| Rate for Payer: BCBS MAPPO |
$775.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.82
|
| Rate for Payer: BCN Commercial |
$2,549.82
|
| Rate for Payer: BCN Medicare Advantage |
$775.40
|
| Rate for Payer: Cash Price |
$2,481.27
|
| Rate for Payer: Cofinity Commercial |
$2,667.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.40
|
| Rate for Payer: Healthscope Commercial |
$2,791.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.19
|
| Rate for Payer: Mclaren Medicaid |
$546.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.17
|
| Rate for Payer: Meridian Medicaid |
$574.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$852.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.35
|
| Rate for Payer: Nomi Health Commercial |
$2,543.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,326.19
|
| Rate for Payer: PACE Senior Care Partners |
$736.63
|
| Rate for Payer: PACE SWMI |
$775.40
|
| Rate for Payer: PHP Commercial |
$2,636.35
|
| Rate for Payer: PHP Medicare Advantage |
$775.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,698.38
|
| Rate for Payer: Priority Health Medicare |
$783.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,158.71
|
| Rate for Payer: Railroad Medicare Medicare |
$775.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.40
|
| Rate for Payer: UHC Core |
$2,589.83
|
| Rate for Payer: UHC Exchange |
$775.40
|
| Rate for Payer: UHC Medicaid |
$546.81
|
| Rate for Payer: UHC Medicare Advantage |
$775.40
|
| Rate for Payer: UHCCP Medicaid |
$546.81
|
| Rate for Payer: VA VA |
$775.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.19
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
IP
|
$3,101.59
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,158.71 |
| Max. Negotiated Rate |
$2,791.43 |
| Rate for Payer: Aetna Commercial |
$2,636.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.60
|
| Rate for Payer: BCN Commercial |
$2,561.60
|
| Rate for Payer: Cash Price |
$2,481.27
|
| Rate for Payer: Cofinity Commercial |
$2,667.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.27
|
| Rate for Payer: Healthscope Commercial |
$2,791.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.35
|
| Rate for Payer: Nomi Health Commercial |
$2,543.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,326.19
|
| Rate for Payer: PHP Commercial |
$2,636.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,698.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,158.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.40
|
| Rate for Payer: UHC Core |
$2,589.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.19
|
|
|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
IP
|
$2,819.98
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,962.71 |
| Max. Negotiated Rate |
$2,537.98 |
| Rate for Payer: Aetna Commercial |
$2,396.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,329.02
|
| Rate for Payer: BCN Commercial |
$2,329.02
|
| Rate for Payer: Cash Price |
$2,255.98
|
| Rate for Payer: Cofinity Commercial |
$2,425.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,255.98
|
| Rate for Payer: Healthscope Commercial |
$2,537.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,114.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,396.98
|
| Rate for Payer: Nomi Health Commercial |
$2,312.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,114.99
|
| Rate for Payer: PHP Commercial |
$2,396.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,453.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,962.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,481.58
|
| Rate for Payer: UHC Core |
$2,354.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,114.99
|
|
|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
OP
|
$2,819.98
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$497.16 |
| Max. Negotiated Rate |
$2,537.98 |
| Rate for Payer: Aetna Commercial |
$2,396.98
|
| Rate for Payer: Aetna Medicare |
$733.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.24
|
| Rate for Payer: BCBS Complete |
$521.98
|
| Rate for Payer: BCBS MAPPO |
$705.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,318.31
|
| Rate for Payer: BCN Commercial |
$2,318.31
|
| Rate for Payer: BCN Medicare Advantage |
$705.00
|
| Rate for Payer: Cash Price |
$2,255.98
|
| Rate for Payer: Cofinity Commercial |
$2,425.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,255.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.00
|
| Rate for Payer: Healthscope Commercial |
$2,537.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,114.99
|
| Rate for Payer: Mclaren Medicaid |
$497.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.24
|
| Rate for Payer: Meridian Medicaid |
$521.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$810.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$775.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,396.98
|
| Rate for Payer: Nomi Health Commercial |
$2,312.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,114.99
|
| Rate for Payer: PACE Senior Care Partners |
$669.75
|
| Rate for Payer: PACE SWMI |
$705.00
|
| Rate for Payer: PHP Commercial |
$2,396.98
|
| Rate for Payer: PHP Medicare Advantage |
$705.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,453.38
|
| Rate for Payer: Priority Health Medicare |
$712.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,962.71
|
| Rate for Payer: Railroad Medicare Medicare |
$705.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,481.58
|
| Rate for Payer: UHC Core |
$2,354.68
|
| Rate for Payer: UHC Exchange |
$705.00
|
| Rate for Payer: UHC Medicaid |
$497.16
|
| Rate for Payer: UHC Medicare Advantage |
$705.00
|
| Rate for Payer: UHCCP Medicaid |
$497.16
|
| Rate for Payer: VA VA |
$705.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,114.99
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
OP
|
$4,804.41
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$847.02 |
| Max. Negotiated Rate |
$4,323.97 |
| Rate for Payer: Aetna Commercial |
$4,083.75
|
| Rate for Payer: Aetna Medicare |
$1,249.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,501.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,501.38
|
| Rate for Payer: BCBS Complete |
$889.30
|
| Rate for Payer: BCBS MAPPO |
$1,201.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,949.71
|
| Rate for Payer: BCN Commercial |
$3,949.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.10
|
| Rate for Payer: Cash Price |
$3,843.53
|
| Rate for Payer: Cofinity Commercial |
$4,131.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,843.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.10
|
| Rate for Payer: Healthscope Commercial |
$4,323.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,603.31
|
| Rate for Payer: Mclaren Medicaid |
$847.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,261.16
|
| Rate for Payer: Meridian Medicaid |
$889.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,381.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,321.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,083.75
|
| Rate for Payer: Nomi Health Commercial |
$3,939.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,603.31
|
| Rate for Payer: PACE Senior Care Partners |
$1,141.05
|
| Rate for Payer: PACE SWMI |
$1,201.10
|
| Rate for Payer: PHP Commercial |
$4,083.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,179.84
|
| Rate for Payer: Priority Health Medicare |
$1,213.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,343.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,201.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,227.88
|
| Rate for Payer: UHC Core |
$4,011.68
|
| Rate for Payer: UHC Exchange |
$1,201.10
|
| Rate for Payer: UHC Medicaid |
$847.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,201.10
|
| Rate for Payer: UHCCP Medicaid |
$847.02
|
| Rate for Payer: VA VA |
$1,201.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,603.31
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
IP
|
$4,804.41
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,343.87 |
| Max. Negotiated Rate |
$4,323.97 |
| Rate for Payer: Aetna Commercial |
$4,083.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,967.96
|
| Rate for Payer: BCN Commercial |
$3,967.96
|
| Rate for Payer: Cash Price |
$3,843.53
|
| Rate for Payer: Cofinity Commercial |
$4,131.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,843.53
|
| Rate for Payer: Healthscope Commercial |
$4,323.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,603.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,083.75
|
| Rate for Payer: Nomi Health Commercial |
$3,939.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,603.31
|
| Rate for Payer: PHP Commercial |
$4,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,179.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,343.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,227.88
|
| Rate for Payer: UHC Core |
$4,011.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,603.31
|
|
|
HC CYTO DNA PROBE
|
Facility
|
OP
|
$135.83
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.95 |
| Max. Negotiated Rate |
$122.25 |
| Rate for Payer: Aetna Commercial |
$115.46
|
| Rate for Payer: Aetna Medicare |
$35.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.45
|
| Rate for Payer: BCBS Complete |
$25.14
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCBS Trust/PPO |
$111.67
|
| Rate for Payer: BCN Commercial |
$111.67
|
| Rate for Payer: BCN Medicare Advantage |
$33.96
|
| Rate for Payer: Cash Price |
$108.66
|
| Rate for Payer: Cofinity Commercial |
$116.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$122.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.87
|
| Rate for Payer: Mclaren Medicaid |
$23.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.66
|
| Rate for Payer: Meridian Medicaid |
$25.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.46
|
| Rate for Payer: Nomi Health Commercial |
$111.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.87
|
| Rate for Payer: PACE Senior Care Partners |
$32.26
|
| Rate for Payer: PACE SWMI |
$33.96
|
| Rate for Payer: PHP Commercial |
$115.46
|
| Rate for Payer: PHP Medicare Advantage |
$33.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.17
|
| Rate for Payer: Priority Health Medicare |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.54
|
| Rate for Payer: Railroad Medicare Medicare |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.53
|
| Rate for Payer: UHC Core |
$113.42
|
| Rate for Payer: UHC Exchange |
$33.96
|
| Rate for Payer: UHC Medicaid |
$23.95
|
| Rate for Payer: UHC Medicare Advantage |
$33.96
|
| Rate for Payer: UHCCP Medicaid |
$23.95
|
| Rate for Payer: VA VA |
$33.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.87
|
|
|
HC CYTO DNA PROBE
|
Facility
|
IP
|
$135.83
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.54 |
| Max. Negotiated Rate |
$122.25 |
| Rate for Payer: Aetna Commercial |
$115.46
|
| Rate for Payer: BCBS Trust/PPO |
$112.18
|
| Rate for Payer: BCN Commercial |
$112.18
|
| Rate for Payer: Cash Price |
$108.66
|
| Rate for Payer: Cofinity Commercial |
$116.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.66
|
| Rate for Payer: Healthscope Commercial |
$122.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.46
|
| Rate for Payer: Nomi Health Commercial |
$111.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.87
|
| Rate for Payer: PHP Commercial |
$115.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.53
|
| Rate for Payer: UHC Core |
$113.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.87
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
OP
|
$108.24
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna Medicare |
$28.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.83
|
| Rate for Payer: BCBS Complete |
$20.04
|
| Rate for Payer: BCBS MAPPO |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$88.98
|
| Rate for Payer: BCN Commercial |
$88.98
|
| Rate for Payer: BCN Medicare Advantage |
$27.06
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.06
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Mclaren Medicaid |
$19.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.41
|
| Rate for Payer: Meridian Medicaid |
$20.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$88.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PACE Senior Care Partners |
$25.71
|
| Rate for Payer: PACE SWMI |
$27.06
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: PHP Medicare Advantage |
$27.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.17
|
| Rate for Payer: Priority Health Medicare |
$27.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.34
|
| Rate for Payer: Railroad Medicare Medicare |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.25
|
| Rate for Payer: UHC Core |
$90.38
|
| Rate for Payer: UHC Exchange |
$27.06
|
| Rate for Payer: UHC Medicaid |
$19.08
|
| Rate for Payer: UHC Medicare Advantage |
$27.06
|
| Rate for Payer: UHCCP Medicaid |
$19.08
|
| Rate for Payer: VA VA |
$27.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
IP
|
$108.24
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.34 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: BCBS Trust/PPO |
$89.40
|
| Rate for Payer: BCN Commercial |
$89.40
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$88.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.25
|
| Rate for Payer: UHC Core |
$90.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
IP
|
$273.63
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$190.45 |
| Max. Negotiated Rate |
$246.27 |
| Rate for Payer: Aetna Commercial |
$232.59
|
| Rate for Payer: BCBS Trust/PPO |
$225.99
|
| Rate for Payer: BCN Commercial |
$225.99
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cofinity Commercial |
$235.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.90
|
| Rate for Payer: Healthscope Commercial |
$246.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.59
|
| Rate for Payer: Nomi Health Commercial |
$224.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.22
|
| Rate for Payer: PHP Commercial |
$232.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$238.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.79
|
| Rate for Payer: UHC Core |
$228.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.22
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
OP
|
$273.63
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.24 |
| Max. Negotiated Rate |
$246.27 |
| Rate for Payer: Aetna Commercial |
$232.59
|
| Rate for Payer: Aetna Medicare |
$71.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.51
|
| Rate for Payer: BCBS Complete |
$50.65
|
| Rate for Payer: BCBS MAPPO |
$68.41
|
| Rate for Payer: BCBS Trust/PPO |
$224.95
|
| Rate for Payer: BCN Commercial |
$224.95
|
| Rate for Payer: BCN Medicare Advantage |
$68.41
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cofinity Commercial |
$235.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.41
|
| Rate for Payer: Healthscope Commercial |
$246.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.22
|
| Rate for Payer: Mclaren Medicaid |
$48.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.83
|
| Rate for Payer: Meridian Medicaid |
$50.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.59
|
| Rate for Payer: Nomi Health Commercial |
$224.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.22
|
| Rate for Payer: PACE Senior Care Partners |
$64.99
|
| Rate for Payer: PACE SWMI |
$68.41
|
| Rate for Payer: PHP Commercial |
$232.59
|
| Rate for Payer: PHP Medicare Advantage |
$68.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$238.06
|
| Rate for Payer: Priority Health Medicare |
$69.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.45
|
| Rate for Payer: Railroad Medicare Medicare |
$68.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.79
|
| Rate for Payer: UHC Core |
$228.48
|
| Rate for Payer: UHC Exchange |
$68.41
|
| Rate for Payer: UHC Medicaid |
$48.24
|
| Rate for Payer: UHC Medicare Advantage |
$68.41
|
| Rate for Payer: UHCCP Medicaid |
$48.24
|
| Rate for Payer: VA VA |
$68.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.22
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$247.62
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$172.34 |
| Max. Negotiated Rate |
$222.86 |
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: BCBS Trust/PPO |
$204.51
|
| Rate for Payer: BCN Commercial |
$204.51
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Nomi Health Commercial |
$203.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.91
|
| Rate for Payer: UHC Core |
$206.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$247.62
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$222.86 |
| Rate for Payer: Aetna Commercial |
$210.48
|
| Rate for Payer: Aetna Medicare |
$64.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.38
|
| Rate for Payer: BCBS Complete |
$45.83
|
| Rate for Payer: BCBS MAPPO |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$203.57
|
| Rate for Payer: BCN Commercial |
$203.57
|
| Rate for Payer: BCN Medicare Advantage |
$61.91
|
| Rate for Payer: Cash Price |
$198.10
|
| Rate for Payer: Cofinity Commercial |
$212.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.91
|
| Rate for Payer: Healthscope Commercial |
$222.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.72
|
| Rate for Payer: Mclaren Medicaid |
$43.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.00
|
| Rate for Payer: Meridian Medicaid |
$45.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.48
|
| Rate for Payer: Nomi Health Commercial |
$203.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.72
|
| Rate for Payer: PACE Senior Care Partners |
$58.81
|
| Rate for Payer: PACE SWMI |
$61.91
|
| Rate for Payer: PHP Commercial |
$210.48
|
| Rate for Payer: PHP Medicare Advantage |
$61.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.43
|
| Rate for Payer: Priority Health Medicare |
$62.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.34
|
| Rate for Payer: Railroad Medicare Medicare |
$61.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.91
|
| Rate for Payer: UHC Core |
$206.76
|
| Rate for Payer: UHC Exchange |
$61.91
|
| Rate for Payer: UHC Medicaid |
$43.66
|
| Rate for Payer: UHC Medicare Advantage |
$61.91
|
| Rate for Payer: UHCCP Medicaid |
$43.66
|
| Rate for Payer: VA VA |
$61.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.72
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$114.13
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$102.72 |
| Rate for Payer: Aetna Commercial |
$97.01
|
| Rate for Payer: Aetna Medicare |
$29.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.67
|
| Rate for Payer: BCBS Complete |
$21.13
|
| Rate for Payer: BCBS MAPPO |
$28.53
|
| Rate for Payer: BCBS Trust/PPO |
$93.83
|
| Rate for Payer: BCN Commercial |
$93.83
|
| Rate for Payer: BCN Medicare Advantage |
$28.53
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cofinity Commercial |
$98.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.53
|
| Rate for Payer: Healthscope Commercial |
$102.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.60
|
| Rate for Payer: Mclaren Medicaid |
$20.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.96
|
| Rate for Payer: Meridian Medicaid |
$21.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.01
|
| Rate for Payer: Nomi Health Commercial |
$93.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.60
|
| Rate for Payer: PACE Senior Care Partners |
$27.11
|
| Rate for Payer: PACE SWMI |
$28.53
|
| Rate for Payer: PHP Commercial |
$97.01
|
| Rate for Payer: PHP Medicare Advantage |
$28.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.29
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.43
|
| Rate for Payer: Railroad Medicare Medicare |
$28.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.43
|
| Rate for Payer: UHC Core |
$95.30
|
| Rate for Payer: UHC Exchange |
$28.53
|
| Rate for Payer: UHC Medicaid |
$20.12
|
| Rate for Payer: UHC Medicare Advantage |
$28.53
|
| Rate for Payer: UHCCP Medicaid |
$20.12
|
| Rate for Payer: VA VA |
$28.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.60
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$114.13
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$79.43 |
| Max. Negotiated Rate |
$102.72 |
| Rate for Payer: Aetna Commercial |
$97.01
|
| Rate for Payer: BCBS Trust/PPO |
$94.26
|
| Rate for Payer: BCN Commercial |
$94.26
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cofinity Commercial |
$98.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.30
|
| Rate for Payer: Healthscope Commercial |
$102.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.01
|
| Rate for Payer: Nomi Health Commercial |
$93.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.60
|
| Rate for Payer: PHP Commercial |
$97.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.43
|
| Rate for Payer: UHC Core |
$95.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.60
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
