|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
IP
|
$1,649.34
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,072.07 |
| Max. Negotiated Rate |
$1,484.41 |
| Rate for Payer: Aetna Commercial |
$1,401.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,346.36
|
| Rate for Payer: BCN Commercial |
$1,274.61
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cofinity Commercial |
$1,418.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,319.47
|
| Rate for Payer: Healthscope Commercial |
$1,484.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,237.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,401.94
|
| Rate for Payer: Nomi Health Commercial |
$1,352.46
|
| Rate for Payer: PHP Commercial |
$1,401.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,434.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,105.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,451.42
|
| Rate for Payer: UHC Core |
$1,377.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,237.01
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$28.14
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$28.31
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$24.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$25.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.10
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: UHCCP Medicaid |
$24.20
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
IP
|
$207.04
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$134.58 |
| Max. Negotiated Rate |
$186.34 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: BCBS Trust/PPO |
$169.01
|
| Rate for Payer: BCN Commercial |
$160.00
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$178.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Healthscope Commercial |
$186.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$169.77
|
| Rate for Payer: PHP Commercial |
$175.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.58
|
| Rate for Payer: Priority Health HMO/PPO |
$180.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.20
|
| Rate for Payer: UHC Core |
$172.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.28
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
OP
|
$207.04
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.17 |
| Max. Negotiated Rate |
$186.34 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: Aetna Medicare |
$53.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.70
|
| Rate for Payer: BCBS Complete |
$131.84
|
| Rate for Payer: BCBS MAPPO |
$51.76
|
| Rate for Payer: BCBS Trust/PPO |
$170.21
|
| Rate for Payer: BCN Commercial |
$160.97
|
| Rate for Payer: BCN Medicare Advantage |
$51.76
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$178.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.76
|
| Rate for Payer: Healthscope Commercial |
$186.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.28
|
| Rate for Payer: Mclaren Medicaid |
$125.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.35
|
| Rate for Payer: Meridian Medicaid |
$131.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$169.77
|
| Rate for Payer: PACE Senior Care Partners |
$49.17
|
| Rate for Payer: PACE SWMI |
$51.76
|
| Rate for Payer: PHP Commercial |
$175.98
|
| Rate for Payer: PHP Medicare Advantage |
$51.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.58
|
| Rate for Payer: Priority Health HMO/PPO |
$180.12
|
| Rate for Payer: Priority Health Medicare |
$52.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.72
|
| Rate for Payer: Railroad Medicare Medicare |
$51.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.20
|
| Rate for Payer: UHC Core |
$172.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.76
|
| Rate for Payer: UHC Exchange |
$51.76
|
| Rate for Payer: UHC Medicare Advantage |
$51.76
|
| Rate for Payer: UHCCP Medicaid |
$125.56
|
| Rate for Payer: VA VA |
$51.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.28
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
IP
|
$375.58
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$244.13 |
| Max. Negotiated Rate |
$338.02 |
| Rate for Payer: Aetna Commercial |
$319.24
|
| Rate for Payer: BCBS Trust/PPO |
$306.59
|
| Rate for Payer: BCN Commercial |
$290.25
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cofinity Commercial |
$323.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.46
|
| Rate for Payer: Healthscope Commercial |
$338.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.24
|
| Rate for Payer: Nomi Health Commercial |
$307.98
|
| Rate for Payer: PHP Commercial |
$319.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health HMO/PPO |
$326.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.51
|
| Rate for Payer: UHC Core |
$313.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.69
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
OP
|
$375.58
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.20 |
| Max. Negotiated Rate |
$338.02 |
| Rate for Payer: Aetna Commercial |
$319.24
|
| Rate for Payer: Aetna Medicare |
$97.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.37
|
| Rate for Payer: BCBS Complete |
$143.16
|
| Rate for Payer: BCBS MAPPO |
$93.89
|
| Rate for Payer: BCBS Trust/PPO |
$308.76
|
| Rate for Payer: BCN Commercial |
$292.01
|
| Rate for Payer: BCN Medicare Advantage |
$93.89
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cofinity Commercial |
$323.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.89
|
| Rate for Payer: Healthscope Commercial |
$338.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.69
|
| Rate for Payer: Mclaren Medicaid |
$136.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.59
|
| Rate for Payer: Meridian Medicaid |
$143.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.24
|
| Rate for Payer: Nomi Health Commercial |
$307.98
|
| Rate for Payer: PACE Senior Care Partners |
$89.20
|
| Rate for Payer: PACE SWMI |
$93.89
|
| Rate for Payer: PHP Commercial |
$319.24
|
| Rate for Payer: PHP Medicare Advantage |
$93.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health HMO/PPO |
$326.75
|
| Rate for Payer: Priority Health Medicare |
$94.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.64
|
| Rate for Payer: Railroad Medicare Medicare |
$93.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.51
|
| Rate for Payer: UHC Core |
$313.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.89
|
| Rate for Payer: UHC Exchange |
$93.89
|
| Rate for Payer: UHC Medicare Advantage |
$93.89
|
| Rate for Payer: UHCCP Medicaid |
$136.34
|
| Rate for Payer: VA VA |
$93.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.69
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
IP
|
$221.61
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.05 |
| Max. Negotiated Rate |
$199.45 |
| Rate for Payer: Aetna Commercial |
$188.37
|
| Rate for Payer: BCBS Trust/PPO |
$180.90
|
| Rate for Payer: BCN Commercial |
$171.26
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$190.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Healthscope Commercial |
$199.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: PHP Commercial |
$188.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.05
|
| Rate for Payer: Priority Health HMO/PPO |
$192.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.02
|
| Rate for Payer: UHC Core |
$185.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.21
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
OP
|
$221.61
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.63 |
| Max. Negotiated Rate |
$199.45 |
| Rate for Payer: Aetna Commercial |
$188.37
|
| Rate for Payer: Aetna Medicare |
$57.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.25
|
| Rate for Payer: BCBS Complete |
$88.44
|
| Rate for Payer: BCBS MAPPO |
$55.40
|
| Rate for Payer: BCBS Trust/PPO |
$182.19
|
| Rate for Payer: BCN Commercial |
$172.30
|
| Rate for Payer: BCN Medicare Advantage |
$55.40
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$190.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.40
|
| Rate for Payer: Healthscope Commercial |
$199.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.21
|
| Rate for Payer: Mclaren Medicaid |
$84.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.17
|
| Rate for Payer: Meridian Medicaid |
$88.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: PACE Senior Care Partners |
$52.63
|
| Rate for Payer: PACE SWMI |
$55.40
|
| Rate for Payer: PHP Commercial |
$188.37
|
| Rate for Payer: PHP Medicare Advantage |
$55.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.05
|
| Rate for Payer: Priority Health HMO/PPO |
$192.80
|
| Rate for Payer: Priority Health Medicare |
$55.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.48
|
| Rate for Payer: Railroad Medicare Medicare |
$55.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.02
|
| Rate for Payer: UHC Core |
$185.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.40
|
| Rate for Payer: UHC Exchange |
$55.40
|
| Rate for Payer: UHC Medicare Advantage |
$55.40
|
| Rate for Payer: UHCCP Medicaid |
$84.22
|
| Rate for Payer: VA VA |
$55.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.21
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$206.44 |
| Rate for Payer: Aetna Commercial |
$194.97
|
| Rate for Payer: Aetna Medicare |
$59.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.68
|
| Rate for Payer: BCBS Complete |
$109.14
|
| Rate for Payer: BCBS MAPPO |
$57.34
|
| Rate for Payer: BCBS Trust/PPO |
$188.57
|
| Rate for Payer: BCN Commercial |
$178.34
|
| Rate for Payer: BCN Medicare Advantage |
$57.34
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$197.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.34
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.03
|
| Rate for Payer: Mclaren Medicaid |
$103.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.21
|
| Rate for Payer: Meridian Medicaid |
$109.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: Nomi Health Commercial |
$188.09
|
| Rate for Payer: PACE Senior Care Partners |
$54.48
|
| Rate for Payer: PACE SWMI |
$57.34
|
| Rate for Payer: PHP Commercial |
$194.97
|
| Rate for Payer: PHP Medicare Advantage |
$57.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO |
$199.56
|
| Rate for Payer: Priority Health Medicare |
$57.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.68
|
| Rate for Payer: Railroad Medicare Medicare |
$57.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.85
|
| Rate for Payer: UHC Core |
$191.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.34
|
| Rate for Payer: UHC Exchange |
$57.34
|
| Rate for Payer: UHC Medicare Advantage |
$57.34
|
| Rate for Payer: UHCCP Medicaid |
$103.93
|
| Rate for Payer: VA VA |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.03
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$206.44 |
| Rate for Payer: Aetna Commercial |
$194.97
|
| Rate for Payer: BCBS Trust/PPO |
$187.24
|
| Rate for Payer: BCN Commercial |
$177.26
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$197.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Healthscope Commercial |
$206.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: Nomi Health Commercial |
$188.09
|
| Rate for Payer: PHP Commercial |
$194.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO |
$199.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.85
|
| Rate for Payer: UHC Core |
$191.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.03
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.84 |
| Max. Negotiated Rate |
$211.62 |
| Rate for Payer: Aetna Commercial |
$199.86
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.48
|
| Rate for Payer: BCBS Complete |
$109.14
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$193.30
|
| Rate for Payer: BCN Commercial |
$182.81
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$202.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$211.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.35
|
| Rate for Payer: Mclaren Medicaid |
$103.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$109.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: Nomi Health Commercial |
$192.81
|
| Rate for Payer: PACE Senior Care Partners |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$199.86
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health HMO/PPO |
$204.56
|
| Rate for Payer: Priority Health Medicare |
$59.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.54
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.91
|
| Rate for Payer: UHC Core |
$196.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.78
|
| Rate for Payer: UHC Exchange |
$58.78
|
| Rate for Payer: UHC Medicare Advantage |
$58.78
|
| Rate for Payer: UHCCP Medicaid |
$103.93
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.35
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$152.83 |
| Max. Negotiated Rate |
$211.62 |
| Rate for Payer: Aetna Commercial |
$199.86
|
| Rate for Payer: BCBS Trust/PPO |
$191.94
|
| Rate for Payer: BCN Commercial |
$181.71
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$202.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Healthscope Commercial |
$211.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: Nomi Health Commercial |
$192.81
|
| Rate for Payer: PHP Commercial |
$199.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health HMO/PPO |
$204.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.91
|
| Rate for Payer: UHC Core |
$196.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.35
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$184.75 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna Medicare |
$53.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.15
|
| Rate for Payer: BCBS Complete |
$95.27
|
| Rate for Payer: BCBS MAPPO |
$51.32
|
| Rate for Payer: BCBS Trust/PPO |
$168.76
|
| Rate for Payer: BCN Commercial |
$159.61
|
| Rate for Payer: BCN Medicare Advantage |
$51.32
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$176.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.32
|
| Rate for Payer: Healthscope Commercial |
$184.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.96
|
| Rate for Payer: Mclaren Medicaid |
$90.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.89
|
| Rate for Payer: Meridian Medicaid |
$95.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: Nomi Health Commercial |
$168.33
|
| Rate for Payer: PACE Senior Care Partners |
$48.75
|
| Rate for Payer: PACE SWMI |
$51.32
|
| Rate for Payer: PHP Commercial |
$174.49
|
| Rate for Payer: PHP Medicare Advantage |
$51.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health HMO/PPO |
$178.59
|
| Rate for Payer: Priority Health Medicare |
$51.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.54
|
| Rate for Payer: Railroad Medicare Medicare |
$51.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.65
|
| Rate for Payer: UHC Core |
$171.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.32
|
| Rate for Payer: UHC Exchange |
$51.32
|
| Rate for Payer: UHC Medicare Advantage |
$51.32
|
| Rate for Payer: UHCCP Medicaid |
$90.73
|
| Rate for Payer: VA VA |
$51.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.96
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$133.43 |
| Max. Negotiated Rate |
$184.75 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: BCBS Trust/PPO |
$167.57
|
| Rate for Payer: BCN Commercial |
$158.64
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$176.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Healthscope Commercial |
$184.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: Nomi Health Commercial |
$168.33
|
| Rate for Payer: PHP Commercial |
$174.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health HMO/PPO |
$178.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.65
|
| Rate for Payer: UHC Core |
$171.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.96
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$198.15 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: BCBS Trust/PPO |
$248.84
|
| Rate for Payer: BCN Commercial |
$235.58
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.40 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$79.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.26
|
| Rate for Payer: BCBS Complete |
$114.11
|
| Rate for Payer: BCBS MAPPO |
$76.21
|
| Rate for Payer: BCBS Trust/PPO |
$250.61
|
| Rate for Payer: BCN Commercial |
$237.01
|
| Rate for Payer: BCN Medicare Advantage |
$76.21
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.21
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Mclaren Medicaid |
$108.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.02
|
| Rate for Payer: Meridian Medicaid |
$114.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: PACE Senior Care Partners |
$72.40
|
| Rate for Payer: PACE SWMI |
$76.21
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$76.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Medicare |
$76.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.24
|
| Rate for Payer: Railroad Medicare Medicare |
$76.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.21
|
| Rate for Payer: UHC Exchange |
$76.21
|
| Rate for Payer: UHC Medicare Advantage |
$76.21
|
| Rate for Payer: UHCCP Medicaid |
$108.67
|
| Rate for Payer: VA VA |
$76.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC CIRCUMCISION
|
Facility
|
IP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,797.05 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,256.82
|
| Rate for Payer: BCN Commercial |
$2,136.55
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,073.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,405.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,852.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,432.93
|
| Rate for Payer: UHC Core |
$2,308.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,073.52
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$656.61 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna Medicare |
$718.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$863.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$863.97
|
| Rate for Payer: BCBS Complete |
$1,105.88
|
| Rate for Payer: BCBS MAPPO |
$691.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,272.85
|
| Rate for Payer: BCN Commercial |
$2,149.55
|
| Rate for Payer: BCN Medicare Advantage |
$691.17
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$691.17
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,073.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$725.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$794.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: PACE Senior Care Partners |
$656.61
|
| Rate for Payer: PACE SWMI |
$691.17
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: PHP Medicare Advantage |
$691.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,405.28
|
| Rate for Payer: Priority Health Medicare |
$698.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,852.34
|
| Rate for Payer: Railroad Medicare Medicare |
$691.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,432.93
|
| Rate for Payer: UHC Core |
$2,308.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$691.17
|
| Rate for Payer: UHC Exchange |
$691.17
|
| Rate for Payer: UHC Medicare Advantage |
$691.17
|
| Rate for Payer: VA VA |
$691.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,073.52
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,715.06
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$644.83 |
| Max. Negotiated Rate |
$2,443.55 |
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: Aetna Medicare |
$705.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.46
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$678.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.05
|
| Rate for Payer: BCN Commercial |
$2,110.96
|
| Rate for Payer: BCN Medicare Advantage |
$678.76
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.76
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,036.30
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.70
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: PACE Senior Care Partners |
$644.83
|
| Rate for Payer: PACE SWMI |
$678.76
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: PHP Medicare Advantage |
$678.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO |
$2,362.10
|
| Rate for Payer: Priority Health Medicare |
$685.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,819.09
|
| Rate for Payer: Railroad Medicare Medicare |
$678.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,389.25
|
| Rate for Payer: UHC Core |
$2,267.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.76
|
| Rate for Payer: UHC Exchange |
$678.76
|
| Rate for Payer: UHC Medicare Advantage |
$678.76
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$678.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
IP
|
$2,715.06
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,764.79 |
| Max. Negotiated Rate |
$2,443.55 |
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,216.30
|
| Rate for Payer: BCN Commercial |
$2,098.20
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,036.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO |
$2,362.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,819.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,389.25
|
| Rate for Payer: UHC Core |
$2,267.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
OP
|
$2,764.69
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$656.61 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: Aetna Medicare |
$718.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$863.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$863.97
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$691.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,272.85
|
| Rate for Payer: BCN Commercial |
$2,149.55
|
| Rate for Payer: BCN Medicare Advantage |
$691.17
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$691.17
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,073.52
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$725.73
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$794.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: PACE Senior Care Partners |
$656.61
|
| Rate for Payer: PACE SWMI |
$691.17
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: PHP Medicare Advantage |
$691.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,405.28
|
| Rate for Payer: Priority Health Medicare |
$698.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,852.34
|
| Rate for Payer: Railroad Medicare Medicare |
$691.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,432.93
|
| Rate for Payer: UHC Core |
$2,308.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$691.17
|
| Rate for Payer: UHC Exchange |
$691.17
|
| Rate for Payer: UHC Medicare Advantage |
$691.17
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$691.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,073.52
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
IP
|
$2,764.69
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,797.05 |
| Max. Negotiated Rate |
$2,488.22 |
| Rate for Payer: Aetna Commercial |
$2,349.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,256.82
|
| Rate for Payer: BCN Commercial |
$2,136.55
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,377.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,488.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,073.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: PHP Commercial |
$2,349.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,405.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,852.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,432.93
|
| Rate for Payer: UHC Core |
$2,308.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,073.52
|
|
|
HC CITRIC ACID URINE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| 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 |
$21.11
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| 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 |
$20.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$21.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| 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 |
$20.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| 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 Dual Complete DSNP |
$13.27
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$20.10
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CITRIC ACID URINE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.49 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.31
|
| Rate for Payer: BCN Commercial |
$41.00
|
| 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: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| 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
|
|
