|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
IP
|
$2,764.69
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
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 CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
IP
|
$4,710.21
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,061.64 |
| Max. Negotiated Rate |
$4,239.19 |
| Rate for Payer: Aetna Commercial |
$4,003.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,844.94
|
| Rate for Payer: BCN Commercial |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,768.17
|
| Rate for Payer: Cofinity Commercial |
$4,050.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,768.17
|
| Rate for Payer: Healthscope Commercial |
$4,239.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,532.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,003.68
|
| Rate for Payer: Nomi Health Commercial |
$3,862.37
|
| Rate for Payer: PHP Commercial |
$4,003.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,061.64
|
| Rate for Payer: Priority Health HMO/PPO |
$4,097.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,155.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,144.98
|
| Rate for Payer: UHC Core |
$3,933.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,532.66
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
OP
|
$4,710.21
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,118.67 |
| Max. Negotiated Rate |
$4,239.19 |
| Rate for Payer: Aetna Commercial |
$4,003.68
|
| Rate for Payer: Aetna Medicare |
$1,224.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,471.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,471.94
|
| Rate for Payer: BCBS Complete |
$2,565.51
|
| Rate for Payer: BCBS MAPPO |
$1,177.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,872.26
|
| Rate for Payer: BCN Commercial |
$3,662.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,177.55
|
| Rate for Payer: Cash Price |
$3,768.17
|
| Rate for Payer: Cash Price |
$3,768.17
|
| Rate for Payer: Cofinity Commercial |
$4,050.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,768.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,177.55
|
| Rate for Payer: Healthscope Commercial |
$4,239.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,532.66
|
| Rate for Payer: Mclaren Medicaid |
$2,443.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,236.43
|
| Rate for Payer: Meridian Medicaid |
$2,565.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,354.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,003.68
|
| Rate for Payer: Nomi Health Commercial |
$3,862.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,118.67
|
| Rate for Payer: PACE SWMI |
$1,177.55
|
| Rate for Payer: PHP Commercial |
$4,003.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,177.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,443.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,061.64
|
| Rate for Payer: Priority Health HMO/PPO |
$4,097.88
|
| Rate for Payer: Priority Health Medicare |
$1,189.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,155.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,177.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,144.98
|
| Rate for Payer: UHC Core |
$3,933.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,177.55
|
| Rate for Payer: UHC Exchange |
$1,177.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,177.55
|
| Rate for Payer: UHCCP Medicaid |
$2,443.18
|
| Rate for Payer: VA VA |
$1,177.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,532.66
|
|
|
HC CYTO DNA PROBE
|
Facility
|
IP
|
$133.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$86.56 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: BCBS Trust/PPO |
$108.71
|
| Rate for Payer: BCN Commercial |
$102.91
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.56
|
| Rate for Payer: Priority Health HMO/PPO |
$115.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.19
|
| Rate for Payer: UHC Core |
$111.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CYTO DNA PROBE
|
Facility
|
OP
|
$133.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Aetna Medicare |
$34.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.62
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$33.29
|
| Rate for Payer: BCBS Trust/PPO |
$109.48
|
| Rate for Payer: BCN Commercial |
$103.54
|
| Rate for Payer: BCN Medicare Advantage |
$33.29
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.29
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.96
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: PACE Senior Care Partners |
$31.63
|
| Rate for Payer: PACE SWMI |
$33.29
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: PHP Medicare Advantage |
$33.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.56
|
| Rate for Payer: Priority Health HMO/PPO |
$115.86
|
| Rate for Payer: Priority Health Medicare |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.22
|
| Rate for Payer: Railroad Medicare Medicare |
$33.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.19
|
| Rate for Payer: UHC Core |
$111.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.29
|
| Rate for Payer: UHC Exchange |
$33.29
|
| Rate for Payer: UHC Medicare Advantage |
$33.29
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$33.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$87.24
|
| Rate for Payer: BCN Commercial |
$82.51
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.86
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.10
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.53
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.98 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$86.63
|
| Rate for Payer: BCN Commercial |
$82.01
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
IP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.37 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: BCBS Trust/PPO |
$218.98
|
| Rate for Payer: BCN Commercial |
$207.31
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health HMO/PPO |
$233.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.07
|
| Rate for Payer: UHC Core |
$224.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.20
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
OP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: Aetna Medicare |
$69.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.83
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$67.06
|
| Rate for Payer: BCBS Trust/PPO |
$220.54
|
| Rate for Payer: BCN Commercial |
$208.57
|
| Rate for Payer: BCN Medicare Advantage |
$67.06
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.06
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.20
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.42
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: PACE Senior Care Partners |
$63.71
|
| Rate for Payer: PACE SWMI |
$67.06
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: PHP Medicare Advantage |
$67.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health HMO/PPO |
$233.39
|
| Rate for Payer: Priority Health Medicare |
$67.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.73
|
| Rate for Payer: Railroad Medicare Medicare |
$67.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.07
|
| Rate for Payer: UHC Core |
$224.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.06
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$67.06
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$67.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.20
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$157.79 |
| Max. Negotiated Rate |
$218.48 |
| Rate for Payer: Aetna Commercial |
$206.35
|
| Rate for Payer: BCBS Trust/PPO |
$198.16
|
| Rate for Payer: BCN Commercial |
$187.60
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$208.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Healthscope Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: Nomi Health Commercial |
$199.06
|
| Rate for Payer: PHP Commercial |
$206.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health HMO/PPO |
$211.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.63
|
| Rate for Payer: UHC Core |
$202.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.07
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$218.48 |
| Rate for Payer: Aetna Commercial |
$206.35
|
| Rate for Payer: Aetna Medicare |
$63.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.86
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$60.69
|
| Rate for Payer: BCBS Trust/PPO |
$199.57
|
| Rate for Payer: BCN Commercial |
$188.75
|
| Rate for Payer: BCN Medicare Advantage |
$60.69
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$208.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.69
|
| Rate for Payer: Healthscope Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.07
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.72
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: Nomi Health Commercial |
$199.06
|
| Rate for Payer: PACE Senior Care Partners |
$57.66
|
| Rate for Payer: PACE SWMI |
$60.69
|
| Rate for Payer: PHP Commercial |
$206.35
|
| Rate for Payer: PHP Medicare Advantage |
$60.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health HMO/PPO |
$211.20
|
| Rate for Payer: Priority Health Medicare |
$61.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.65
|
| Rate for Payer: Railroad Medicare Medicare |
$60.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.63
|
| Rate for Payer: UHC Core |
$202.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.69
|
| Rate for Payer: UHC Exchange |
$60.69
|
| Rate for Payer: UHC Medicare Advantage |
$60.69
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$60.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.07
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.73 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: BCBS Trust/PPO |
$91.34
|
| Rate for Payer: BCN Commercial |
$86.47
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$96.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: Nomi Health Commercial |
$91.75
|
| Rate for Payer: PHP Commercial |
$95.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health HMO/PPO |
$97.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.46
|
| Rate for Payer: UHC Core |
$93.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.92
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.14 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: Aetna Medicare |
$29.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.97
|
| Rate for Payer: BCBS Complete |
$14.85
|
| Rate for Payer: BCBS MAPPO |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$91.98
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Medicare Advantage |
$27.97
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$96.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.92
|
| Rate for Payer: Mclaren Medicaid |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.37
|
| Rate for Payer: Meridian Medicaid |
$14.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: Nomi Health Commercial |
$91.75
|
| Rate for Payer: PACE Senior Care Partners |
$26.57
|
| Rate for Payer: PACE SWMI |
$27.97
|
| Rate for Payer: PHP Commercial |
$95.11
|
| Rate for Payer: PHP Medicare Advantage |
$27.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health HMO/PPO |
$97.34
|
| Rate for Payer: Priority Health Medicare |
$28.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.97
|
| Rate for Payer: Railroad Medicare Medicare |
$27.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.46
|
| Rate for Payer: UHC Core |
$93.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.97
|
| Rate for Payer: UHC Exchange |
$27.97
|
| Rate for Payer: UHC Medicare Advantage |
$27.97
|
| Rate for Payer: UHCCP Medicaid |
$14.14
|
| Rate for Payer: VA VA |
$27.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.92
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$12.79
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$12.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$12.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$12.18
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$31.92 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna Commercial |
$114.26
|
| Rate for Payer: Aetna Medicare |
$34.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.01
|
| Rate for Payer: BCBS Complete |
$39.74
|
| Rate for Payer: BCBS MAPPO |
$33.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.51
|
| Rate for Payer: BCN Commercial |
$104.51
|
| Rate for Payer: BCN Medicare Advantage |
$33.60
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$120.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.82
|
| Rate for Payer: Mclaren Medicaid |
$37.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.29
|
| Rate for Payer: Meridian Medicaid |
$39.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: Nomi Health Commercial |
$110.22
|
| Rate for Payer: PACE Senior Care Partners |
$31.92
|
| Rate for Payer: PACE SWMI |
$33.60
|
| Rate for Payer: PHP Commercial |
$114.26
|
| Rate for Payer: PHP Medicare Advantage |
$33.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health HMO/PPO |
$116.95
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.06
|
| Rate for Payer: Railroad Medicare Medicare |
$33.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.29
|
| Rate for Payer: UHC Core |
$112.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.60
|
| Rate for Payer: UHC Exchange |
$33.60
|
| Rate for Payer: UHC Medicare Advantage |
$33.60
|
| Rate for Payer: UHCCP Medicaid |
$37.85
|
| Rate for Payer: VA VA |
$33.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.82
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$87.37 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna Commercial |
$114.26
|
| Rate for Payer: BCBS Trust/PPO |
$109.73
|
| Rate for Payer: BCN Commercial |
$103.88
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Healthscope Commercial |
$120.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: Nomi Health Commercial |
$110.22
|
| Rate for Payer: PHP Commercial |
$114.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health HMO/PPO |
$116.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.29
|
| Rate for Payer: UHC Core |
$112.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.82
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$92.17 |
| Rate for Payer: Aetna Commercial |
$87.05
|
| Rate for Payer: BCBS Trust/PPO |
$83.60
|
| Rate for Payer: BCN Commercial |
$79.14
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$88.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Healthscope Commercial |
$92.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: Nomi Health Commercial |
$83.98
|
| Rate for Payer: PHP Commercial |
$87.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health HMO/PPO |
$89.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.12
|
| Rate for Payer: UHC Core |
$85.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.81
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$17.34 |
| Max. Negotiated Rate |
$92.17 |
| Rate for Payer: Aetna Commercial |
$87.05
|
| Rate for Payer: Aetna Medicare |
$26.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.00
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS MAPPO |
$25.60
|
| Rate for Payer: BCBS Trust/PPO |
$84.19
|
| Rate for Payer: BCN Commercial |
$79.62
|
| Rate for Payer: BCN Medicare Advantage |
$25.60
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$88.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.60
|
| Rate for Payer: Healthscope Commercial |
$92.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.81
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.88
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: Nomi Health Commercial |
$83.98
|
| Rate for Payer: PACE Senior Care Partners |
$24.32
|
| Rate for Payer: PACE SWMI |
$25.60
|
| Rate for Payer: PHP Commercial |
$87.05
|
| Rate for Payer: PHP Medicare Advantage |
$25.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health HMO/PPO |
$89.10
|
| Rate for Payer: Priority Health Medicare |
$25.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.61
|
| Rate for Payer: Railroad Medicare Medicare |
$25.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.12
|
| Rate for Payer: UHC Core |
$85.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.60
|
| Rate for Payer: UHC Exchange |
$25.60
|
| Rate for Payer: UHC Medicare Advantage |
$25.60
|
| Rate for Payer: UHCCP Medicaid |
$17.34
|
| Rate for Payer: VA VA |
$25.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.81
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: BCBS Trust/PPO |
$60.78
|
| Rate for Payer: BCN Commercial |
$57.54
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$61.06
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health HMO/PPO |
$64.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$19.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.27
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$61.21
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: BCN Medicare Advantage |
$18.62
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.62
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.55
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$61.06
|
| Rate for Payer: PACE Senior Care Partners |
$17.68
|
| Rate for Payer: PACE SWMI |
$18.62
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$18.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health HMO/PPO |
$64.78
|
| Rate for Payer: Priority Health Medicare |
$18.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.89
|
| Rate for Payer: Railroad Medicare Medicare |
$18.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.62
|
| Rate for Payer: UHC Exchange |
$18.62
|
| Rate for Payer: UHC Medicare Advantage |
$18.62
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$18.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
