|
HC MYCOPLASMA CULTURE
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna Medicare |
$27.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.62
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: BCBS MAPPO |
$26.90
|
| Rate for Payer: BCBS Trust/PPO |
$83.66
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: BCN Medicare Advantage |
$26.90
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.90
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Mclaren Medicaid |
$11.36
|
| Rate for Payer: Meridian Medicaid |
$11.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Senior Care Partners |
$25.56
|
| Rate for Payer: PACE SWMI |
$26.90
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: PHP Medicare Advantage |
$26.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.61
|
| Rate for Payer: Priority Health Medicare |
$26.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.63
|
| Rate for Payer: Railroad Medicare Medicare |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.69
|
| Rate for Payer: UHC Core |
$89.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.90
|
| Rate for Payer: UHC Medicare Advantage |
$27.71
|
| Rate for Payer: VA VA |
$26.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$15.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.75
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$15.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.65
|
| Rate for Payer: BCN Commercial |
$46.65
|
| Rate for Payer: BCN Medicare Advantage |
$15.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Senior Care Partners |
$14.25
|
| Rate for Payer: PACE SWMI |
$15.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$15.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Medicare |
$15.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.45
|
| Rate for Payer: VA VA |
$15.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.59 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.37
|
| Rate for Payer: BCN Commercial |
$46.37
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna Medicare |
$37.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.71
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$35.76
|
| Rate for Payer: BCBS Trust/PPO |
$111.23
|
| Rate for Payer: BCN Commercial |
$111.23
|
| Rate for Payer: BCN Medicare Advantage |
$35.76
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.76
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.30
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Senior Care Partners |
$33.98
|
| Rate for Payer: PACE SWMI |
$35.76
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Medicare |
$35.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.25
|
| Rate for Payer: Railroad Medicare Medicare |
$35.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.89
|
| Rate for Payer: UHC Core |
$119.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.76
|
| Rate for Payer: UHC Medicare Advantage |
$36.84
|
| Rate for Payer: VA VA |
$35.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.30
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.25 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.56
|
| Rate for Payer: BCN Commercial |
$110.56
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.89
|
| Rate for Payer: UHC Core |
$119.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.30
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.25 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.56
|
| Rate for Payer: BCN Commercial |
$110.56
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.89
|
| Rate for Payer: UHC Core |
$119.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.30
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna Medicare |
$37.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.71
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$35.76
|
| Rate for Payer: BCBS Trust/PPO |
$111.23
|
| Rate for Payer: BCN Commercial |
$111.23
|
| Rate for Payer: BCN Medicare Advantage |
$35.76
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.76
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.30
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Senior Care Partners |
$33.98
|
| Rate for Payer: PACE SWMI |
$35.76
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Medicare |
$35.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.25
|
| Rate for Payer: Railroad Medicare Medicare |
$35.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.89
|
| Rate for Payer: UHC Core |
$119.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.76
|
| Rate for Payer: UHC Medicare Advantage |
$36.84
|
| Rate for Payer: VA VA |
$35.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.30
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$143.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: Aetna Medicare |
$37.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.71
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$35.76
|
| Rate for Payer: BCBS Trust/PPO |
$111.23
|
| Rate for Payer: BCN Commercial |
$111.23
|
| Rate for Payer: BCN Medicare Advantage |
$35.76
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.76
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.30
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PACE Senior Care Partners |
$33.98
|
| Rate for Payer: PACE SWMI |
$35.76
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Medicare |
$35.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.25
|
| Rate for Payer: Railroad Medicare Medicare |
$35.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.89
|
| Rate for Payer: UHC Core |
$119.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.76
|
| Rate for Payer: UHC Medicare Advantage |
$36.84
|
| Rate for Payer: VA VA |
$35.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.30
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$143.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.25 |
| Max. Negotiated Rate |
$128.75 |
| Rate for Payer: Aetna Commercial |
$121.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.56
|
| Rate for Payer: BCN Commercial |
$110.56
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cofinity Commercial |
$123.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.45
|
| Rate for Payer: Healthscope Commercial |
$128.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.60
|
| Rate for Payer: PHP Commercial |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.89
|
| Rate for Payer: UHC Core |
$119.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.30
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$16.55
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$5.36
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$5.36
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.36
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Senior Care Partners |
$5.09
|
| Rate for Payer: PACE SWMI |
$5.36
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.36
|
| Rate for Payer: UHC Medicare Advantage |
$5.52
|
| Rate for Payer: VA VA |
$5.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$216.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$131.74 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: BCBS Trust/PPO |
$166.92
|
| Rate for Payer: BCN Commercial |
$166.92
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$185.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.80
|
| Rate for Payer: Healthscope Commercial |
$194.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.60
|
| Rate for Payer: PHP Commercial |
$183.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.08
|
| Rate for Payer: UHC Core |
$180.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.00
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$216.00
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Aetna Commercial |
$183.60
|
| Rate for Payer: Aetna Medicare |
$56.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.50
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$54.00
|
| Rate for Payer: BCBS Trust/PPO |
$167.94
|
| Rate for Payer: BCN Commercial |
$167.94
|
| Rate for Payer: BCN Medicare Advantage |
$54.00
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$185.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.00
|
| Rate for Payer: Healthscope Commercial |
$194.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.00
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.60
|
| Rate for Payer: PACE Senior Care Partners |
$51.30
|
| Rate for Payer: PACE SWMI |
$54.00
|
| Rate for Payer: PHP Commercial |
$183.60
|
| Rate for Payer: PHP Medicare Advantage |
$54.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.92
|
| Rate for Payer: Priority Health Medicare |
$54.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.74
|
| Rate for Payer: Railroad Medicare Medicare |
$54.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.08
|
| Rate for Payer: UHC Core |
$180.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.00
|
| Rate for Payer: UHC Medicare Advantage |
$55.62
|
| Rate for Payer: VA VA |
$54.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.00
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$632.40
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$385.70 |
| Max. Negotiated Rate |
$569.16 |
| Rate for Payer: Aetna Commercial |
$537.54
|
| Rate for Payer: BCBS Trust/PPO |
$488.72
|
| Rate for Payer: BCN Commercial |
$488.72
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cofinity Commercial |
$543.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.92
|
| Rate for Payer: Healthscope Commercial |
$569.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.54
|
| Rate for Payer: PHP Commercial |
$537.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.51
|
| Rate for Payer: UHC Core |
$528.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.30
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$632.40
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$129.45 |
| Max. Negotiated Rate |
$569.16 |
| Rate for Payer: Aetna Commercial |
$537.54
|
| Rate for Payer: Aetna Medicare |
$164.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$197.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$197.62
|
| Rate for Payer: BCBS Complete |
$135.92
|
| Rate for Payer: BCBS MAPPO |
$158.10
|
| Rate for Payer: BCBS Trust/PPO |
$491.69
|
| Rate for Payer: BCN Commercial |
$491.69
|
| Rate for Payer: BCN Medicare Advantage |
$158.10
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cash Price |
$505.92
|
| Rate for Payer: Cofinity Commercial |
$543.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.10
|
| Rate for Payer: Healthscope Commercial |
$569.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.30
|
| Rate for Payer: Mclaren Medicaid |
$129.45
|
| Rate for Payer: Meridian Medicaid |
$135.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$166.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.54
|
| Rate for Payer: PACE Senior Care Partners |
$150.20
|
| Rate for Payer: PACE SWMI |
$158.10
|
| Rate for Payer: PHP Commercial |
$537.54
|
| Rate for Payer: PHP Medicare Advantage |
$158.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.19
|
| Rate for Payer: Priority Health Medicare |
$158.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.70
|
| Rate for Payer: Railroad Medicare Medicare |
$158.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.51
|
| Rate for Payer: UHC Core |
$528.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.10
|
| Rate for Payer: UHC Medicare Advantage |
$162.84
|
| Rate for Payer: VA VA |
$158.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.30
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: Aetna Medicare |
$31.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.25
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$95.17
|
| Rate for Payer: BCN Commercial |
$95.17
|
| Rate for Payer: BCN Medicare Advantage |
$30.60
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PACE Senior Care Partners |
$29.07
|
| Rate for Payer: PACE SWMI |
$30.60
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: PHP Medicare Advantage |
$30.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.49
|
| Rate for Payer: Priority Health Medicare |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.65
|
| Rate for Payer: Railroad Medicare Medicare |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.60
|
| Rate for Payer: UHC Medicare Advantage |
$31.52
|
| Rate for Payer: VA VA |
$30.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$74.65 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: BCBS Trust/PPO |
$94.59
|
| Rate for Payer: BCN Commercial |
$94.59
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.28
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$75.34
|
| Rate for Payer: BCN Commercial |
$75.34
|
| Rate for Payer: BCN Medicare Advantage |
$24.22
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Senior Care Partners |
$23.01
|
| Rate for Payer: PACE SWMI |
$24.22
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Medicare |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.22
|
| Rate for Payer: UHC Medicare Advantage |
$24.95
|
| Rate for Payer: VA VA |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$74.88
|
| Rate for Payer: BCN Commercial |
$74.88
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$104.51 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$145.66
|
| Rate for Payer: BCBS Trust/PPO |
$132.43
|
| Rate for Payer: BCN Commercial |
$132.43
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$145.66
|
| Rate for Payer: PHP Commercial |
$145.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Core |
$143.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.52
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$145.66
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$133.23
|
| Rate for Payer: BCN Commercial |
$133.23
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.52
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$145.66
|
| Rate for Payer: PACE Senior Care Partners |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$145.66
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.08
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.51
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Core |
$143.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.52
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: Aetna Medicare |
$13.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.01
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS MAPPO |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$39.82
|
| Rate for Payer: BCN Commercial |
$39.82
|
| Rate for Payer: BCN Medicare Advantage |
$12.80
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.80
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PACE Senior Care Partners |
$12.16
|
| Rate for Payer: PACE SWMI |
$12.80
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: PHP Medicare Advantage |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Medicare |
$12.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.24
|
| Rate for Payer: Railroad Medicare Medicare |
$12.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.07
|
| Rate for Payer: UHC Core |
$42.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.80
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: VA VA |
$12.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.42
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$31.24 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: BCBS Trust/PPO |
$39.58
|
| Rate for Payer: BCN Commercial |
$39.58
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.07
|
| Rate for Payer: UHC Core |
$42.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.42
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$31.24 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: BCBS Trust/PPO |
$39.58
|
| Rate for Payer: BCN Commercial |
$39.58
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.07
|
| Rate for Payer: UHC Core |
$42.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.42
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: Aetna Medicare |
$13.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.01
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS MAPPO |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$39.82
|
| Rate for Payer: BCN Commercial |
$39.82
|
| Rate for Payer: BCN Medicare Advantage |
$12.80
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.80
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PACE Senior Care Partners |
$12.16
|
| Rate for Payer: PACE SWMI |
$12.80
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: PHP Medicare Advantage |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Medicare |
$12.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.24
|
| Rate for Payer: Railroad Medicare Medicare |
$12.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.07
|
| Rate for Payer: UHC Core |
$42.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.80
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: VA VA |
$12.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.42
|
|
