|
HC MYCOPLASMA CULTURE
|
Facility
|
OP
|
$109.75
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.13 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna Medicare |
$28.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.30
|
| Rate for Payer: BCBS Complete |
$11.68
|
| Rate for Payer: BCBS MAPPO |
$27.44
|
| Rate for Payer: BCBS Trust/PPO |
$90.23
|
| Rate for Payer: BCN Commercial |
$85.33
|
| Rate for Payer: BCN Medicare Advantage |
$27.44
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.44
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.31
|
| Rate for Payer: Mclaren Medicaid |
$11.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.81
|
| Rate for Payer: Meridian Medicaid |
$11.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: Nomi Health Commercial |
$90.00
|
| Rate for Payer: PACE Senior Care Partners |
$26.07
|
| Rate for Payer: PACE SWMI |
$27.44
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: PHP Medicare Advantage |
$27.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health HMO/PPO |
$95.48
|
| Rate for Payer: Priority Health Medicare |
$27.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.53
|
| Rate for Payer: Railroad Medicare Medicare |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.58
|
| Rate for Payer: UHC Core |
$91.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.44
|
| Rate for Payer: UHC Exchange |
$27.44
|
| Rate for Payer: UHC Medicare Advantage |
$27.44
|
| Rate for Payer: UHCCP Medicaid |
$11.13
|
| Rate for Payer: VA VA |
$27.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.31
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
IP
|
$109.75
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.34 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: BCBS Trust/PPO |
$89.59
|
| Rate for Payer: BCN Commercial |
$84.81
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.29
|
| Rate for Payer: Nomi Health Commercial |
$90.00
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.34
|
| Rate for Payer: Priority Health HMO/PPO |
$95.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.58
|
| Rate for Payer: UHC Core |
$91.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.31
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$37.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.60
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$36.48
|
| Rate for Payer: BCBS Trust/PPO |
$119.96
|
| Rate for Payer: BCN Commercial |
$113.45
|
| Rate for Payer: BCN Medicare Advantage |
$36.48
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.48
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.30
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: PACE Senior Care Partners |
$34.66
|
| Rate for Payer: PACE SWMI |
$36.48
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: PHP Medicare Advantage |
$36.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO |
$126.95
|
| Rate for Payer: Priority Health Medicare |
$36.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.77
|
| Rate for Payer: Railroad Medicare Medicare |
$36.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.41
|
| Rate for Payer: UHC Core |
$121.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.48
|
| Rate for Payer: UHC Exchange |
$36.48
|
| Rate for Payer: UHC Medicare Advantage |
$36.48
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$36.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: BCBS Trust/PPO |
$119.11
|
| Rate for Payer: BCN Commercial |
$112.77
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO |
$126.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.41
|
| Rate for Payer: UHC Core |
$121.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: BCBS Trust/PPO |
$119.11
|
| Rate for Payer: BCN Commercial |
$112.77
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO |
$126.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.41
|
| Rate for Payer: UHC Core |
$121.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$37.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.60
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$36.48
|
| Rate for Payer: BCBS Trust/PPO |
$119.96
|
| Rate for Payer: BCN Commercial |
$113.45
|
| Rate for Payer: BCN Medicare Advantage |
$36.48
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.48
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.30
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: PACE Senior Care Partners |
$34.66
|
| Rate for Payer: PACE SWMI |
$36.48
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: PHP Medicare Advantage |
$36.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO |
$126.95
|
| Rate for Payer: Priority Health Medicare |
$36.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.77
|
| Rate for Payer: Railroad Medicare Medicare |
$36.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.41
|
| Rate for Payer: UHC Core |
$121.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.48
|
| Rate for Payer: UHC Exchange |
$36.48
|
| Rate for Payer: UHC Medicare Advantage |
$36.48
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$36.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$145.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: BCBS Trust/PPO |
$119.11
|
| Rate for Payer: BCN Commercial |
$112.77
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO |
$126.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.41
|
| Rate for Payer: UHC Core |
$121.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$145.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$37.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.60
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$36.48
|
| Rate for Payer: BCBS Trust/PPO |
$119.96
|
| Rate for Payer: BCN Commercial |
$113.45
|
| Rate for Payer: BCN Medicare Advantage |
$36.48
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.48
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.30
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: Nomi Health Commercial |
$119.65
|
| Rate for Payer: PACE Senior Care Partners |
$34.66
|
| Rate for Payer: PACE SWMI |
$36.48
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: PHP Medicare Advantage |
$36.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health HMO/PPO |
$126.95
|
| Rate for Payer: Priority Health Medicare |
$36.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.77
|
| Rate for Payer: Railroad Medicare Medicare |
$36.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.41
|
| Rate for Payer: UHC Core |
$121.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.48
|
| Rate for Payer: UHC Exchange |
$36.48
|
| Rate for Payer: UHC Medicare Advantage |
$36.48
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$36.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.19 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$16.99
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Mclaren Medicaid |
$9.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: Meridian Medicaid |
$10.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Medicare |
$5.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.46
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: UHCCP Medicaid |
$9.57
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$17.84
|
| Rate for Payer: BCN Commercial |
$16.89
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$220.32
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$198.29 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: Aetna Medicare |
$57.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.85
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$55.08
|
| Rate for Payer: BCBS Trust/PPO |
$181.13
|
| Rate for Payer: BCN Commercial |
$171.30
|
| Rate for Payer: BCN Medicare Advantage |
$55.08
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$189.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.08
|
| Rate for Payer: Healthscope Commercial |
$198.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.24
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.83
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.27
|
| Rate for Payer: Nomi Health Commercial |
$180.66
|
| Rate for Payer: PACE Senior Care Partners |
$52.33
|
| Rate for Payer: PACE SWMI |
$55.08
|
| Rate for Payer: PHP Commercial |
$187.27
|
| Rate for Payer: PHP Medicare Advantage |
$55.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.21
|
| Rate for Payer: Priority Health HMO/PPO |
$191.68
|
| Rate for Payer: Priority Health Medicare |
$55.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.61
|
| Rate for Payer: Railroad Medicare Medicare |
$55.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.88
|
| Rate for Payer: UHC Core |
$183.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.08
|
| Rate for Payer: UHC Exchange |
$55.08
|
| Rate for Payer: UHC Medicare Advantage |
$55.08
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$55.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.24
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$220.32
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$143.21 |
| Max. Negotiated Rate |
$198.29 |
| Rate for Payer: Aetna Commercial |
$187.27
|
| Rate for Payer: BCBS Trust/PPO |
$179.85
|
| Rate for Payer: BCN Commercial |
$170.26
|
| Rate for Payer: Cash Price |
$176.26
|
| Rate for Payer: Cofinity Commercial |
$189.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.26
|
| Rate for Payer: Healthscope Commercial |
$198.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.27
|
| Rate for Payer: Nomi Health Commercial |
$180.66
|
| Rate for Payer: PHP Commercial |
$187.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.21
|
| Rate for Payer: Priority Health HMO/PPO |
$191.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.88
|
| Rate for Payer: UHC Core |
$183.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.24
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$645.05
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$126.81 |
| Max. Negotiated Rate |
$580.54 |
| Rate for Payer: Aetna Commercial |
$548.29
|
| Rate for Payer: Aetna Medicare |
$167.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.58
|
| Rate for Payer: BCBS Complete |
$133.16
|
| Rate for Payer: BCBS MAPPO |
$161.26
|
| Rate for Payer: BCBS Trust/PPO |
$530.30
|
| Rate for Payer: BCN Commercial |
$501.53
|
| Rate for Payer: BCN Medicare Advantage |
$161.26
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$554.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.26
|
| Rate for Payer: Healthscope Commercial |
$580.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.79
|
| Rate for Payer: Mclaren Medicaid |
$126.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.33
|
| Rate for Payer: Meridian Medicaid |
$133.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.29
|
| Rate for Payer: Nomi Health Commercial |
$528.94
|
| Rate for Payer: PACE Senior Care Partners |
$153.20
|
| Rate for Payer: PACE SWMI |
$161.26
|
| Rate for Payer: PHP Commercial |
$548.29
|
| Rate for Payer: PHP Medicare Advantage |
$161.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.28
|
| Rate for Payer: Priority Health HMO/PPO |
$561.19
|
| Rate for Payer: Priority Health Medicare |
$162.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.18
|
| Rate for Payer: Railroad Medicare Medicare |
$161.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.64
|
| Rate for Payer: UHC Core |
$538.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.26
|
| Rate for Payer: UHC Exchange |
$161.26
|
| Rate for Payer: UHC Medicare Advantage |
$161.26
|
| Rate for Payer: UHCCP Medicaid |
$126.81
|
| Rate for Payer: VA VA |
$161.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.79
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$645.05
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$419.28 |
| Max. Negotiated Rate |
$580.54 |
| Rate for Payer: Aetna Commercial |
$548.29
|
| Rate for Payer: BCBS Trust/PPO |
$526.55
|
| Rate for Payer: BCN Commercial |
$498.49
|
| Rate for Payer: Cash Price |
$516.04
|
| Rate for Payer: Cofinity Commercial |
$554.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.04
|
| Rate for Payer: Healthscope Commercial |
$580.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.29
|
| Rate for Payer: Nomi Health Commercial |
$528.94
|
| Rate for Payer: PHP Commercial |
$548.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.28
|
| Rate for Payer: Priority Health HMO/PPO |
$561.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.64
|
| Rate for Payer: UHC Core |
$538.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.79
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$124.85
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: BCBS Trust/PPO |
$101.92
|
| Rate for Payer: BCN Commercial |
$96.48
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health HMO/PPO |
$108.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.87
|
| Rate for Payer: UHC Core |
$104.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.64
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$124.85
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$112.36 |
| Rate for Payer: Aetna Commercial |
$106.12
|
| Rate for Payer: Aetna Medicare |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.02
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$102.64
|
| Rate for Payer: BCN Commercial |
$97.07
|
| Rate for Payer: BCN Medicare Advantage |
$31.21
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cash Price |
$99.88
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.21
|
| Rate for Payer: Healthscope Commercial |
$112.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.64
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.77
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.12
|
| Rate for Payer: Nomi Health Commercial |
$102.38
|
| Rate for Payer: PACE Senior Care Partners |
$29.65
|
| Rate for Payer: PACE SWMI |
$31.21
|
| Rate for Payer: PHP Commercial |
$106.12
|
| Rate for Payer: PHP Medicare Advantage |
$31.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.15
|
| Rate for Payer: Priority Health HMO/PPO |
$108.62
|
| Rate for Payer: Priority Health Medicare |
$31.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.65
|
| Rate for Payer: Railroad Medicare Medicare |
$31.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.87
|
| Rate for Payer: UHC Core |
$104.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.21
|
| Rate for Payer: UHC Exchange |
$31.21
|
| Rate for Payer: UHC Medicare Advantage |
$31.21
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$31.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.64
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$76.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.71
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$80.68
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$113.61 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: BCBS Trust/PPO |
$142.68
|
| Rate for Payer: BCN Commercial |
$135.08
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: Priority Health HMO/PPO |
$152.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$145.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: Aetna Medicare |
$45.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.62
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$43.70
|
| Rate for Payer: BCBS Trust/PPO |
$143.69
|
| Rate for Payer: BCN Commercial |
$135.90
|
| Rate for Payer: BCN Medicare Advantage |
$43.70
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.70
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.88
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: PACE Senior Care Partners |
$41.51
|
| Rate for Payer: PACE SWMI |
$43.70
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: PHP Medicare Advantage |
$43.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: Priority Health HMO/PPO |
$152.07
|
| Rate for Payer: Priority Health Medicare |
$44.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.11
|
| Rate for Payer: Railroad Medicare Medicare |
$43.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$145.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.70
|
| Rate for Payer: UHC Exchange |
$43.70
|
| Rate for Payer: UHC Medicare Advantage |
$43.70
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$13.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.32
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS MAPPO |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$40.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.06
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PACE Senior Care Partners |
$12.41
|
| Rate for Payer: PACE SWMI |
$13.06
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: PHP Medicare Advantage |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.06
|
| Rate for Payer: UHC Exchange |
$13.06
|
| Rate for Payer: UHC Medicare Advantage |
$13.06
|
| Rate for Payer: VA VA |
$13.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$13.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.32
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS MAPPO |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$40.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.06
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PACE Senior Care Partners |
$12.41
|
| Rate for Payer: PACE SWMI |
$13.06
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: PHP Medicare Advantage |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.06
|
| Rate for Payer: UHC Exchange |
$13.06
|
| Rate for Payer: UHC Medicare Advantage |
$13.06
|
| Rate for Payer: VA VA |
$13.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
