|
HC CYSTOURETHROSCOPY
|
Facility
|
OP
|
$977.70
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$77.93 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna American Axle |
$635.50
|
| Rate for Payer: Aetna Commercial |
$831.04
|
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$635.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$728.68
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$782.16
|
| Rate for Payer: Cash Price |
$782.16
|
| Rate for Payer: Cofinity Commercial |
$840.82
|
| Rate for Payer: Cofinity Commercial |
$684.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$879.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$684.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$733.28
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.04
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$831.04
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Priority Health SBD |
$615.95
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$77.93
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: UMR Bronson Commercial |
$361.75
|
| Rate for Payer: VA VA |
$607.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$733.28
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
IP
|
$2,981.15
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,311.71 |
| Max. Negotiated Rate |
$2,683.04 |
| Rate for Payer: Aetna American Axle |
$1,937.75
|
| Rate for Payer: Aetna Commercial |
$2,533.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,937.75
|
| Rate for Payer: Cash Price |
$2,384.92
|
| Rate for Payer: Cofinity Commercial |
$2,086.80
|
| Rate for Payer: Cofinity Commercial |
$2,563.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,384.92
|
| Rate for Payer: Healthscope Commercial |
$2,683.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,086.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,235.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,533.98
|
| Rate for Payer: PHP Commercial |
$2,533.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,086.80
|
| Rate for Payer: Priority Health SBD |
$1,878.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,311.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,235.86
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
OP
|
$2,981.15
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$137.20 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,937.75
|
| Rate for Payer: Aetna Commercial |
$2,533.98
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,937.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,354.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,384.92
|
| Rate for Payer: Cash Price |
$2,384.92
|
| Rate for Payer: Cofinity Commercial |
$2,563.79
|
| Rate for Payer: Cofinity Commercial |
$2,086.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,384.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,683.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,086.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,235.86
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,533.98
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,533.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,086.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,878.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$137.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,103.03
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,235.86
|
|
|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,192.61 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.39 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,717.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$163.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,002.88
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
IP
|
$4,617.85
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,031.85 |
| Max. Negotiated Rate |
$4,156.06 |
| Rate for Payer: Aetna American Axle |
$3,001.60
|
| Rate for Payer: Aetna Commercial |
$3,925.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,001.60
|
| Rate for Payer: Cash Price |
$3,694.28
|
| Rate for Payer: Cofinity Commercial |
$3,232.50
|
| Rate for Payer: Cofinity Commercial |
$3,971.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,694.28
|
| Rate for Payer: Healthscope Commercial |
$4,156.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,232.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,463.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,925.17
|
| Rate for Payer: PHP Commercial |
$3,925.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,232.50
|
| Rate for Payer: Priority Health SBD |
$2,909.25
|
| Rate for Payer: UMR Bronson Commercial |
$2,031.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,463.39
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
OP
|
$4,617.85
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$277.34 |
| Max. Negotiated Rate |
$9,755.07 |
| Rate for Payer: Aetna American Axle |
$3,001.60
|
| Rate for Payer: Aetna Commercial |
$3,925.17
|
| Rate for Payer: Aetna Medicare |
$3,222.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,001.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,873.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,873.46
|
| Rate for Payer: BCBS Complete |
$1,779.93
|
| Rate for Payer: BCBS MAPPO |
$3,098.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,354.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,098.77
|
| Rate for Payer: Cash Price |
$3,694.28
|
| Rate for Payer: Cash Price |
$3,694.28
|
| Rate for Payer: Cofinity Commercial |
$3,971.35
|
| Rate for Payer: Cofinity Commercial |
$3,232.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,694.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,098.77
|
| Rate for Payer: Healthscope Commercial |
$4,156.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,232.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,463.39
|
| Rate for Payer: Mclaren Medicaid |
$1,695.03
|
| Rate for Payer: Mclaren Medicare |
$3,098.77
|
| Rate for Payer: Meridian Medicaid |
$1,779.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,253.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,563.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,925.17
|
| Rate for Payer: PACE Medicare |
$2,943.83
|
| Rate for Payer: PACE SWMI |
$3,098.77
|
| Rate for Payer: PHP Commercial |
$3,925.17
|
| Rate for Payer: PHP Medicare Advantage |
$3,098.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,232.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,755.07
|
| Rate for Payer: Priority Health Medicare |
$3,098.77
|
| Rate for Payer: Priority Health Narrow Network |
$7,804.06
|
| Rate for Payer: Priority Health SBD |
$2,909.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,098.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,098.77
|
| Rate for Payer: UHC Exchange |
$277.34
|
| Rate for Payer: UHC Medicare Advantage |
$3,191.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,708.60
|
| Rate for Payer: VA VA |
$3,098.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,463.39
|
|
|
HC CYTO DNA PROBE
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna American Axle |
$84.86
|
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$19.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$91.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.98
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.86
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$15.89
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Core |
$35.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: UMR Bronson Commercial |
$48.31
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CYTO DNA PROBE
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$57.45 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna American Axle |
$84.86
|
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$91.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.98
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.39
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: UMR Bronson Commercial |
$57.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$19.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.86
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$15.89
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Core |
$35.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: UMR Bronson Commercial |
$38.49
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna American Axle |
$170.95
|
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$19.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$184.10
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.25
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.86
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$15.89
|
| Rate for Payer: Priority Health SBD |
$165.69
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Core |
$35.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: UMR Bronson Commercial |
$97.31
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.25
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$115.72 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna American Axle |
$170.95
|
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.95
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$184.10
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health SBD |
$165.69
|
| Rate for Payer: UMR Bronson Commercial |
$115.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.25
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$104.72 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Aetna American Axle |
$154.70
|
| Rate for Payer: Aetna Commercial |
$202.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.70
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$166.60
|
| Rate for Payer: Cofinity Commercial |
$204.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.40
|
| Rate for Payer: Healthscope Commercial |
$214.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.30
|
| Rate for Payer: PHP Commercial |
$202.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health SBD |
$149.94
|
| Rate for Payer: UMR Bronson Commercial |
$104.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.50
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Aetna American Axle |
$154.70
|
| Rate for Payer: Aetna Commercial |
$202.30
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$19.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$166.60
|
| Rate for Payer: Cofinity Commercial |
$204.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$214.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.50
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.30
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$202.30
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.86
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$15.89
|
| Rate for Payer: Priority Health SBD |
$149.94
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Core |
$35.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$22.06
|
| Rate for Payer: UMR Bronson Commercial |
$88.06
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.50
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$109.70
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$98.73 |
| Rate for Payer: Aetna American Axle |
$71.30
|
| Rate for Payer: Aetna Commercial |
$93.24
|
| Rate for Payer: Aetna Medicare |
$20.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$11.24
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCBS Trust/PPO |
$17.59
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| Rate for Payer: Cash Price |
$87.76
|
| Rate for Payer: Cash Price |
$87.76
|
| Rate for Payer: Cofinity Commercial |
$94.34
|
| Rate for Payer: Cofinity Commercial |
$76.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$98.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.28
|
| Rate for Payer: Mclaren Medicaid |
$10.70
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Medicaid |
$11.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.24
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$93.24
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.83
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health Narrow Network |
$21.46
|
| Rate for Payer: Priority Health SBD |
$69.11
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.47
|
| Rate for Payer: UHC Core |
$32.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.56
|
| Rate for Payer: UHC Exchange |
$19.56
|
| Rate for Payer: UHC Medicare Advantage |
$20.15
|
| Rate for Payer: UMR Bronson Commercial |
$40.59
|
| Rate for Payer: VA VA |
$19.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.28
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$109.70
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.27 |
| Max. Negotiated Rate |
$98.73 |
| Rate for Payer: Aetna American Axle |
$71.30
|
| Rate for Payer: Aetna Commercial |
$93.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.30
|
| Rate for Payer: Cash Price |
$87.76
|
| Rate for Payer: Cofinity Commercial |
$76.79
|
| Rate for Payer: Cofinity Commercial |
$94.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.76
|
| Rate for Payer: Healthscope Commercial |
$98.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.24
|
| Rate for Payer: PHP Commercial |
$93.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.79
|
| Rate for Payer: Priority Health SBD |
$69.11
|
| Rate for Payer: UMR Bronson Commercial |
$48.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.28
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.94
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.88
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$15.10
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Core |
$23.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UMR Bronson Commercial |
$15.10
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UMR Bronson Commercial |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.68
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$15.16
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.22
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Medicaid |
$9.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.22
|
| Rate for Payer: UHC Core |
$27.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$17.36
|
| Rate for Payer: UMR Bronson Commercial |
$15.10
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UMR Bronson Commercial |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$131.78
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$151.62 |
| Rate for Payer: Aetna American Axle |
$85.66
|
| Rate for Payer: Aetna Commercial |
$112.01
|
| Rate for Payer: Aetna Medicare |
$50.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.54
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$105.42
|
| Rate for Payer: Cash Price |
$105.42
|
| Rate for Payer: Cofinity Commercial |
$92.25
|
| Rate for Payer: Cofinity Commercial |
$113.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$118.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.84
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.01
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$112.01
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.62
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$121.30
|
| Rate for Payer: Priority Health SBD |
$83.02
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.48
|
| Rate for Payer: UHC Core |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.17
|
| Rate for Payer: UHC Exchange |
$66.80
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: UMR Bronson Commercial |
$48.76
|
| Rate for Payer: VA VA |
$48.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.84
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$131.78
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$57.98 |
| Max. Negotiated Rate |
$118.60 |
| Rate for Payer: Aetna American Axle |
$85.66
|
| Rate for Payer: Aetna Commercial |
$112.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.66
|
| Rate for Payer: Cash Price |
$105.42
|
| Rate for Payer: Cofinity Commercial |
$113.33
|
| Rate for Payer: Cofinity Commercial |
$92.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.42
|
| Rate for Payer: Healthscope Commercial |
$118.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.01
|
| Rate for Payer: PHP Commercial |
$112.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.25
|
| Rate for Payer: Priority Health SBD |
$83.02
|
| Rate for Payer: UMR Bronson Commercial |
$57.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.84
|
|
