|
HC CHROMOGRANIN A
|
Facility
|
IP
|
$60.18
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.13 |
| Max. Negotiated Rate |
$60.18 |
| Rate for Payer: Aetna Commercial |
$54.16
|
| Rate for Payer: ASR ASR |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$46.66
|
| Rate for Payer: BCN Commercial |
$46.66
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$56.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$60.18
|
| Rate for Payer: Healthscope Whirlpool |
$58.37
|
| Rate for Payer: Mclaren Commercial |
$54.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.96
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
OP
|
$2,400.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$371.62 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$2,160.00
|
| Rate for Payer: Aetna Medicare |
$1,160.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,450.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,450.00
|
| Rate for Payer: ASR ASR |
$2,328.00
|
| Rate for Payer: BCBS Complete |
$666.30
|
| Rate for Payer: BCBS MAPPO |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,860.72
|
| Rate for Payer: BCN Commercial |
$1,860.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthscope Commercial |
$2,400.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,328.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,160.00
|
| Rate for Payer: Mclaren Commercial |
$2,160.00
|
| Rate for Payer: Mclaren Medicaid |
$634.52
|
| Rate for Payer: Mclaren Medicare |
$1,160.00
|
| Rate for Payer: Meridian Medicaid |
$666.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,218.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,040.00
|
| Rate for Payer: PACE Medicare |
$1,102.00
|
| Rate for Payer: PACE SWMI |
$1,160.00
|
| Rate for Payer: PHP Commercial |
$1,276.00
|
| Rate for Payer: PHP Medicaid |
$634.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.53
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$371.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,112.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,194.80
|
| Rate for Payer: VA VA |
$1,160.00
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
IP
|
$2,400.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,680.00 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$2,160.00
|
| Rate for Payer: ASR ASR |
$2,328.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,860.72
|
| Rate for Payer: BCN Commercial |
$1,860.72
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$2,256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.00
|
| Rate for Payer: Healthscope Commercial |
$2,400.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,328.00
|
| Rate for Payer: Mclaren Commercial |
$2,160.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,040.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,112.00
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
OP
|
$1,617.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$371.62 |
| Max. Negotiated Rate |
$1,617.00 |
| Rate for Payer: Aetna Commercial |
$1,455.30
|
| Rate for Payer: Aetna Medicare |
$1,160.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,450.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,450.00
|
| Rate for Payer: ASR ASR |
$1,568.49
|
| Rate for Payer: BCBS Complete |
$666.30
|
| Rate for Payer: BCBS MAPPO |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$1,253.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,519.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,293.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthscope Commercial |
$1,617.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,568.49
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,160.00
|
| Rate for Payer: Mclaren Commercial |
$1,455.30
|
| Rate for Payer: Mclaren Medicaid |
$634.52
|
| Rate for Payer: Mclaren Medicare |
$1,160.00
|
| Rate for Payer: Meridian Medicaid |
$666.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,218.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,374.45
|
| Rate for Payer: PACE Medicare |
$1,102.00
|
| Rate for Payer: PACE SWMI |
$1,160.00
|
| Rate for Payer: PHP Commercial |
$1,276.00
|
| Rate for Payer: PHP Medicaid |
$634.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.53
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$371.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,422.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,194.80
|
| Rate for Payer: VA VA |
$1,160.00
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
IP
|
$1,617.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,131.90 |
| Max. Negotiated Rate |
$1,617.00 |
| Rate for Payer: Aetna Commercial |
$1,455.30
|
| Rate for Payer: ASR ASR |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$1,253.66
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,519.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,293.60
|
| Rate for Payer: Healthscope Commercial |
$1,617.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,568.49
|
| Rate for Payer: Mclaren Commercial |
$1,455.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,374.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,131.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,422.96
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.99 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Trust/PPO |
$27.68
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$41.84 |
| Rate for Payer: Aetna Commercial |
$32.13
|
| Rate for Payer: Aetna Medicare |
$33.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.84
|
| Rate for Payer: ASR ASR |
$34.63
|
| Rate for Payer: BCBS Complete |
$19.23
|
| Rate for Payer: BCBS MAPPO |
$33.47
|
| Rate for Payer: BCBS Trust/PPO |
$27.68
|
| Rate for Payer: BCN Commercial |
$27.68
|
| Rate for Payer: BCN Medicare Advantage |
$33.47
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.47
|
| Rate for Payer: Healthscope Commercial |
$35.70
|
| Rate for Payer: Healthscope Whirlpool |
$34.63
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.47
|
| Rate for Payer: Mclaren Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$18.31
|
| Rate for Payer: Mclaren Medicare |
$33.47
|
| Rate for Payer: Meridian Medicaid |
$19.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Medicare |
$31.80
|
| Rate for Payer: PACE SWMI |
$33.47
|
| Rate for Payer: PHP Commercial |
$36.82
|
| Rate for Payer: PHP Medicaid |
$18.31
|
| Rate for Payer: PHP Medicare Advantage |
$33.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.49
|
| Rate for Payer: Priority Health Medicare |
$33.47
|
| Rate for Payer: Priority Health Narrow Network |
$25.35
|
| Rate for Payer: Railroad Medicare Medicare |
$33.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.42
|
| Rate for Payer: UHC Medicare Advantage |
$34.47
|
| Rate for Payer: VA VA |
$33.47
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
IP
|
$202.98
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$142.09 |
| Max. Negotiated Rate |
$202.98 |
| Rate for Payer: Aetna Commercial |
$182.68
|
| Rate for Payer: ASR ASR |
$196.89
|
| Rate for Payer: BCBS Trust/PPO |
$157.37
|
| Rate for Payer: BCN Commercial |
$157.37
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cofinity Commercial |
$190.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.38
|
| Rate for Payer: Healthscope Commercial |
$202.98
|
| Rate for Payer: Healthscope Whirlpool |
$196.89
|
| Rate for Payer: Mclaren Commercial |
$182.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.62
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
OP
|
$202.98
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.99 |
| Max. Negotiated Rate |
$217.08 |
| Rate for Payer: Aetna Commercial |
$182.68
|
| Rate for Payer: Aetna Medicare |
$173.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.08
|
| Rate for Payer: ASR ASR |
$196.89
|
| Rate for Payer: BCBS Complete |
$99.75
|
| Rate for Payer: BCBS MAPPO |
$173.66
|
| Rate for Payer: BCBS Trust/PPO |
$157.37
|
| Rate for Payer: BCN Commercial |
$157.37
|
| Rate for Payer: BCN Medicare Advantage |
$173.66
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cofinity Commercial |
$190.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.66
|
| Rate for Payer: Healthscope Commercial |
$202.98
|
| Rate for Payer: Healthscope Whirlpool |
$196.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.66
|
| Rate for Payer: Mclaren Commercial |
$182.68
|
| Rate for Payer: Mclaren Medicaid |
$94.99
|
| Rate for Payer: Mclaren Medicare |
$173.66
|
| Rate for Payer: Meridian Medicaid |
$99.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.53
|
| Rate for Payer: PACE Medicare |
$164.98
|
| Rate for Payer: PACE SWMI |
$173.66
|
| Rate for Payer: PHP Commercial |
$191.03
|
| Rate for Payer: PHP Medicaid |
$94.99
|
| Rate for Payer: PHP Medicare Advantage |
$173.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.71
|
| Rate for Payer: Priority Health Medicare |
$173.66
|
| Rate for Payer: Priority Health Narrow Network |
$144.12
|
| Rate for Payer: Railroad Medicare Medicare |
$173.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$178.62
|
| Rate for Payer: UHC Medicare Advantage |
$178.87
|
| Rate for Payer: VA VA |
$173.66
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
OP
|
$368.22
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$103.15 |
| Max. Negotiated Rate |
$368.22 |
| Rate for Payer: Aetna Commercial |
$331.40
|
| Rate for Payer: Aetna Medicare |
$188.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.71
|
| Rate for Payer: ASR ASR |
$357.17
|
| Rate for Payer: BCBS Complete |
$108.31
|
| Rate for Payer: BCBS MAPPO |
$188.57
|
| Rate for Payer: BCBS Trust/PPO |
$285.48
|
| Rate for Payer: BCN Commercial |
$285.48
|
| Rate for Payer: BCN Medicare Advantage |
$188.57
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cofinity Commercial |
$346.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.57
|
| Rate for Payer: Healthscope Commercial |
$368.22
|
| Rate for Payer: Healthscope Whirlpool |
$357.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$188.57
|
| Rate for Payer: Mclaren Commercial |
$331.40
|
| Rate for Payer: Mclaren Medicaid |
$103.15
|
| Rate for Payer: Mclaren Medicare |
$188.57
|
| Rate for Payer: Meridian Medicaid |
$108.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.99
|
| Rate for Payer: PACE Medicare |
$179.14
|
| Rate for Payer: PACE SWMI |
$188.57
|
| Rate for Payer: PHP Commercial |
$207.43
|
| Rate for Payer: PHP Medicaid |
$103.15
|
| Rate for Payer: PHP Medicare Advantage |
$188.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$335.08
|
| Rate for Payer: Priority Health Medicare |
$188.57
|
| Rate for Payer: Priority Health Narrow Network |
$261.44
|
| Rate for Payer: Railroad Medicare Medicare |
$188.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.03
|
| Rate for Payer: UHC Medicare Advantage |
$194.23
|
| Rate for Payer: VA VA |
$188.57
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
IP
|
$368.22
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$257.75 |
| Max. Negotiated Rate |
$368.22 |
| Rate for Payer: Aetna Commercial |
$331.40
|
| Rate for Payer: ASR ASR |
$357.17
|
| Rate for Payer: BCBS Trust/PPO |
$285.48
|
| Rate for Payer: BCN Commercial |
$285.48
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cofinity Commercial |
$346.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.58
|
| Rate for Payer: Healthscope Commercial |
$368.22
|
| Rate for Payer: Healthscope Whirlpool |
$357.17
|
| Rate for Payer: Mclaren Commercial |
$331.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$324.03
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
IP
|
$217.26
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$152.08 |
| Max. Negotiated Rate |
$217.26 |
| Rate for Payer: Aetna Commercial |
$195.53
|
| Rate for Payer: ASR ASR |
$210.74
|
| Rate for Payer: BCBS Trust/PPO |
$168.44
|
| Rate for Payer: BCN Commercial |
$168.44
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$204.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Healthscope Commercial |
$217.26
|
| Rate for Payer: Healthscope Whirlpool |
$210.74
|
| Rate for Payer: Mclaren Commercial |
$195.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.19
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
OP
|
$217.26
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.72 |
| Max. Negotiated Rate |
$217.26 |
| Rate for Payer: Aetna Commercial |
$195.53
|
| Rate for Payer: Aetna Medicare |
$116.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.61
|
| Rate for Payer: ASR ASR |
$210.74
|
| Rate for Payer: BCBS Complete |
$66.91
|
| Rate for Payer: BCBS MAPPO |
$116.49
|
| Rate for Payer: BCBS Trust/PPO |
$168.44
|
| Rate for Payer: BCN Commercial |
$168.44
|
| Rate for Payer: BCN Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$204.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.49
|
| Rate for Payer: Healthscope Commercial |
$217.26
|
| Rate for Payer: Healthscope Whirlpool |
$210.74
|
| Rate for Payer: Humana Choice PPO Medicare |
$116.49
|
| Rate for Payer: Mclaren Commercial |
$195.53
|
| Rate for Payer: Mclaren Medicaid |
$63.72
|
| Rate for Payer: Mclaren Medicare |
$116.49
|
| Rate for Payer: Meridian Medicaid |
$66.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.67
|
| Rate for Payer: PACE Medicare |
$110.67
|
| Rate for Payer: PACE SWMI |
$116.49
|
| Rate for Payer: PHP Commercial |
$128.14
|
| Rate for Payer: PHP Medicaid |
$63.72
|
| Rate for Payer: PHP Medicare Advantage |
$116.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.71
|
| Rate for Payer: Priority Health Medicare |
$116.49
|
| Rate for Payer: Priority Health Narrow Network |
$154.25
|
| Rate for Payer: Railroad Medicare Medicare |
$116.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.19
|
| Rate for Payer: UHC Medicare Advantage |
$119.98
|
| Rate for Payer: VA VA |
$116.49
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$224.88
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$157.42 |
| Max. Negotiated Rate |
$224.88 |
| Rate for Payer: Aetna Commercial |
$202.39
|
| Rate for Payer: ASR ASR |
$218.13
|
| Rate for Payer: BCBS Trust/PPO |
$174.35
|
| Rate for Payer: BCN Commercial |
$174.35
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cofinity Commercial |
$211.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.90
|
| Rate for Payer: Healthscope Commercial |
$224.88
|
| Rate for Payer: Healthscope Whirlpool |
$218.13
|
| Rate for Payer: Mclaren Commercial |
$202.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.89
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$224.88
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.63 |
| Max. Negotiated Rate |
$224.88 |
| Rate for Payer: Aetna Commercial |
$202.39
|
| Rate for Payer: Aetna Medicare |
$143.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: ASR ASR |
$218.13
|
| Rate for Payer: BCBS Complete |
$82.57
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$174.35
|
| Rate for Payer: BCN Commercial |
$174.35
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cofinity Commercial |
$211.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$224.88
|
| Rate for Payer: Healthscope Whirlpool |
$218.13
|
| Rate for Payer: Humana Choice PPO Medicare |
$143.75
|
| Rate for Payer: Mclaren Commercial |
$202.39
|
| Rate for Payer: Mclaren Medicaid |
$78.63
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Medicaid |
$82.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.15
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$158.12
|
| Rate for Payer: PHP Medicaid |
$78.63
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.64
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$159.66
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.89
|
| Rate for Payer: UHC Medicare Advantage |
$148.06
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$225.75
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.63 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$203.18
|
| Rate for Payer: Aetna Medicare |
$143.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: ASR ASR |
$218.98
|
| Rate for Payer: BCBS Complete |
$82.57
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$175.02
|
| Rate for Payer: BCN Commercial |
$175.02
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cofinity Commercial |
$212.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$225.75
|
| Rate for Payer: Healthscope Whirlpool |
$218.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$143.75
|
| Rate for Payer: Mclaren Commercial |
$203.18
|
| Rate for Payer: Mclaren Medicaid |
$78.63
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Medicaid |
$82.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.89
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$158.12
|
| Rate for Payer: PHP Medicaid |
$78.63
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.43
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$160.28
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.66
|
| Rate for Payer: UHC Medicare Advantage |
$148.06
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$225.75
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$158.02 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$203.18
|
| Rate for Payer: ASR ASR |
$218.98
|
| Rate for Payer: BCBS Trust/PPO |
$175.02
|
| Rate for Payer: BCN Commercial |
$175.02
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cofinity Commercial |
$212.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.60
|
| Rate for Payer: Healthscope Commercial |
$225.75
|
| Rate for Payer: Healthscope Whirlpool |
$218.98
|
| Rate for Payer: Mclaren Commercial |
$203.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.66
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$139.23 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Commercial |
$179.01
|
| Rate for Payer: ASR ASR |
$192.93
|
| Rate for Payer: BCBS Trust/PPO |
$154.21
|
| Rate for Payer: BCN Commercial |
$154.21
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$186.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Healthscope Whirlpool |
$192.93
|
| Rate for Payer: Mclaren Commercial |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.03
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.64 |
| Max. Negotiated Rate |
$977.95 |
| Rate for Payer: Aetna Commercial |
$179.01
|
| Rate for Payer: Aetna Medicare |
$125.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.86
|
| Rate for Payer: ASR ASR |
$192.93
|
| Rate for Payer: BCBS Complete |
$72.08
|
| Rate for Payer: BCBS MAPPO |
$125.49
|
| Rate for Payer: BCBS Trust/PPO |
$154.21
|
| Rate for Payer: BCN Commercial |
$154.21
|
| Rate for Payer: BCN Medicare Advantage |
$125.49
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$186.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.49
|
| Rate for Payer: Healthscope Commercial |
$198.90
|
| Rate for Payer: Healthscope Whirlpool |
$192.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.49
|
| Rate for Payer: Mclaren Commercial |
$179.01
|
| Rate for Payer: Mclaren Medicaid |
$68.64
|
| Rate for Payer: Mclaren Medicare |
$125.49
|
| Rate for Payer: Meridian Medicaid |
$72.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.06
|
| Rate for Payer: PACE Medicare |
$119.22
|
| Rate for Payer: PACE SWMI |
$125.49
|
| Rate for Payer: PHP Commercial |
$138.04
|
| Rate for Payer: PHP Medicaid |
$68.64
|
| Rate for Payer: PHP Medicare Advantage |
$125.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$977.95
|
| Rate for Payer: Priority Health Medicare |
$125.49
|
| Rate for Payer: Priority Health Narrow Network |
$782.36
|
| Rate for Payer: Railroad Medicare Medicare |
$125.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.03
|
| Rate for Payer: UHC Medicare Advantage |
$129.25
|
| Rate for Payer: VA VA |
$125.49
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.21 |
| Max. Negotiated Rate |
$298.86 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: Aetna Medicare |
$150.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.88
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$150.30
|
| Rate for Payer: BCBS Trust/PPO |
$231.71
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: BCN Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.30
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$150.30
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Mclaren Medicaid |
$82.21
|
| Rate for Payer: Mclaren Medicare |
$150.30
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Medicare |
$142.78
|
| Rate for Payer: PACE SWMI |
$150.30
|
| Rate for Payer: PHP Commercial |
$165.33
|
| Rate for Payer: PHP Medicaid |
$82.21
|
| Rate for Payer: PHP Medicare Advantage |
$150.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.96
|
| Rate for Payer: Priority Health Medicare |
$150.30
|
| Rate for Payer: Priority Health Narrow Network |
$212.19
|
| Rate for Payer: Railroad Medicare Medicare |
$150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
| Rate for Payer: UHC Medicare Advantage |
$154.81
|
| Rate for Payer: VA VA |
$150.30
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$209.20 |
| Max. Negotiated Rate |
$298.86 |
| Rate for Payer: Aetna Commercial |
$268.97
|
| Rate for Payer: ASR ASR |
$289.89
|
| Rate for Payer: BCBS Trust/PPO |
$231.71
|
| Rate for Payer: BCN Commercial |
$231.71
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$280.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$298.86
|
| Rate for Payer: Healthscope Whirlpool |
$289.89
|
| Rate for Payer: Mclaren Commercial |
$268.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.00
|
|
|
HC CIRCUMCISION
|
Facility
|
IP
|
$2,710.48
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,897.34 |
| Max. Negotiated Rate |
$2,710.48 |
| Rate for Payer: Aetna Commercial |
$2,439.43
|
| Rate for Payer: ASR ASR |
$2,629.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.44
|
| Rate for Payer: BCN Commercial |
$2,101.44
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,547.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,710.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,629.17
|
| Rate for Payer: Mclaren Commercial |
$2,439.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,385.22
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,710.48
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,084.19 |
| Max. Negotiated Rate |
$2,710.48 |
| Rate for Payer: Aetna Commercial |
$2,439.43
|
| Rate for Payer: ASR ASR |
$2,629.17
|
| Rate for Payer: BCBS Complete |
$1,084.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.44
|
| Rate for Payer: BCN Commercial |
$2,101.44
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,547.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,710.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,629.17
|
| Rate for Payer: Mclaren Commercial |
$2,439.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,466.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,924.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,385.22
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$990.33 |
| Max. Negotiated Rate |
$2,661.82 |
| Rate for Payer: Aetna Commercial |
$2,395.64
|
| Rate for Payer: Aetna Medicare |
$1,810.48
|
| 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: ASR ASR |
$2,581.97
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.71
|
| Rate for Payer: BCN Commercial |
$2,063.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,502.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,661.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,581.97
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,810.48
|
| Rate for Payer: Mclaren Commercial |
$2,395.64
|
| 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 |
$2,262.55
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,991.53
|
| Rate for Payer: PHP Medicaid |
$990.33
|
| 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 |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,422.26
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,889.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,342.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: VA VA |
$1,810.48
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
IP
|
$2,661.82
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,863.27 |
| Max. Negotiated Rate |
$2,661.82 |
| Rate for Payer: Aetna Commercial |
$2,395.64
|
| Rate for Payer: ASR ASR |
$2,581.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.71
|
| Rate for Payer: BCN Commercial |
$2,063.71
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,502.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Healthscope Commercial |
$2,661.82
|
| Rate for Payer: Healthscope Whirlpool |
$2,581.97
|
| Rate for Payer: Mclaren Commercial |
$2,395.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,342.40
|
|
