|
HC CHOLINESTERASE RBC
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
30100157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Trust/PPO |
$54.03
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
|
|
HC CHOLINESTERASE RBC
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82482
|
| Hospital Charge Code |
30100157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$59.67
|
| Rate for Payer: Aetna Medicare |
$9.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.26
|
| Rate for Payer: ASR ASR |
$64.31
|
| Rate for Payer: ASR Commercial |
$64.31
|
| Rate for Payer: BCBS Complete |
$5.52
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$54.29
|
| Rate for Payer: BCN Commercial |
$51.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$62.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$66.30
|
| Rate for Payer: Healthscope Whirlpool |
$64.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$9.81
|
| Rate for Payer: Mclaren Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$5.26
|
| Rate for Payer: Mclaren Medicare |
$9.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.30
|
| Rate for Payer: Meridian Medicaid |
$5.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Medicare |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$10.79
|
| Rate for Payer: PHP Medicaid |
$5.26
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.09
|
| Rate for Payer: Priority Health Medicare |
$9.81
|
| Rate for Payer: Priority Health Narrow Network |
$46.48
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.81
|
| Rate for Payer: UHC Exchange |
$15.21
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP DNSP |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$5.26
|
| Rate for Payer: VA VA |
$9.81
|
|
|
HC CHORIONIC VILLUS SAMPLING
|
Facility
|
IP
|
$680.42
|
|
|
Service Code
|
CPT 59015
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$442.27 |
| Max. Negotiated Rate |
$680.42 |
| Rate for Payer: Aetna Commercial |
$612.38
|
| Rate for Payer: ASR ASR |
$660.01
|
| Rate for Payer: ASR Commercial |
$660.01
|
| Rate for Payer: BCBS Trust/PPO |
$554.47
|
| Rate for Payer: BCN Commercial |
$527.53
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cofinity Commercial |
$639.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.34
|
| Rate for Payer: Healthscope Commercial |
$680.42
|
| Rate for Payer: Healthscope Whirlpool |
$660.01
|
| Rate for Payer: Mclaren Commercial |
$612.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.36
|
| Rate for Payer: Nomi Health Commercial |
$557.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.77
|
|
|
HC CHORIONIC VILLUS SAMPLING
|
Facility
|
OP
|
$680.42
|
|
|
Service Code
|
CPT 59015
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$442.27 |
| Max. Negotiated Rate |
$1,322.35 |
| Rate for Payer: Aetna Commercial |
$612.38
|
| Rate for Payer: Aetna Medicare |
$853.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,066.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,066.41
|
| Rate for Payer: ASR ASR |
$660.01
|
| Rate for Payer: ASR Commercial |
$660.01
|
| Rate for Payer: BCBS Complete |
$480.14
|
| Rate for Payer: BCBS MAPPO |
$853.13
|
| Rate for Payer: BCBS Trust/PPO |
$557.20
|
| Rate for Payer: BCN Commercial |
$527.53
|
| Rate for Payer: BCN Medicare Advantage |
$853.13
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cash Price |
$544.34
|
| Rate for Payer: Cofinity Commercial |
$639.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.13
|
| Rate for Payer: Healthscope Commercial |
$680.42
|
| Rate for Payer: Healthscope Whirlpool |
$660.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$853.13
|
| Rate for Payer: Mclaren Commercial |
$612.38
|
| Rate for Payer: Mclaren Medicaid |
$457.28
|
| Rate for Payer: Mclaren Medicare |
$853.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.79
|
| Rate for Payer: Meridian Medicaid |
$480.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$981.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.36
|
| Rate for Payer: Nomi Health Commercial |
$557.94
|
| Rate for Payer: PACE Medicare |
$810.47
|
| Rate for Payer: PACE SWMI |
$853.13
|
| Rate for Payer: PHP Commercial |
$938.44
|
| Rate for Payer: PHP Medicaid |
$457.28
|
| Rate for Payer: PHP Medicare Advantage |
$853.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.18
|
| Rate for Payer: Priority Health Medicare |
$853.13
|
| Rate for Payer: Priority Health Narrow Network |
$476.97
|
| Rate for Payer: Railroad Medicare Medicare |
$853.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$598.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.13
|
| Rate for Payer: UHC Exchange |
$1,322.35
|
| Rate for Payer: UHC Medicare Advantage |
$853.13
|
| Rate for Payer: UHCCP DNSP |
$853.13
|
| Rate for Payer: UHCCP Medicaid |
$457.28
|
| Rate for Payer: VA VA |
$853.13
|
|
|
HC CHROM ANALYSIS METAPHASE <20 AND 20 TO 25
|
Facility
|
OP
|
$236.55
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
31000020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.51 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Aetna Commercial |
$212.90
|
| Rate for Payer: Aetna Medicare |
$144.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.76
|
| Rate for Payer: ASR ASR |
$229.45
|
| Rate for Payer: ASR Commercial |
$229.45
|
| Rate for Payer: BCBS Complete |
$81.39
|
| Rate for Payer: BCBS MAPPO |
$144.61
|
| Rate for Payer: BCBS Trust/PPO |
$193.71
|
| Rate for Payer: BCN Commercial |
$183.40
|
| Rate for Payer: BCN Medicare Advantage |
$144.61
|
| Rate for Payer: Cash Price |
$189.24
|
| Rate for Payer: Cash Price |
$189.24
|
| Rate for Payer: Cofinity Commercial |
$222.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.61
|
| Rate for Payer: Healthscope Commercial |
$236.55
|
| Rate for Payer: Healthscope Whirlpool |
$229.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$144.61
|
| Rate for Payer: Mclaren Commercial |
$212.90
|
| Rate for Payer: Mclaren Medicaid |
$77.51
|
| Rate for Payer: Mclaren Medicare |
$144.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.84
|
| Rate for Payer: Meridian Medicaid |
$81.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.07
|
| Rate for Payer: Nomi Health Commercial |
$193.97
|
| Rate for Payer: PACE Medicare |
$137.38
|
| Rate for Payer: PACE SWMI |
$144.61
|
| Rate for Payer: PHP Commercial |
$159.07
|
| Rate for Payer: PHP Medicaid |
$77.51
|
| Rate for Payer: PHP Medicare Advantage |
$144.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.27
|
| Rate for Payer: Priority Health Medicare |
$144.61
|
| Rate for Payer: Priority Health Narrow Network |
$165.82
|
| Rate for Payer: Railroad Medicare Medicare |
$144.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.61
|
| Rate for Payer: UHC Exchange |
$224.15
|
| Rate for Payer: UHC Medicare Advantage |
$144.61
|
| Rate for Payer: UHCCP DNSP |
$144.61
|
| Rate for Payer: UHCCP Medicaid |
$77.51
|
| Rate for Payer: VA VA |
$144.61
|
|
|
HC CHROM ANALYSIS METAPHASE <20 AND 20 TO 25
|
Facility
|
IP
|
$236.55
|
|
|
Service Code
|
CPT 88264
|
| Hospital Charge Code |
31000020
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$153.76 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Aetna Commercial |
$212.90
|
| Rate for Payer: ASR ASR |
$229.45
|
| Rate for Payer: ASR Commercial |
$229.45
|
| Rate for Payer: BCBS Trust/PPO |
$192.76
|
| Rate for Payer: BCN Commercial |
$183.40
|
| Rate for Payer: Cash Price |
$189.24
|
| Rate for Payer: Cofinity Commercial |
$222.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.24
|
| Rate for Payer: Healthscope Commercial |
$236.55
|
| Rate for Payer: Healthscope Whirlpool |
$229.45
|
| Rate for Payer: Mclaren Commercial |
$212.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.07
|
| Rate for Payer: Nomi Health Commercial |
$193.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.16
|
|
|
HC CHROMATIN DNP
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200432
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$153.73 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$28.80
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$17.93
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$19.72
|
| Rate for Payer: PHP Medicaid |
$9.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.73
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$122.98
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$27.79
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP DNSP |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: VA VA |
$17.93
|
|
|
HC CHROMATIN DNP
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200432
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$35.17 |
| Rate for Payer: Aetna Commercial |
$31.65
|
| Rate for Payer: ASR ASR |
$34.11
|
| Rate for Payer: ASR Commercial |
$34.11
|
| Rate for Payer: BCBS Trust/PPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$27.27
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$33.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$35.17
|
| Rate for Payer: Healthscope Whirlpool |
$34.11
|
| Rate for Payer: Mclaren Commercial |
$31.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.95
|
|
|
HC CHROMIUM
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
30100165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: Aetna Medicare |
$20.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.35
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Complete |
$11.41
|
| Rate for Payer: BCBS MAPPO |
$20.28
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.28
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.28
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.28
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Mclaren Medicaid |
$10.87
|
| Rate for Payer: Mclaren Medicare |
$20.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.29
|
| Rate for Payer: Meridian Medicaid |
$11.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Medicare |
$19.27
|
| Rate for Payer: PACE SWMI |
$20.28
|
| Rate for Payer: PHP Commercial |
$22.31
|
| Rate for Payer: PHP Medicaid |
$10.87
|
| Rate for Payer: PHP Medicare Advantage |
$20.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.52
|
| Rate for Payer: Priority Health Medicare |
$20.28
|
| Rate for Payer: Priority Health Narrow Network |
$43.62
|
| Rate for Payer: Railroad Medicare Medicare |
$20.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.28
|
| Rate for Payer: UHC Exchange |
$31.43
|
| Rate for Payer: UHC Medicare Advantage |
$20.28
|
| Rate for Payer: UHCCP DNSP |
$20.28
|
| Rate for Payer: UHCCP Medicaid |
$10.87
|
| Rate for Payer: VA VA |
$20.28
|
|
|
HC CHROMIUM
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
30100165
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$56.00
|
| Rate for Payer: ASR ASR |
$60.35
|
| Rate for Payer: ASR Commercial |
$60.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.70
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$58.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$62.22
|
| Rate for Payer: Healthscope Whirlpool |
$60.35
|
| Rate for Payer: Mclaren Commercial |
$56.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.75
|
|
|
HC CHROMOGRANIN A
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$85.65 |
| Rate for Payer: Aetna Commercial |
$55.24
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: ASR ASR |
$59.54
|
| Rate for Payer: ASR Commercial |
$59.54
|
| Rate for Payer: BCBS Complete |
$11.71
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$50.26
|
| Rate for Payer: BCN Commercial |
$47.59
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Healthscope Whirlpool |
$59.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$20.81
|
| Rate for Payer: Mclaren Commercial |
$55.24
|
| Rate for Payer: Mclaren Medicaid |
$11.15
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicaid |
$11.15
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.65
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$68.52
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.81
|
| Rate for Payer: UHC Exchange |
$32.26
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP DNSP |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$11.15
|
| Rate for Payer: VA VA |
$20.81
|
|
|
HC CHROMOGRANIN A
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
30200187
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$61.38 |
| Rate for Payer: Aetna Commercial |
$55.24
|
| Rate for Payer: ASR ASR |
$59.54
|
| Rate for Payer: ASR Commercial |
$59.54
|
| Rate for Payer: BCBS Trust/PPO |
$50.02
|
| Rate for Payer: BCN Commercial |
$47.59
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$57.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$61.38
|
| Rate for Payer: Healthscope Whirlpool |
$59.54
|
| Rate for Payer: Mclaren Commercial |
$55.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.01
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
IP
|
$2,448.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,591.20 |
| Max. Negotiated Rate |
$2,448.00 |
| Rate for Payer: Aetna Commercial |
$2,203.20
|
| Rate for Payer: ASR ASR |
$2,374.56
|
| Rate for Payer: ASR Commercial |
$2,374.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,994.88
|
| Rate for Payer: BCN Commercial |
$1,897.93
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$2,301.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,958.40
|
| Rate for Payer: Healthscope Commercial |
$2,448.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,374.56
|
| Rate for Payer: Mclaren Commercial |
$2,203.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,080.80
|
| Rate for Payer: Nomi Health Commercial |
$2,007.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,154.24
|
|
|
HC CHROMOSOMAL MICROARRAY, CONGENITAL, BLOOD
|
Facility
|
OP
|
$2,448.00
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000150
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$397.64 |
| Max. Negotiated Rate |
$2,448.00 |
| Rate for Payer: Aetna Commercial |
$2,203.20
|
| 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 |
$2,374.56
|
| Rate for Payer: ASR Commercial |
$2,374.56
|
| Rate for Payer: BCBS Complete |
$652.85
|
| Rate for Payer: BCBS MAPPO |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,004.67
|
| Rate for Payer: BCN Commercial |
$1,897.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$2,301.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,958.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthscope Commercial |
$2,448.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,374.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,160.00
|
| Rate for Payer: Mclaren Commercial |
$2,203.20
|
| Rate for Payer: Mclaren Medicaid |
$621.76
|
| Rate for Payer: Mclaren Medicare |
$1,160.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,218.00
|
| Rate for Payer: Meridian Medicaid |
$652.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,080.80
|
| Rate for Payer: Nomi Health Commercial |
$2,007.36
|
| 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 |
$621.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.05
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$397.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,154.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,160.00
|
| Rate for Payer: UHC Exchange |
$1,798.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.00
|
| Rate for Payer: UHCCP DNSP |
$1,160.00
|
| Rate for Payer: UHCCP Medicaid |
$621.76
|
| Rate for Payer: VA VA |
$1,160.00
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
OP
|
$1,649.34
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$397.64 |
| Max. Negotiated Rate |
$1,798.00 |
| Rate for Payer: Aetna Commercial |
$1,484.41
|
| 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 |
$1,599.86
|
| Rate for Payer: ASR Commercial |
$1,599.86
|
| Rate for Payer: BCBS Complete |
$652.85
|
| Rate for Payer: BCBS MAPPO |
$1,160.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,350.64
|
| Rate for Payer: BCN Commercial |
$1,278.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cofinity Commercial |
$1,550.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,319.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthscope Commercial |
$1,649.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,599.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,160.00
|
| Rate for Payer: Mclaren Commercial |
$1,484.41
|
| Rate for Payer: Mclaren Medicaid |
$621.76
|
| Rate for Payer: Mclaren Medicare |
$1,160.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,218.00
|
| Rate for Payer: Meridian Medicaid |
$652.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,401.94
|
| Rate for Payer: Nomi Health Commercial |
$1,352.46
|
| 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 |
$621.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.05
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$397.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,451.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,160.00
|
| Rate for Payer: UHC Exchange |
$1,798.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.00
|
| Rate for Payer: UHCCP DNSP |
$1,160.00
|
| Rate for Payer: UHCCP Medicaid |
$621.76
|
| Rate for Payer: VA VA |
$1,160.00
|
|
|
HC CHROMOSOMAL MICROARRAY, PRENATAL
|
Facility
|
IP
|
$1,649.34
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
31000141
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,072.07 |
| Max. Negotiated Rate |
$1,649.34 |
| Rate for Payer: Aetna Commercial |
$1,484.41
|
| Rate for Payer: ASR ASR |
$1,599.86
|
| Rate for Payer: ASR Commercial |
$1,599.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,344.05
|
| Rate for Payer: BCN Commercial |
$1,278.73
|
| Rate for Payer: Cash Price |
$1,319.47
|
| Rate for Payer: Cofinity Commercial |
$1,550.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,319.47
|
| Rate for Payer: Healthscope Commercial |
$1,649.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,599.86
|
| Rate for Payer: Mclaren Commercial |
$1,484.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,401.94
|
| Rate for Payer: Nomi Health Commercial |
$1,352.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,072.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,451.42
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.94 |
| Max. Negotiated Rate |
$51.88 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| 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 |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Complete |
$18.84
|
| Rate for Payer: BCBS MAPPO |
$33.47
|
| Rate for Payer: BCBS Trust/PPO |
$29.82
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: BCN Medicare Advantage |
$33.47
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.47
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$33.47
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$17.94
|
| Rate for Payer: Mclaren Medicare |
$33.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.14
|
| Rate for Payer: Meridian Medicaid |
$18.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| 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 |
$17.94
|
| Rate for Payer: PHP Medicare Advantage |
$33.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.90
|
| Rate for Payer: Priority Health Medicare |
$33.47
|
| Rate for Payer: Priority Health Narrow Network |
$25.52
|
| Rate for Payer: Railroad Medicare Medicare |
$33.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.47
|
| Rate for Payer: UHC Exchange |
$51.88
|
| Rate for Payer: UHC Medicare Advantage |
$33.47
|
| Rate for Payer: UHCCP DNSP |
$33.47
|
| Rate for Payer: UHCCP Medicaid |
$17.94
|
| Rate for Payer: VA VA |
$33.47
|
|
|
HC CHROMOSOME ADDITIONAL KARYOTYPES
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 88280
|
| Hospital Charge Code |
31000044
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$36.41 |
| Rate for Payer: Aetna Commercial |
$32.77
|
| Rate for Payer: ASR ASR |
$35.32
|
| Rate for Payer: ASR Commercial |
$35.32
|
| Rate for Payer: BCBS Trust/PPO |
$29.67
|
| Rate for Payer: BCN Commercial |
$28.23
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$36.41
|
| Rate for Payer: Healthscope Whirlpool |
$35.32
|
| Rate for Payer: Mclaren Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.04
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
IP
|
$207.04
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$134.58 |
| Max. Negotiated Rate |
$207.04 |
| Rate for Payer: Aetna Commercial |
$186.34
|
| Rate for Payer: ASR ASR |
$200.83
|
| Rate for Payer: ASR Commercial |
$200.83
|
| Rate for Payer: BCBS Trust/PPO |
$168.72
|
| Rate for Payer: BCN Commercial |
$160.52
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$194.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Healthscope Commercial |
$207.04
|
| Rate for Payer: Healthscope Whirlpool |
$200.83
|
| Rate for Payer: Mclaren Commercial |
$186.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$169.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.20
|
|
|
HC CHROMOSOME ANALYSIS AMNIOTIC
|
Facility
|
OP
|
$207.04
|
|
|
Service Code
|
CPT 88269
|
| Hospital Charge Code |
31000022
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$269.17 |
| Rate for Payer: Aetna Commercial |
$186.34
|
| 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 |
$200.83
|
| Rate for Payer: ASR Commercial |
$200.83
|
| Rate for Payer: BCBS Complete |
$97.74
|
| Rate for Payer: BCBS MAPPO |
$173.66
|
| Rate for Payer: BCBS Trust/PPO |
$169.55
|
| Rate for Payer: BCN Commercial |
$160.52
|
| Rate for Payer: BCN Medicare Advantage |
$173.66
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$194.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.66
|
| Rate for Payer: Healthscope Commercial |
$207.04
|
| Rate for Payer: Healthscope Whirlpool |
$200.83
|
| Rate for Payer: Humana Choice PPO Medicare |
$173.66
|
| Rate for Payer: Mclaren Commercial |
$186.34
|
| Rate for Payer: Mclaren Medicaid |
$93.08
|
| Rate for Payer: Mclaren Medicare |
$173.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.34
|
| Rate for Payer: Meridian Medicaid |
$97.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$169.77
|
| 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 |
$93.08
|
| Rate for Payer: PHP Medicare Advantage |
$173.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.41
|
| Rate for Payer: Priority Health Medicare |
$173.66
|
| Rate for Payer: Priority Health Narrow Network |
$145.14
|
| Rate for Payer: Railroad Medicare Medicare |
$173.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.66
|
| Rate for Payer: UHC Exchange |
$269.17
|
| Rate for Payer: UHC Medicare Advantage |
$173.66
|
| Rate for Payer: UHCCP DNSP |
$173.66
|
| Rate for Payer: UHCCP Medicaid |
$93.08
|
| Rate for Payer: VA VA |
$173.66
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
OP
|
$375.58
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$375.58 |
| Rate for Payer: Aetna Commercial |
$338.02
|
| 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 |
$364.31
|
| Rate for Payer: ASR Commercial |
$364.31
|
| Rate for Payer: BCBS Complete |
$106.13
|
| Rate for Payer: BCBS MAPPO |
$188.57
|
| Rate for Payer: BCBS Trust/PPO |
$307.56
|
| Rate for Payer: BCN Commercial |
$291.19
|
| Rate for Payer: BCN Medicare Advantage |
$188.57
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cofinity Commercial |
$353.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.57
|
| Rate for Payer: Healthscope Commercial |
$375.58
|
| Rate for Payer: Healthscope Whirlpool |
$364.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$188.57
|
| Rate for Payer: Mclaren Commercial |
$338.02
|
| Rate for Payer: Mclaren Medicaid |
$101.07
|
| Rate for Payer: Mclaren Medicare |
$188.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.00
|
| Rate for Payer: Meridian Medicaid |
$106.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.24
|
| Rate for Payer: Nomi Health Commercial |
$307.98
|
| 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 |
$101.07
|
| Rate for Payer: PHP Medicare Advantage |
$188.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.08
|
| Rate for Payer: Priority Health Medicare |
$188.57
|
| Rate for Payer: Priority Health Narrow Network |
$263.28
|
| Rate for Payer: Railroad Medicare Medicare |
$188.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.57
|
| Rate for Payer: UHC Exchange |
$292.28
|
| Rate for Payer: UHC Medicare Advantage |
$188.57
|
| Rate for Payer: UHCCP DNSP |
$188.57
|
| Rate for Payer: UHCCP Medicaid |
$101.07
|
| Rate for Payer: VA VA |
$188.57
|
|
|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
IP
|
$375.58
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$244.13 |
| Max. Negotiated Rate |
$375.58 |
| Rate for Payer: Aetna Commercial |
$338.02
|
| Rate for Payer: ASR ASR |
$364.31
|
| Rate for Payer: ASR Commercial |
$364.31
|
| Rate for Payer: BCBS Trust/PPO |
$306.06
|
| Rate for Payer: BCN Commercial |
$291.19
|
| Rate for Payer: Cash Price |
$300.46
|
| Rate for Payer: Cofinity Commercial |
$353.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.46
|
| Rate for Payer: Healthscope Commercial |
$375.58
|
| Rate for Payer: Healthscope Whirlpool |
$364.31
|
| Rate for Payer: Mclaren Commercial |
$338.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.24
|
| Rate for Payer: Nomi Health Commercial |
$307.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.51
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
OP
|
$221.61
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.44 |
| Max. Negotiated Rate |
$221.61 |
| Rate for Payer: Aetna Commercial |
$199.45
|
| 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 |
$214.96
|
| Rate for Payer: ASR Commercial |
$214.96
|
| Rate for Payer: BCBS Complete |
$65.56
|
| Rate for Payer: BCBS MAPPO |
$116.49
|
| Rate for Payer: BCBS Trust/PPO |
$181.48
|
| Rate for Payer: BCN Commercial |
$171.81
|
| Rate for Payer: BCN Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$208.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.49
|
| Rate for Payer: Healthscope Commercial |
$221.61
|
| Rate for Payer: Healthscope Whirlpool |
$214.96
|
| Rate for Payer: Humana Choice PPO Medicare |
$116.49
|
| Rate for Payer: Mclaren Commercial |
$199.45
|
| Rate for Payer: Mclaren Medicaid |
$62.44
|
| Rate for Payer: Mclaren Medicare |
$116.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.31
|
| Rate for Payer: Meridian Medicaid |
$65.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| 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 |
$62.44
|
| Rate for Payer: PHP Medicare Advantage |
$116.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.17
|
| Rate for Payer: Priority Health Medicare |
$116.49
|
| Rate for Payer: Priority Health Narrow Network |
$155.35
|
| Rate for Payer: Railroad Medicare Medicare |
$116.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.49
|
| Rate for Payer: UHC Exchange |
$180.56
|
| Rate for Payer: UHC Medicare Advantage |
$116.49
|
| Rate for Payer: UHCCP DNSP |
$116.49
|
| Rate for Payer: UHCCP Medicaid |
$62.44
|
| Rate for Payer: VA VA |
$116.49
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
IP
|
$221.61
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$144.05 |
| Max. Negotiated Rate |
$221.61 |
| Rate for Payer: Aetna Commercial |
$199.45
|
| Rate for Payer: ASR ASR |
$214.96
|
| Rate for Payer: ASR Commercial |
$214.96
|
| Rate for Payer: BCBS Trust/PPO |
$180.59
|
| Rate for Payer: BCN Commercial |
$171.81
|
| Rate for Payer: Cash Price |
$177.29
|
| Rate for Payer: Cofinity Commercial |
$208.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.29
|
| Rate for Payer: Healthscope Commercial |
$221.61
|
| Rate for Payer: Healthscope Whirlpool |
$214.96
|
| Rate for Payer: Mclaren Commercial |
$199.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.37
|
| Rate for Payer: Nomi Health Commercial |
$181.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.02
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$229.38 |
| Rate for Payer: Aetna Commercial |
$206.44
|
| Rate for Payer: ASR ASR |
$222.50
|
| Rate for Payer: ASR Commercial |
$222.50
|
| Rate for Payer: BCBS Trust/PPO |
$186.92
|
| Rate for Payer: BCN Commercial |
$177.84
|
| Rate for Payer: Cash Price |
$183.50
|
| Rate for Payer: Cofinity Commercial |
$215.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.50
|
| Rate for Payer: Healthscope Commercial |
$229.38
|
| Rate for Payer: Healthscope Whirlpool |
$222.50
|
| Rate for Payer: Mclaren Commercial |
$206.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: Nomi Health Commercial |
$188.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.85
|
|
