|
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 |
$61.38 |
| 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 |
$53.78
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$43.03
|
| 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 |
$621.76 |
| 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 |
$2,144.94
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,716.05
|
| 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 |
$621.76 |
| 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 |
$1,445.15
|
| Rate for Payer: Priority Health Medicare |
$1,160.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.19
|
| 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
|
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 |
$217.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.07
|
| 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 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 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 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 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
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$229.38
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$229.38 |
| Rate for Payer: Aetna Commercial |
$206.44
|
| 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 |
$222.50
|
| Rate for Payer: ASR Commercial |
$222.50
|
| Rate for Payer: BCBS Complete |
$80.90
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$187.84
|
| Rate for Payer: BCN Commercial |
$177.84
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$183.50
|
| 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: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$229.38
|
| Rate for Payer: Healthscope Whirlpool |
$222.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$143.75
|
| Rate for Payer: Mclaren Commercial |
$206.44
|
| Rate for Payer: Mclaren Medicaid |
$77.05
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: Meridian Medicaid |
$80.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.97
|
| Rate for Payer: Nomi Health Commercial |
$188.09
|
| 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 |
$77.05
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.98
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$160.80
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Exchange |
$222.81
|
| Rate for Payer: UHC Medicare Advantage |
$143.75
|
| Rate for Payer: UHCCP DNSP |
$143.75
|
| Rate for Payer: UHCCP Medicaid |
$77.05
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.05 |
| Max. Negotiated Rate |
$235.13 |
| Rate for Payer: Aetna Commercial |
$211.62
|
| 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 |
$228.08
|
| Rate for Payer: ASR Commercial |
$228.08
|
| Rate for Payer: BCBS Complete |
$80.90
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$192.55
|
| Rate for Payer: BCN Commercial |
$182.30
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$221.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$235.13
|
| Rate for Payer: Healthscope Whirlpool |
$228.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$143.75
|
| Rate for Payer: Mclaren Commercial |
$211.62
|
| Rate for Payer: Mclaren Medicaid |
$77.05
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: Meridian Medicaid |
$80.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: Nomi Health Commercial |
$192.81
|
| 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 |
$77.05
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.02
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$164.83
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Exchange |
$222.81
|
| Rate for Payer: UHC Medicare Advantage |
$143.75
|
| Rate for Payer: UHCCP DNSP |
$143.75
|
| Rate for Payer: UHCCP Medicaid |
$77.05
|
| Rate for Payer: VA VA |
$143.75
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$235.13
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$152.83 |
| Max. Negotiated Rate |
$235.13 |
| Rate for Payer: Aetna Commercial |
$211.62
|
| Rate for Payer: ASR ASR |
$228.08
|
| Rate for Payer: ASR Commercial |
$228.08
|
| Rate for Payer: BCBS Trust/PPO |
$191.61
|
| Rate for Payer: BCN Commercial |
$182.30
|
| Rate for Payer: Cash Price |
$188.10
|
| Rate for Payer: Cofinity Commercial |
$221.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.10
|
| Rate for Payer: Healthscope Commercial |
$235.13
|
| Rate for Payer: Healthscope Whirlpool |
$228.08
|
| Rate for Payer: Mclaren Commercial |
$211.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.86
|
| Rate for Payer: Nomi Health Commercial |
$192.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.91
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.26 |
| Max. Negotiated Rate |
$205.28 |
| Rate for Payer: Aetna Commercial |
$184.75
|
| 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 |
$199.12
|
| Rate for Payer: ASR Commercial |
$199.12
|
| Rate for Payer: BCBS Complete |
$70.63
|
| Rate for Payer: BCBS MAPPO |
$125.49
|
| Rate for Payer: BCBS Trust/PPO |
$168.10
|
| Rate for Payer: BCN Commercial |
$159.15
|
| Rate for Payer: BCN Medicare Advantage |
$125.49
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$192.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.49
|
| Rate for Payer: Healthscope Commercial |
$205.28
|
| Rate for Payer: Healthscope Whirlpool |
$199.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.49
|
| Rate for Payer: Mclaren Commercial |
$184.75
|
| Rate for Payer: Mclaren Medicaid |
$67.26
|
| Rate for Payer: Mclaren Medicare |
$125.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.76
|
| Rate for Payer: Meridian Medicaid |
$70.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: Nomi Health Commercial |
$168.33
|
| 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 |
$67.26
|
| Rate for Payer: PHP Medicare Advantage |
$125.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.87
|
| Rate for Payer: Priority Health Medicare |
$125.49
|
| Rate for Payer: Priority Health Narrow Network |
$143.90
|
| Rate for Payer: Railroad Medicare Medicare |
$125.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.49
|
| Rate for Payer: UHC Exchange |
$194.51
|
| Rate for Payer: UHC Medicare Advantage |
$125.49
|
| Rate for Payer: UHCCP DNSP |
$125.49
|
| Rate for Payer: UHCCP Medicaid |
$67.26
|
| Rate for Payer: VA VA |
$125.49
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$205.28
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$133.43 |
| Max. Negotiated Rate |
$205.28 |
| Rate for Payer: Aetna Commercial |
$184.75
|
| Rate for Payer: ASR ASR |
$199.12
|
| Rate for Payer: ASR Commercial |
$199.12
|
| Rate for Payer: BCBS Trust/PPO |
$167.28
|
| Rate for Payer: BCN Commercial |
$159.15
|
| Rate for Payer: Cash Price |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$192.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.22
|
| Rate for Payer: Healthscope Commercial |
$205.28
|
| Rate for Payer: Healthscope Whirlpool |
$199.12
|
| Rate for Payer: Mclaren Commercial |
$184.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.49
|
| Rate for Payer: Nomi Health Commercial |
$168.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.65
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.56 |
| Max. Negotiated Rate |
$304.84 |
| Rate for Payer: Aetna Commercial |
$274.36
|
| 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 |
$295.69
|
| Rate for Payer: ASR Commercial |
$295.69
|
| Rate for Payer: BCBS Complete |
$84.59
|
| Rate for Payer: BCBS MAPPO |
$150.30
|
| Rate for Payer: BCBS Trust/PPO |
$249.63
|
| Rate for Payer: BCN Commercial |
$236.34
|
| Rate for Payer: BCN Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$286.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.30
|
| Rate for Payer: Healthscope Commercial |
$304.84
|
| Rate for Payer: Healthscope Whirlpool |
$295.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$150.30
|
| Rate for Payer: Mclaren Commercial |
$274.36
|
| Rate for Payer: Mclaren Medicaid |
$80.56
|
| Rate for Payer: Mclaren Medicare |
$150.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.81
|
| Rate for Payer: Meridian Medicaid |
$84.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| 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 |
$80.56
|
| Rate for Payer: PHP Medicare Advantage |
$150.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.10
|
| Rate for Payer: Priority Health Medicare |
$150.30
|
| Rate for Payer: Priority Health Narrow Network |
$213.69
|
| Rate for Payer: Railroad Medicare Medicare |
$150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.30
|
| Rate for Payer: UHC Exchange |
$232.97
|
| Rate for Payer: UHC Medicare Advantage |
$150.30
|
| Rate for Payer: UHCCP DNSP |
$150.30
|
| Rate for Payer: UHCCP Medicaid |
$80.56
|
| Rate for Payer: VA VA |
$150.30
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$198.15 |
| Max. Negotiated Rate |
$304.84 |
| Rate for Payer: Aetna Commercial |
$274.36
|
| Rate for Payer: ASR ASR |
$295.69
|
| Rate for Payer: ASR Commercial |
$295.69
|
| Rate for Payer: BCBS Trust/PPO |
$248.41
|
| Rate for Payer: BCN Commercial |
$236.34
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$286.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$304.84
|
| Rate for Payer: Healthscope Whirlpool |
$295.69
|
| Rate for Payer: Mclaren Commercial |
$274.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$268.26
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,105.88 |
| Max. Negotiated Rate |
$2,764.69 |
| Rate for Payer: Aetna Commercial |
$2,488.22
|
| Rate for Payer: Aetna Medicare |
$1,382.35
|
| Rate for Payer: ASR ASR |
$2,681.75
|
| Rate for Payer: ASR Commercial |
$2,681.75
|
| Rate for Payer: BCBS Complete |
$1,105.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.00
|
| Rate for Payer: BCN Commercial |
$2,143.46
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,598.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,764.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,681.75
|
| Rate for Payer: Mclaren Commercial |
$2,488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,422.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,938.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,432.93
|
|
|
HC CIRCUMCISION
|
Facility
|
IP
|
$2,764.69
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,797.05 |
| Max. Negotiated Rate |
$2,764.69 |
| Rate for Payer: Aetna Commercial |
$2,488.22
|
| Rate for Payer: ASR ASR |
$2,681.75
|
| Rate for Payer: ASR Commercial |
$2,681.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,252.95
|
| Rate for Payer: BCN Commercial |
$2,143.46
|
| Rate for Payer: Cash Price |
$2,211.75
|
| Rate for Payer: Cofinity Commercial |
$2,598.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,211.75
|
| Rate for Payer: Healthscope Commercial |
$2,764.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,681.75
|
| Rate for Payer: Mclaren Commercial |
$2,488.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,432.93
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,715.06
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$3,096.70 |
| Rate for Payer: Aetna Commercial |
$2,443.55
|
| Rate for Payer: Aetna Medicare |
$1,997.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: ASR ASR |
$2,633.61
|
| Rate for Payer: ASR Commercial |
$2,633.61
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.36
|
| Rate for Payer: BCN Commercial |
$2,104.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,552.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,715.06
|
| Rate for Payer: Healthscope Whirlpool |
$2,633.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,997.87
|
| Rate for Payer: Mclaren Commercial |
$2,443.55
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,197.66
|
| Rate for Payer: PHP Medicaid |
$1,070.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,378.94
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,903.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,389.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,096.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP DNSP |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: VA VA |
$1,997.87
|
|
