|
HC CYSTO TX FEMALE URETHRAL SYNDROME
|
Facility
|
OP
|
$868.53
|
|
|
Service Code
|
CPT 52285
|
| Hospital Charge Code |
76100272
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.53 |
| Max. Negotiated Rate |
$1,013.65 |
| Rate for Payer: Aetna Commercial |
$781.68
|
| Rate for Payer: Aetna Medicare |
$653.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.46
|
| Rate for Payer: ASR ASR |
$842.47
|
| Rate for Payer: ASR Commercial |
$842.47
|
| Rate for Payer: BCBS Complete |
$368.05
|
| Rate for Payer: BCBS MAPPO |
$653.97
|
| Rate for Payer: BCBS Trust/PPO |
$711.24
|
| Rate for Payer: BCN Commercial |
$673.37
|
| Rate for Payer: BCN Medicare Advantage |
$653.97
|
| Rate for Payer: Cash Price |
$694.82
|
| Rate for Payer: Cash Price |
$694.82
|
| Rate for Payer: Cofinity Commercial |
$816.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.97
|
| Rate for Payer: Healthscope Commercial |
$868.53
|
| Rate for Payer: Healthscope Whirlpool |
$842.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$653.97
|
| Rate for Payer: Mclaren Commercial |
$781.68
|
| Rate for Payer: Mclaren Medicaid |
$350.53
|
| Rate for Payer: Mclaren Medicare |
$653.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.67
|
| Rate for Payer: Meridian Medicaid |
$368.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$738.25
|
| Rate for Payer: Nomi Health Commercial |
$712.19
|
| Rate for Payer: PACE Medicare |
$621.27
|
| Rate for Payer: PACE SWMI |
$653.97
|
| Rate for Payer: PHP Commercial |
$719.37
|
| Rate for Payer: PHP Medicaid |
$350.53
|
| Rate for Payer: PHP Medicare Advantage |
$653.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$761.01
|
| Rate for Payer: Priority Health Medicare |
$653.97
|
| Rate for Payer: Priority Health Narrow Network |
$608.84
|
| Rate for Payer: Railroad Medicare Medicare |
$653.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$764.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.97
|
| Rate for Payer: UHC Exchange |
$1,013.65
|
| Rate for Payer: UHC Medicare Advantage |
$653.97
|
| Rate for Payer: UHCCP DNSP |
$653.97
|
| Rate for Payer: UHCCP Medicaid |
$350.53
|
| Rate for Payer: VA VA |
$653.97
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
|
OP
|
$997.25
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.53 |
| Max. Negotiated Rate |
$1,013.65 |
| Rate for Payer: Aetna Commercial |
$897.52
|
| Rate for Payer: Aetna Medicare |
$653.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.46
|
| Rate for Payer: ASR ASR |
$967.33
|
| Rate for Payer: ASR Commercial |
$967.33
|
| Rate for Payer: BCBS Complete |
$368.05
|
| Rate for Payer: BCBS MAPPO |
$653.97
|
| Rate for Payer: BCBS Trust/PPO |
$816.65
|
| Rate for Payer: BCN Commercial |
$773.17
|
| Rate for Payer: BCN Medicare Advantage |
$653.97
|
| Rate for Payer: Cash Price |
$797.80
|
| Rate for Payer: Cash Price |
$797.80
|
| Rate for Payer: Cofinity Commercial |
$937.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$797.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.97
|
| Rate for Payer: Healthscope Commercial |
$997.25
|
| Rate for Payer: Healthscope Whirlpool |
$967.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$653.97
|
| Rate for Payer: Mclaren Commercial |
$897.52
|
| Rate for Payer: Mclaren Medicaid |
$350.53
|
| Rate for Payer: Mclaren Medicare |
$653.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.67
|
| Rate for Payer: Meridian Medicaid |
$368.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$847.66
|
| Rate for Payer: Nomi Health Commercial |
$817.74
|
| Rate for Payer: PACE Medicare |
$621.27
|
| Rate for Payer: PACE SWMI |
$653.97
|
| Rate for Payer: PHP Commercial |
$719.37
|
| Rate for Payer: PHP Medicaid |
$350.53
|
| Rate for Payer: PHP Medicare Advantage |
$653.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$873.79
|
| Rate for Payer: Priority Health Medicare |
$653.97
|
| Rate for Payer: Priority Health Narrow Network |
$699.07
|
| Rate for Payer: Railroad Medicare Medicare |
$653.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$877.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.97
|
| Rate for Payer: UHC Exchange |
$1,013.65
|
| Rate for Payer: UHC Medicare Advantage |
$653.97
|
| Rate for Payer: UHCCP DNSP |
$653.97
|
| Rate for Payer: UHCCP Medicaid |
$350.53
|
| Rate for Payer: VA VA |
$653.97
|
|
|
HC CYSTOURETHROSCOPY
|
Facility
|
IP
|
$997.25
|
|
|
Service Code
|
CPT 52000
|
| Hospital Charge Code |
45000095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$648.21 |
| Max. Negotiated Rate |
$997.25 |
| Rate for Payer: Aetna Commercial |
$897.52
|
| Rate for Payer: ASR ASR |
$967.33
|
| Rate for Payer: ASR Commercial |
$967.33
|
| Rate for Payer: BCBS Trust/PPO |
$812.66
|
| Rate for Payer: BCN Commercial |
$773.17
|
| Rate for Payer: Cash Price |
$797.80
|
| Rate for Payer: Cofinity Commercial |
$937.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$797.80
|
| Rate for Payer: Healthscope Commercial |
$997.25
|
| Rate for Payer: Healthscope Whirlpool |
$967.33
|
| Rate for Payer: Mclaren Commercial |
$897.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$847.66
|
| Rate for Payer: Nomi Health Commercial |
$817.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$877.58
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
IP
|
$3,040.77
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,976.50 |
| Max. Negotiated Rate |
$3,040.77 |
| Rate for Payer: Aetna Commercial |
$2,736.69
|
| Rate for Payer: ASR ASR |
$2,949.55
|
| Rate for Payer: ASR Commercial |
$2,949.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,477.92
|
| Rate for Payer: BCN Commercial |
$2,357.51
|
| Rate for Payer: Cash Price |
$2,432.62
|
| Rate for Payer: Cofinity Commercial |
$2,858.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,432.62
|
| Rate for Payer: Healthscope Commercial |
$3,040.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,949.55
|
| Rate for Payer: Mclaren Commercial |
$2,736.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,584.65
|
| Rate for Payer: Nomi Health Commercial |
$2,493.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,675.88
|
|
|
HC CYSTOURETHROSCOPY BIOPSY
|
Facility
|
OP
|
$3,040.77
|
|
|
Service Code
|
CPT 52204
|
| Hospital Charge Code |
76100221
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.80 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$2,736.69
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$2,949.55
|
| Rate for Payer: ASR Commercial |
$2,949.55
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,490.09
|
| Rate for Payer: BCN Commercial |
$2,357.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,432.62
|
| Rate for Payer: Cash Price |
$2,432.62
|
| Rate for Payer: Cofinity Commercial |
$2,858.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,432.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$3,040.77
|
| Rate for Payer: Healthscope Whirlpool |
$2,949.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,736.69
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,584.65
|
| Rate for Payer: Nomi Health Commercial |
$2,493.43
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,664.32
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$2,131.58
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,675.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
IP
|
$2,764.69
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| 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 CYSTOURETHROSCOPY W/INJ FOR CHEMODENERV BLADDER
|
Facility
|
OP
|
$2,764.69
|
|
|
Service Code
|
CPT 52287
|
| Hospital Charge Code |
76100238
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,036.15 |
| Max. Negotiated Rate |
$3,110.99 |
| Rate for Payer: Aetna Commercial |
$2,488.22
|
| Rate for Payer: Aetna Medicare |
$2,007.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: ASR ASR |
$2,681.75
|
| Rate for Payer: ASR Commercial |
$2,681.75
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.00
|
| Rate for Payer: BCN Commercial |
$2,143.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,211.75
|
| 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: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,764.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,681.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,007.09
|
| Rate for Payer: Mclaren Commercial |
$2,488.22
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,349.99
|
| Rate for Payer: Nomi Health Commercial |
$2,267.05
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,207.80
|
| Rate for Payer: PHP Medicaid |
$1,075.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,295.19
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,036.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,432.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,110.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP DNSP |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: VA VA |
$2,007.09
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
IP
|
$4,710.21
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,061.64 |
| Max. Negotiated Rate |
$4,710.21 |
| Rate for Payer: Aetna Commercial |
$4,239.19
|
| Rate for Payer: ASR ASR |
$4,568.90
|
| Rate for Payer: ASR Commercial |
$4,568.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,838.35
|
| Rate for Payer: BCN Commercial |
$3,651.83
|
| Rate for Payer: Cash Price |
$3,768.17
|
| Rate for Payer: Cofinity Commercial |
$4,427.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,768.17
|
| Rate for Payer: Healthscope Commercial |
$4,710.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,568.90
|
| Rate for Payer: Mclaren Commercial |
$4,239.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,003.68
|
| Rate for Payer: Nomi Health Commercial |
$3,862.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,061.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,144.98
|
|
|
HC CYSTO W/IRRIG & EVAC CLOTS
|
Facility
|
OP
|
$4,710.21
|
|
|
Service Code
|
CPT 52001
|
| Hospital Charge Code |
76100226
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,811.27 |
| Max. Negotiated Rate |
$5,237.81 |
| Rate for Payer: Aetna Commercial |
$4,239.19
|
| Rate for Payer: Aetna Medicare |
$3,379.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: ASR ASR |
$4,568.90
|
| Rate for Payer: ASR Commercial |
$4,568.90
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,857.19
|
| Rate for Payer: BCN Commercial |
$3,651.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Cash Price |
$3,768.17
|
| Rate for Payer: Cash Price |
$3,768.17
|
| Rate for Payer: Cofinity Commercial |
$4,427.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,768.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Healthscope Commercial |
$4,710.21
|
| Rate for Payer: Healthscope Whirlpool |
$4,568.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,379.23
|
| Rate for Payer: Mclaren Commercial |
$4,239.19
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,003.68
|
| Rate for Payer: Nomi Health Commercial |
$3,862.37
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Commercial |
$3,717.15
|
| Rate for Payer: PHP Medicaid |
$1,811.27
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,061.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,127.09
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$3,301.86
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,144.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Exchange |
$5,237.81
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP DNSP |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,811.27
|
| Rate for Payer: VA VA |
$3,379.23
|
|
|
HC CYTO DNA PROBE
|
Facility
|
OP
|
$133.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$133.17 |
| Rate for Payer: Aetna Commercial |
$119.85
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$129.17
|
| Rate for Payer: ASR Commercial |
$129.17
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$109.05
|
| Rate for Payer: BCN Commercial |
$103.25
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$125.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$133.17
|
| Rate for Payer: Healthscope Whirlpool |
$129.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$119.85
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.68
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$93.35
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC CYTO DNA PROBE
|
Facility
|
IP
|
$133.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$86.56 |
| Max. Negotiated Rate |
$133.17 |
| Rate for Payer: Aetna Commercial |
$119.85
|
| Rate for Payer: ASR ASR |
$129.17
|
| Rate for Payer: ASR Commercial |
$129.17
|
| Rate for Payer: BCBS Trust/PPO |
$108.52
|
| Rate for Payer: BCN Commercial |
$103.25
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$125.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Healthscope Commercial |
$133.17
|
| Rate for Payer: Healthscope Whirlpool |
$129.17
|
| Rate for Payer: Mclaren Commercial |
$119.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.19
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.98 |
| Max. Negotiated Rate |
$106.12 |
| Rate for Payer: Aetna Commercial |
$95.51
|
| Rate for Payer: ASR ASR |
$102.94
|
| Rate for Payer: ASR Commercial |
$102.94
|
| Rate for Payer: BCBS Trust/PPO |
$86.48
|
| Rate for Payer: BCN Commercial |
$82.27
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$106.12
|
| Rate for Payer: Healthscope Whirlpool |
$102.94
|
| Rate for Payer: Mclaren Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.39
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$106.12 |
| Rate for Payer: Aetna Commercial |
$95.51
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$102.94
|
| Rate for Payer: ASR Commercial |
$102.94
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$86.90
|
| Rate for Payer: BCN Commercial |
$82.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$106.12
|
| Rate for Payer: Healthscope Whirlpool |
$102.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.98
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$74.39
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
OP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$268.26 |
| Rate for Payer: Aetna Commercial |
$241.43
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$260.21
|
| Rate for Payer: ASR Commercial |
$260.21
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$219.68
|
| Rate for Payer: BCN Commercial |
$207.98
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$252.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$268.26
|
| Rate for Payer: Healthscope Whirlpool |
$260.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$241.43
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.05
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$188.05
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
IP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.37 |
| Max. Negotiated Rate |
$268.26 |
| Rate for Payer: Aetna Commercial |
$241.43
|
| Rate for Payer: ASR ASR |
$260.21
|
| Rate for Payer: ASR Commercial |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$218.61
|
| Rate for Payer: BCN Commercial |
$207.98
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$252.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Healthscope Commercial |
$268.26
|
| Rate for Payer: Healthscope Whirlpool |
$260.21
|
| Rate for Payer: Mclaren Commercial |
$241.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.07
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$242.76 |
| Rate for Payer: Aetna Commercial |
$218.48
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: ASR ASR |
$235.48
|
| Rate for Payer: ASR Commercial |
$235.48
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$198.80
|
| Rate for Payer: BCN Commercial |
$188.21
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$228.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$242.76
|
| Rate for Payer: Healthscope Whirlpool |
$235.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$21.42
|
| Rate for Payer: Mclaren Commercial |
$218.48
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: Nomi Health Commercial |
$199.06
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicaid |
$11.48
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.71
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$170.17
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP DNSP |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: VA VA |
$21.42
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$157.79 |
| Max. Negotiated Rate |
$242.76 |
| Rate for Payer: Aetna Commercial |
$218.48
|
| Rate for Payer: ASR ASR |
$235.48
|
| Rate for Payer: ASR Commercial |
$235.48
|
| Rate for Payer: BCBS Trust/PPO |
$197.83
|
| Rate for Payer: BCN Commercial |
$188.21
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$228.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Healthscope Commercial |
$242.76
|
| Rate for Payer: Healthscope Whirlpool |
$235.48
|
| Rate for Payer: Mclaren Commercial |
$218.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: Nomi Health Commercial |
$199.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$213.63
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$52.02 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$42.39
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$54.39 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: ASR ASR |
$50.46
|
| Rate for Payer: ASR Commercial |
$50.46
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$42.60
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Whirlpool |
$50.46
|
| Rate for Payer: Humana Choice PPO Medicare |
$35.09
|
| Rate for Payer: Mclaren Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$38.60
|
| Rate for Payer: PHP Medicaid |
$18.81
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.58
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$35.09
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.73 |
| Max. Negotiated Rate |
$111.89 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: ASR ASR |
$108.53
|
| Rate for Payer: ASR Commercial |
$108.53
|
| Rate for Payer: BCBS Trust/PPO |
$91.18
|
| Rate for Payer: BCN Commercial |
$86.75
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$105.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Healthscope Commercial |
$111.89
|
| Rate for Payer: Healthscope Whirlpool |
$108.53
|
| Rate for Payer: Mclaren Commercial |
$100.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: Nomi Health Commercial |
$91.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.46
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$137.25 |
| Rate for Payer: Aetna Commercial |
$100.70
|
| Rate for Payer: Aetna Medicare |
$19.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: ASR ASR |
$108.53
|
| Rate for Payer: ASR Commercial |
$108.53
|
| Rate for Payer: BCBS Complete |
$11.01
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.63
|
| Rate for Payer: BCN Commercial |
$86.75
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$105.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$111.89
|
| Rate for Payer: Healthscope Whirlpool |
$108.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$19.56
|
| Rate for Payer: Mclaren Commercial |
$100.70
|
| Rate for Payer: Mclaren Medicaid |
$10.48
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Medicaid |
$11.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: Nomi Health Commercial |
$91.75
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$21.52
|
| Rate for Payer: PHP Medicaid |
$10.48
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.25
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health Narrow Network |
$109.80
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$98.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.56
|
| Rate for Payer: UHC Exchange |
$30.32
|
| Rate for Payer: UHC Medicare Advantage |
$19.56
|
| Rate for Payer: UHCCP DNSP |
$19.56
|
| Rate for Payer: UHCCP Medicaid |
$10.48
|
| Rate for Payer: VA VA |
$19.56
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$51.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$14.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$14.39
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$15.83
|
| Rate for Payer: PHP Medicaid |
$7.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.62
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$41.30
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$22.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP DNSP |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: VA VA |
$14.39
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$41.62 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Trust/PPO |
$33.92
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$52.70 |
| Rate for Payer: Aetna Commercial |
$37.46
|
| Rate for Payer: Aetna Medicare |
$16.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: ASR ASR |
$40.37
|
| Rate for Payer: ASR Commercial |
$40.37
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$34.08
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$39.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$41.62
|
| Rate for Payer: Healthscope Whirlpool |
$40.37
|
| Rate for Payer: Humana Choice PPO Medicare |
$16.85
|
| Rate for Payer: Mclaren Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$18.54
|
| Rate for Payer: PHP Medicaid |
$9.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.70
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$42.16
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP DNSP |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: VA VA |
$16.85
|
|
