|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$197.03 |
| Max. Negotiated Rate |
$636.48 |
| Rate for Payer: Priority Health SBD |
$636.48
|
| Rate for Payer: Aetna Commercial |
$402.28
|
| Rate for Payer: Aetna Medicare |
$312.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.30
|
| Rate for Payer: BCBS Complete |
$206.88
|
| Rate for Payer: BCBS MAPPO |
$300.21
|
| Rate for Payer: BCN Commercial |
$522.38
|
| Rate for Payer: BCN Medicare Advantage |
$300.21
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$432.30
|
| Rate for Payer: Cofinity Commercial |
$402.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.21
|
| Rate for Payer: Healthscope Commercial |
$555.39
|
| Rate for Payer: Healthscope Commercial |
$480.34
|
| Rate for Payer: Mclaren Medicaid |
$197.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.22
|
| Rate for Payer: Meridian Medicaid |
$206.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$330.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.62
|
| Rate for Payer: Nomi Health Commercial |
$360.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.75
|
| Rate for Payer: PACE SWMI |
$300.21
|
| Rate for Payer: PHP Medicare Advantage |
$300.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$636.48
|
| Rate for Payer: Priority Health Medicare |
$300.21
|
| Rate for Payer: Priority Health Tiered Network |
$636.48
|
| Rate for Payer: Railroad Medicare Medicare |
$300.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.99
|
| Rate for Payer: UHC Core |
$582.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$300.21
|
| Rate for Payer: UHC Exchange |
$582.99
|
| Rate for Payer: UHC Medicaid |
$197.03
|
| Rate for Payer: UHCCP Medicaid |
$197.03
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$152.72 |
| Max. Negotiated Rate |
$789.00 |
| Rate for Payer: Aetna Commercial |
$310.56
|
| Rate for Payer: Aetna Medicare |
$241.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.73
|
| Rate for Payer: BCBS Complete |
$160.36
|
| Rate for Payer: BCBS MAPPO |
$231.76
|
| Rate for Payer: BCN Commercial |
$400.87
|
| Rate for Payer: BCN Medicare Advantage |
$231.76
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$333.73
|
| Rate for Payer: Cofinity Commercial |
$310.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.76
|
| Rate for Payer: Healthscope Commercial |
$428.76
|
| Rate for Payer: Healthscope Commercial |
$370.82
|
| Rate for Payer: Mclaren Medicaid |
$152.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.35
|
| Rate for Payer: Meridian Medicaid |
$160.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$254.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.68
|
| Rate for Payer: Nomi Health Commercial |
$278.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.00
|
| Rate for Payer: PACE SWMI |
$231.76
|
| Rate for Payer: PHP Medicare Advantage |
$231.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$488.44
|
| Rate for Payer: Priority Health Medicare |
$231.76
|
| Rate for Payer: Priority Health SBD |
$488.44
|
| Rate for Payer: Priority Health Tiered Network |
$488.44
|
| Rate for Payer: Railroad Medicare Medicare |
$231.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.10
|
| Rate for Payer: UHC Core |
$444.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$231.76
|
| Rate for Payer: UHC Exchange |
$444.10
|
| Rate for Payer: UHC Medicaid |
$152.72
|
| Rate for Payer: UHCCP Medicaid |
$152.72
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$324.00 |
| Rate for Payer: Aetna Commercial |
$195.64
|
| Rate for Payer: Aetna Medicare |
$151.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.24
|
| Rate for Payer: BCBS Complete |
$100.64
|
| Rate for Payer: BCBS MAPPO |
$146.00
|
| Rate for Payer: BCN Commercial |
$249.99
|
| Rate for Payer: BCN Medicare Advantage |
$146.00
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Cofinity Commercial |
$210.24
|
| Rate for Payer: Cofinity Commercial |
$195.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.00
|
| Rate for Payer: Healthscope Commercial |
$270.10
|
| Rate for Payer: Healthscope Commercial |
$233.60
|
| Rate for Payer: Mclaren Medicaid |
$95.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.30
|
| Rate for Payer: Meridian Medicaid |
$100.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.46
|
| Rate for Payer: Nomi Health Commercial |
$175.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.00
|
| Rate for Payer: PACE SWMI |
$146.00
|
| Rate for Payer: PHP Medicare Advantage |
$146.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$304.59
|
| Rate for Payer: Priority Health Medicare |
$146.00
|
| Rate for Payer: Priority Health SBD |
$304.59
|
| Rate for Payer: Priority Health Tiered Network |
$304.59
|
| Rate for Payer: Railroad Medicare Medicare |
$146.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.13
|
| Rate for Payer: UHC Core |
$283.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.00
|
| Rate for Payer: UHC Exchange |
$283.13
|
| Rate for Payer: UHC Medicaid |
$95.85
|
| Rate for Payer: UHCCP Medicaid |
$95.85
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$309.60 |
| Max. Negotiated Rate |
$580.50 |
| Rate for Payer: Aetna Medicare |
$387.00
|
| Rate for Payer: BCBS Complete |
$309.60
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.50
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$779.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$91.38 |
| Max. Negotiated Rate |
$584.25 |
| Rate for Payer: Aetna Commercial |
$189.26
|
| Rate for Payer: Aetna Medicare |
$146.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.39
|
| Rate for Payer: BCBS Complete |
$95.95
|
| Rate for Payer: BCBS MAPPO |
$141.24
|
| Rate for Payer: BCN Commercial |
$236.55
|
| Rate for Payer: BCN Medicare Advantage |
$141.24
|
| Rate for Payer: Cash Price |
$623.20
|
| Rate for Payer: Cash Price |
$623.20
|
| Rate for Payer: Cofinity Commercial |
$203.39
|
| Rate for Payer: Cofinity Commercial |
$189.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.24
|
| Rate for Payer: Healthscope Commercial |
$225.98
|
| Rate for Payer: Healthscope Commercial |
$261.29
|
| Rate for Payer: Mclaren Medicaid |
$91.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.30
|
| Rate for Payer: Meridian Medicaid |
$95.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.05
|
| Rate for Payer: Nomi Health Commercial |
$169.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$584.25
|
| Rate for Payer: PACE SWMI |
$141.24
|
| Rate for Payer: PHP Medicare Advantage |
$141.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$288.22
|
| Rate for Payer: Priority Health Medicare |
$141.24
|
| Rate for Payer: Priority Health SBD |
$288.22
|
| Rate for Payer: Priority Health Tiered Network |
$288.22
|
| Rate for Payer: Railroad Medicare Medicare |
$141.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.14
|
| Rate for Payer: UHC Core |
$282.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$141.24
|
| Rate for Payer: UHC Exchange |
$282.14
|
| Rate for Payer: UHC Medicaid |
$91.38
|
| Rate for Payer: UHCCP Medicaid |
$91.38
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$687.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$515.25 |
| Rate for Payer: Aetna Commercial |
$139.25
|
| Rate for Payer: Aetna Medicare |
$108.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.64
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$103.92
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: BCN Medicare Advantage |
$103.92
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cash Price |
$549.60
|
| Rate for Payer: Cofinity Commercial |
$149.64
|
| Rate for Payer: Cofinity Commercial |
$139.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.92
|
| Rate for Payer: Healthscope Commercial |
$192.25
|
| Rate for Payer: Healthscope Commercial |
$166.27
|
| Rate for Payer: Mclaren Medicaid |
$67.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.12
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.63
|
| Rate for Payer: Nomi Health Commercial |
$124.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.25
|
| Rate for Payer: PACE SWMI |
$103.92
|
| Rate for Payer: PHP Medicare Advantage |
$103.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$211.76
|
| Rate for Payer: Priority Health Medicare |
$103.92
|
| Rate for Payer: Priority Health SBD |
$211.76
|
| Rate for Payer: Priority Health Tiered Network |
$211.76
|
| Rate for Payer: Railroad Medicare Medicare |
$103.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.10
|
| Rate for Payer: UHC Core |
$206.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.92
|
| Rate for Payer: UHC Exchange |
$206.10
|
| Rate for Payer: UHC Medicaid |
$67.52
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$161.28 |
| Max. Negotiated Rate |
$2,996.60 |
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna Medicare |
$963.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$685.19
|
| Rate for Payer: BCN Commercial |
$685.19
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Advantage |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Mclaren Medicaid |
$484.62
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$972.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Nomi Health Commercial |
$2,779.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,996.60
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health SBD |
$161.28
|
| Rate for Payer: Priority Health Tiered Network |
$2,397.28
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$161.28 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.40
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Advantage |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: Priority Health SBD |
$161.28
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$70.15
|
| Rate for Payer: Aetna Medicare |
$54.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.38
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCN Commercial |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$75.38
|
| Rate for Payer: Cofinity Commercial |
$70.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$96.85
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Mclaren Medicaid |
$34.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$36.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.01
|
| Rate for Payer: Nomi Health Commercial |
$62.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$103.75
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health SBD |
$103.75
|
| Rate for Payer: Priority Health Tiered Network |
$103.75
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.58
|
| Rate for Payer: UHC Core |
$97.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.35
|
| Rate for Payer: UHC Exchange |
$97.58
|
| Rate for Payer: UHC Medicaid |
$34.29
|
| Rate for Payer: UHCCP Medicaid |
$34.29
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$256.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$192.00 |
| Rate for Payer: Aetna Commercial |
$70.15
|
| Rate for Payer: Aetna Medicare |
$54.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.38
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCN Commercial |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$75.38
|
| Rate for Payer: Cofinity Commercial |
$70.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$96.85
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Mclaren Medicaid |
$34.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$36.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.01
|
| Rate for Payer: Nomi Health Commercial |
$62.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$103.75
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health SBD |
$103.75
|
| Rate for Payer: Priority Health Tiered Network |
$103.75
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.58
|
| Rate for Payer: UHC Core |
$97.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.35
|
| Rate for Payer: UHC Exchange |
$97.58
|
| Rate for Payer: UHC Medicaid |
$34.29
|
| Rate for Payer: UHCCP Medicaid |
$34.29
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$146.77
|
| Rate for Payer: Aetna Medicare |
$113.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.72
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS MAPPO |
$109.53
|
| Rate for Payer: BCN Commercial |
$183.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.53
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$157.72
|
| Rate for Payer: Cofinity Commercial |
$146.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.53
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Healthscope Commercial |
$175.25
|
| Rate for Payer: Mclaren Medicaid |
$71.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.01
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.73
|
| Rate for Payer: Nomi Health Commercial |
$131.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.50
|
| Rate for Payer: PACE SWMI |
$109.53
|
| Rate for Payer: PHP Medicare Advantage |
$109.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$223.30
|
| Rate for Payer: Priority Health Medicare |
$109.53
|
| Rate for Payer: Priority Health SBD |
$223.30
|
| Rate for Payer: Priority Health Tiered Network |
$223.30
|
| Rate for Payer: Railroad Medicare Medicare |
$109.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.71
|
| Rate for Payer: UHC Core |
$217.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.53
|
| Rate for Payer: UHC Exchange |
$217.71
|
| Rate for Payer: UHC Medicaid |
$71.14
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
|
|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$382.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$286.50 |
| Rate for Payer: Aetna Commercial |
$180.35
|
| Rate for Payer: Aetna Medicare |
$139.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.81
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$134.59
|
| Rate for Payer: BCN Commercial |
$227.08
|
| Rate for Payer: BCN Medicare Advantage |
$134.59
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cash Price |
$305.60
|
| Rate for Payer: Cofinity Commercial |
$193.81
|
| Rate for Payer: Cofinity Commercial |
$180.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.59
|
| Rate for Payer: Healthscope Commercial |
$248.99
|
| Rate for Payer: Healthscope Commercial |
$215.34
|
| Rate for Payer: Mclaren Medicaid |
$87.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.32
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.51
|
| Rate for Payer: Nomi Health Commercial |
$161.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.50
|
| Rate for Payer: PACE SWMI |
$134.59
|
| Rate for Payer: PHP Medicare Advantage |
$134.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$276.68
|
| Rate for Payer: Priority Health Medicare |
$134.59
|
| Rate for Payer: Priority Health SBD |
$276.68
|
| Rate for Payer: Priority Health Tiered Network |
$276.68
|
| Rate for Payer: Railroad Medicare Medicare |
$134.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.21
|
| Rate for Payer: UHC Core |
$271.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.59
|
| Rate for Payer: UHC Exchange |
$271.21
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 45340
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$95.07
|
| Rate for Payer: Aetna Medicare |
$73.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.07
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$70.95
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: BCN Medicare Advantage |
$70.95
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$95.07
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.95
|
| Rate for Payer: Healthscope Commercial |
$131.26
|
| Rate for Payer: Healthscope Commercial |
$113.52
|
| Rate for Payer: Mclaren Medicaid |
$46.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.50
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.96
|
| Rate for Payer: Nomi Health Commercial |
$85.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$70.95
|
| Rate for Payer: PHP Medicare Advantage |
$70.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$140.76
|
| Rate for Payer: Priority Health Medicare |
$70.95
|
| Rate for Payer: Priority Health SBD |
$140.76
|
| Rate for Payer: Priority Health Tiered Network |
$140.76
|
| Rate for Payer: Railroad Medicare Medicare |
$70.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.22
|
| Rate for Payer: UHC Core |
$136.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.95
|
| Rate for Payer: UHC Exchange |
$136.22
|
| Rate for Payer: UHC Medicaid |
$46.22
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 45342
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$623.25 |
| Rate for Payer: Aetna Commercial |
$200.33
|
| Rate for Payer: Aetna Medicare |
$155.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.28
|
| Rate for Payer: BCBS Complete |
$101.53
|
| Rate for Payer: BCBS MAPPO |
$149.50
|
| Rate for Payer: BCN Commercial |
$250.98
|
| Rate for Payer: BCN Medicare Advantage |
$149.50
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$215.28
|
| Rate for Payer: Cofinity Commercial |
$200.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.50
|
| Rate for Payer: Healthscope Commercial |
$276.57
|
| Rate for Payer: Healthscope Commercial |
$239.20
|
| Rate for Payer: Mclaren Medicaid |
$96.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.97
|
| Rate for Payer: Meridian Medicaid |
$101.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.16
|
| Rate for Payer: Nomi Health Commercial |
$179.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$623.25
|
| Rate for Payer: PACE SWMI |
$149.50
|
| Rate for Payer: PHP Medicare Advantage |
$149.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$305.81
|
| Rate for Payer: Priority Health Medicare |
$149.50
|
| Rate for Payer: Priority Health SBD |
$305.81
|
| Rate for Payer: Priority Health Tiered Network |
$305.81
|
| Rate for Payer: Railroad Medicare Medicare |
$149.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.57
|
| Rate for Payer: UHC Core |
$298.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.50
|
| Rate for Payer: UHC Exchange |
$298.57
|
| Rate for Payer: UHC Medicaid |
$96.70
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Aetna Commercial |
$87.41
|
| Rate for Payer: Aetna Medicare |
$67.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.93
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: BCN Medicare Advantage |
$65.23
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$93.93
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.23
|
| Rate for Payer: Healthscope Commercial |
$120.68
|
| Rate for Payer: Healthscope Commercial |
$104.37
|
| Rate for Payer: Mclaren Medicaid |
$42.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.49
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.41
|
| Rate for Payer: Nomi Health Commercial |
$78.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.75
|
| Rate for Payer: PACE SWMI |
$65.23
|
| Rate for Payer: PHP Medicare Advantage |
$65.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.66
|
| Rate for Payer: Priority Health Medicare |
$65.23
|
| Rate for Payer: Priority Health SBD |
$131.66
|
| Rate for Payer: Priority Health Tiered Network |
$131.66
|
| Rate for Payer: Railroad Medicare Medicare |
$65.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.14
|
| Rate for Payer: UHC Core |
$125.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.23
|
| Rate for Payer: UHC Exchange |
$125.14
|
| Rate for Payer: UHC Medicaid |
$42.60
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Aetna Commercial |
$87.41
|
| Rate for Payer: Aetna Medicare |
$67.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.93
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: BCN Medicare Advantage |
$65.23
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$93.93
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.23
|
| Rate for Payer: Healthscope Commercial |
$120.68
|
| Rate for Payer: Healthscope Commercial |
$104.37
|
| Rate for Payer: Mclaren Medicaid |
$42.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.49
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.41
|
| Rate for Payer: Nomi Health Commercial |
$78.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.75
|
| Rate for Payer: PACE SWMI |
$65.23
|
| Rate for Payer: PHP Medicare Advantage |
$65.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.66
|
| Rate for Payer: Priority Health Medicare |
$65.23
|
| Rate for Payer: Priority Health SBD |
$131.66
|
| Rate for Payer: Priority Health Tiered Network |
$131.66
|
| Rate for Payer: Railroad Medicare Medicare |
$65.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.14
|
| Rate for Payer: UHC Core |
$125.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.23
|
| Rate for Payer: UHC Exchange |
$125.14
|
| Rate for Payer: UHC Medicaid |
$42.60
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$222.39 |
| Max. Negotiated Rate |
$2,996.60 |
| Rate for Payer: Aetna Commercial |
$300.05
|
| Rate for Payer: Aetna Medicare |
$963.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$855.72
|
| Rate for Payer: BCN Commercial |
$855.72
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Advantage |
$247.10
|
| Rate for Payer: Cofinity Commercial |
$303.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Healthscope Commercial |
$317.70
|
| Rate for Payer: Mclaren Medicaid |
$484.62
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$972.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.05
|
| Rate for Payer: Nomi Health Commercial |
$2,779.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.75
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Commercial |
$300.05
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,996.60
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health SBD |
$222.39
|
| Rate for Payer: Priority Health Tiered Network |
$2,397.28
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$222.39 |
| Max. Negotiated Rate |
$317.70 |
| Rate for Payer: Aetna Commercial |
$300.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.45
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Advantage |
$247.10
|
| Rate for Payer: Cofinity Commercial |
$303.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.40
|
| Rate for Payer: Healthscope Commercial |
$317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.75
|
| Rate for Payer: PHP Commercial |
$300.05
|
| Rate for Payer: Priority Health SBD |
$222.39
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$457.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$342.75 |
| Rate for Payer: Aetna Commercial |
$120.79
|
| Rate for Payer: Aetna Medicare |
$93.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.80
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$90.14
|
| Rate for Payer: BCN Commercial |
$149.39
|
| Rate for Payer: BCN Medicare Advantage |
$90.14
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cofinity Commercial |
$129.80
|
| Rate for Payer: Cofinity Commercial |
$120.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.14
|
| Rate for Payer: Healthscope Commercial |
$166.76
|
| Rate for Payer: Healthscope Commercial |
$144.22
|
| Rate for Payer: Mclaren Medicaid |
$58.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.65
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.82
|
| Rate for Payer: Nomi Health Commercial |
$108.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.75
|
| Rate for Payer: PACE SWMI |
$90.14
|
| Rate for Payer: PHP Medicare Advantage |
$90.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$182.03
|
| Rate for Payer: Priority Health Medicare |
$90.14
|
| Rate for Payer: Priority Health SBD |
$182.03
|
| Rate for Payer: Priority Health Tiered Network |
$182.03
|
| Rate for Payer: Railroad Medicare Medicare |
$90.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.90
|
| Rate for Payer: UHC Core |
$177.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.14
|
| Rate for Payer: UHC Exchange |
$177.90
|
| Rate for Payer: UHC Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$536.00
|
|
|
Service Code
|
HCPCS 45332
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: Aetna Commercial |
$126.11
|
| Rate for Payer: Aetna Medicare |
$97.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.52
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$94.11
|
| Rate for Payer: BCN Commercial |
$155.86
|
| Rate for Payer: BCN Medicare Advantage |
$94.11
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Commercial |
$135.52
|
| Rate for Payer: Cofinity Commercial |
$126.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.11
|
| Rate for Payer: Healthscope Commercial |
$174.10
|
| Rate for Payer: Healthscope Commercial |
$150.58
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.82
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.02
|
| Rate for Payer: Nomi Health Commercial |
$112.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.00
|
| Rate for Payer: PACE SWMI |
$94.11
|
| Rate for Payer: PHP Medicare Advantage |
$94.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.91
|
| Rate for Payer: Priority Health Medicare |
$94.11
|
| Rate for Payer: Priority Health SBD |
$189.91
|
| Rate for Payer: Priority Health Tiered Network |
$189.91
|
| Rate for Payer: Railroad Medicare Medicare |
$94.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.33
|
| Rate for Payer: UHC Core |
$185.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.11
|
| Rate for Payer: UHC Exchange |
$185.33
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 45333
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$580.50 |
| Rate for Payer: Aetna Commercial |
$113.85
|
| Rate for Payer: Aetna Medicare |
$88.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.34
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS MAPPO |
$84.96
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: BCN Medicare Advantage |
$84.96
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$122.34
|
| Rate for Payer: Cofinity Commercial |
$113.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.96
|
| Rate for Payer: Healthscope Commercial |
$157.18
|
| Rate for Payer: Healthscope Commercial |
$135.94
|
| Rate for Payer: Mclaren Medicaid |
$55.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.21
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.11
|
| Rate for Payer: Nomi Health Commercial |
$101.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.50
|
| Rate for Payer: PACE SWMI |
$84.96
|
| Rate for Payer: PHP Medicare Advantage |
$84.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.49
|
| Rate for Payer: Priority Health Medicare |
$84.96
|
| Rate for Payer: Priority Health SBD |
$170.49
|
| Rate for Payer: Priority Health Tiered Network |
$170.49
|
| Rate for Payer: Railroad Medicare Medicare |
$84.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.14
|
| Rate for Payer: UHC Core |
$165.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.96
|
| Rate for Payer: UHC Exchange |
$165.14
|
| Rate for Payer: UHC Medicaid |
$55.17
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
|
|
PR SIGMOIDOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 45345
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Medicare |
$170.00
|
| Rate for Payer: BCBS Complete |
$136.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
|
|
PR SIGMOIDOSCOPY W/STENT
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS G6023
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Medicare |
$170.00
|
| Rate for Payer: BCBS Complete |
$136.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
|
|
PR SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 93278
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$57.41 |
| Rate for Payer: Aetna Commercial |
$41.58
|
| Rate for Payer: Aetna Medicare |
$32.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.68
|
| Rate for Payer: BCBS MAPPO |
$31.03
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$31.03
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$41.58
|
| Rate for Payer: Cofinity Commercial |
$44.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.03
|
| Rate for Payer: Healthscope Commercial |
$49.65
|
| Rate for Payer: Healthscope Commercial |
$57.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.13
|
| Rate for Payer: Nomi Health Commercial |
$37.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$31.03
|
| Rate for Payer: PHP Medicare Advantage |
$31.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44.97
|
| Rate for Payer: Priority Health Medicare |
$31.03
|
| Rate for Payer: Priority Health SBD |
$44.97
|
| Rate for Payer: Priority Health Tiered Network |
$44.97
|
| Rate for Payer: Railroad Medicare Medicare |
$31.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.53
|
| Rate for Payer: UHC Core |
$46.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.03
|
| Rate for Payer: UHC Exchange |
$46.53
|
|
|
PR SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 51725
|
| Min. Negotiated Rate |
$186.85 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Aetna Commercial |
$250.38
|
| Rate for Payer: Aetna Medicare |
$194.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.06
|
| Rate for Payer: BCBS MAPPO |
$186.85
|
| Rate for Payer: BCN Commercial |
$309.24
|
| Rate for Payer: BCN Medicare Advantage |
$186.85
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cofinity Commercial |
$269.06
|
| Rate for Payer: Cofinity Commercial |
$250.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.85
|
| Rate for Payer: Healthscope Commercial |
$345.67
|
| Rate for Payer: Healthscope Commercial |
$298.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$205.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.30
|
| Rate for Payer: Nomi Health Commercial |
$224.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.75
|
| Rate for Payer: PACE SWMI |
$186.85
|
| Rate for Payer: PHP Medicare Advantage |
$186.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$186.85
|
| Rate for Payer: Priority Health SBD |
$336.87
|
| Rate for Payer: Priority Health Tiered Network |
$336.87
|
| Rate for Payer: Railroad Medicare Medicare |
$186.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.90
|
| Rate for Payer: UHC Core |
$355.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.85
|
| Rate for Payer: UHC Exchange |
$355.90
|
|
