|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$156.87 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$174.30
|
| Rate for Payer: Cofinity Commercial |
$214.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$224.10
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$211.65
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$156.87
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$500.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$161.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.24
|
| Rate for Payer: BCBS Complete |
$99.60
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Healthscope Commercial |
$99.73
|
| Rate for Payer: Healthscope Commercial |
$86.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.85
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$161.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.63
|
| Rate for Payer: BCBS Complete |
$99.60
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Healthscope Commercial |
$86.26
|
| Rate for Payer: Healthscope Commercial |
$99.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.85
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$156.87 |
| Max. Negotiated Rate |
$224.10 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.85
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$174.30
|
| Rate for Payer: Cofinity Commercial |
$214.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Healthscope Commercial |
$224.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: PHP Commercial |
$211.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health SBD |
$156.87
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$116.66 |
| Max. Negotiated Rate |
$215.82 |
| Rate for Payer: Aetna Commercial |
$156.32
|
| Rate for Payer: Aetna Medicare |
$121.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.32
|
| Rate for Payer: BCBS Complete |
$118.80
|
| Rate for Payer: BCBS MAPPO |
$116.66
|
| Rate for Payer: BCN Medicare Advantage |
$116.66
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Cofinity Commercial |
$156.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.66
|
| Rate for Payer: Healthscope Commercial |
$186.66
|
| Rate for Payer: Healthscope Commercial |
$215.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.05
|
| Rate for Payer: Nomi Health Commercial |
$139.99
|
| Rate for Payer: PACE SWMI |
$116.66
|
| Rate for Payer: PHP Medicare Advantage |
$116.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.05
|
| Rate for Payer: Priority Health Medicare |
$116.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.66
|
| Rate for Payer: UHC Medicare Advantage |
$116.66
|
|
|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$145.00 |
| Max. Negotiated Rate |
$268.25 |
| Rate for Payer: Aetna Commercial |
$194.30
|
| Rate for Payer: Aetna Medicare |
$150.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.30
|
| Rate for Payer: BCBS Complete |
$148.40
|
| Rate for Payer: BCBS MAPPO |
$145.00
|
| Rate for Payer: BCN Medicare Advantage |
$145.00
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$194.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.00
|
| Rate for Payer: Healthscope Commercial |
$268.25
|
| Rate for Payer: Healthscope Commercial |
$232.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.15
|
| Rate for Payer: Nomi Health Commercial |
$174.00
|
| Rate for Payer: PACE SWMI |
$145.00
|
| Rate for Payer: PHP Medicare Advantage |
$145.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health Medicare |
$145.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.00
|
| Rate for Payer: UHC Medicare Advantage |
$145.00
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45340
|
| Min. Negotiated Rate |
$73.32 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: Aetna Medicare |
$76.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.58
|
| Rate for Payer: BCBS Complete |
$128.80
|
| Rate for Payer: BCBS MAPPO |
$73.32
|
| Rate for Payer: BCN Medicare Advantage |
$73.32
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.32
|
| Rate for Payer: Healthscope Commercial |
$117.31
|
| Rate for Payer: Healthscope Commercial |
$135.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.30
|
| Rate for Payer: Nomi Health Commercial |
$87.98
|
| Rate for Payer: PACE SWMI |
$73.32
|
| Rate for Payer: PHP Medicare Advantage |
$73.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Medicare |
$73.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.32
|
| Rate for Payer: UHC Medicare Advantage |
$73.32
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX
|
Professional
|
Both
|
$807.00
|
|
|
Service Code
|
HCPCS 45342
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$524.55 |
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna Medicare |
$166.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.94
|
| Rate for Payer: BCBS Complete |
$322.80
|
| Rate for Payer: BCBS MAPPO |
$160.40
|
| Rate for Payer: BCN Medicare Advantage |
$160.40
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cofinity Commercial |
$230.98
|
| Rate for Payer: Cofinity Commercial |
$214.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.40
|
| Rate for Payer: Healthscope Commercial |
$296.74
|
| Rate for Payer: Healthscope Commercial |
$256.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$524.55
|
| Rate for Payer: Nomi Health Commercial |
$192.48
|
| Rate for Payer: PACE SWMI |
$160.40
|
| Rate for Payer: PHP Medicare Advantage |
$160.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.55
|
| Rate for Payer: Priority Health Medicare |
$160.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.40
|
| Rate for Payer: UHC Medicare Advantage |
$160.40
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$216.09 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$240.10
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$216.09
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$500.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$216.09 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.95
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$240.10
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health SBD |
$216.09
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$222.95 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$71.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.76
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$109.73
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.95
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$222.95 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$71.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.90
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$109.73
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.95
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$95.10 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$127.43
|
| Rate for Payer: Aetna Medicare |
$98.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.43
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$95.10
|
| Rate for Payer: BCN Medicare Advantage |
$95.10
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.10
|
| Rate for Payer: Healthscope Commercial |
$175.94
|
| Rate for Payer: Healthscope Commercial |
$152.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.60
|
| Rate for Payer: Nomi Health Commercial |
$114.12
|
| Rate for Payer: PACE SWMI |
$95.10
|
| Rate for Payer: PHP Medicare Advantage |
$95.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$95.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.10
|
| Rate for Payer: UHC Medicare Advantage |
$95.10
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$99.25 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.92
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Healthscope Commercial |
$158.80
|
| Rate for Payer: Healthscope Commercial |
$183.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.00
|
| Rate for Payer: Nomi Health Commercial |
$119.10
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$99.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health SBD |
$327.60
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$364.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$327.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,236.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$647.41
|
| Rate for Payer: VA VA |
$1,149.93
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 45332
|
| Min. Negotiated Rate |
$99.25 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.00
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Healthscope Commercial |
$158.80
|
| Rate for Payer: Healthscope Commercial |
$183.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.00
|
| Rate for Payer: Nomi Health Commercial |
$119.10
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$99.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$473.13 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$525.70
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$473.13
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$500.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$89.22 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$119.55
|
| Rate for Payer: Aetna Medicare |
$92.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.48
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$89.22
|
| Rate for Payer: BCN Medicare Advantage |
$89.22
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$128.48
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.22
|
| Rate for Payer: Healthscope Commercial |
$142.75
|
| Rate for Payer: Healthscope Commercial |
$165.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.15
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE SWMI |
$89.22
|
| Rate for Payer: PHP Medicare Advantage |
$89.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$89.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.22
|
| Rate for Payer: UHC Medicare Advantage |
$89.22
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$473.13 |
| Max. Negotiated Rate |
$675.90 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$525.70
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health SBD |
$473.13
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45333
|
| Min. Negotiated Rate |
$89.22 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$119.55
|
| Rate for Payer: Aetna Medicare |
$92.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.55
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$89.22
|
| Rate for Payer: BCN Medicare Advantage |
$89.22
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$128.48
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.22
|
| Rate for Payer: Healthscope Commercial |
$142.75
|
| Rate for Payer: Healthscope Commercial |
$165.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$488.15
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE SWMI |
$89.22
|
| Rate for Payer: PHP Medicare Advantage |
$89.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$89.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.22
|
| Rate for Payer: UHC Medicare Advantage |
$89.22
|
|
|
PR SIGMOIDOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 45345
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
|
|
PR SIGMOIDOSCOPY W/STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS G6023
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
|
|
PR SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 93278
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$53.43 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$30.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$53.43
|
| Rate for Payer: Healthscope Commercial |
$46.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.00
|
| Rate for Payer: Nomi Health Commercial |
$34.66
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$28.88
|
|
|
PR SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 51725
|
| Min. Negotiated Rate |
$188.87 |
| Max. Negotiated Rate |
$349.41 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.09
|
| Rate for Payer: BCBS Complete |
$214.80
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Healthscope Commercial |
$302.19
|
| Rate for Payer: Healthscope Commercial |
$349.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.05
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health Medicare |
$188.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
|
