|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$242.63 |
| Max. Negotiated Rate |
$3,228.76 |
| Rate for Payer: Aetna Commercial |
$676.60
|
| Rate for Payer: Aetna Medicare |
$1,092.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,312.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,312.52
|
| Rate for Payer: BCBS Complete |
$603.13
|
| Rate for Payer: BCBS MAPPO |
$1,050.02
|
| Rate for Payer: BCBS Trust/PPO |
$480.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,050.02
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$684.56
|
| Rate for Payer: Cofinity Commercial |
$557.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,050.02
|
| Rate for Payer: Healthscope Commercial |
$716.40
|
| Rate for Payer: Mclaren Medicaid |
$574.36
|
| Rate for Payer: Mclaren Medicare |
$1,050.02
|
| Rate for Payer: Meridian Medicaid |
$603.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,102.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,207.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$676.60
|
| Rate for Payer: PACE Medicare |
$997.52
|
| Rate for Payer: PACE SWMI |
$1,050.02
|
| Rate for Payer: PHP Commercial |
$676.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,050.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,228.76
|
| Rate for Payer: Priority Health Medicare |
$1,050.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,583.01
|
| Rate for Payer: Priority Health SBD |
$501.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,050.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,050.02
|
| Rate for Payer: UHC Exchange |
$242.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.52
|
| Rate for Payer: VA VA |
$1,050.02
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 45388
|
| Min. Negotiated Rate |
$169.76 |
| Max. Negotiated Rate |
$1,087.10 |
| Rate for Payer: Aetna Commercial |
$360.51
|
| Rate for Payer: BCBS Complete |
$178.25
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$467.43
|
| Rate for Payer: Priority Health Narrow Network |
$467.43
|
| Rate for Payer: Priority Health SBD |
$467.43
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
OP
|
$1,553.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$260.97 |
| Max. Negotiated Rate |
$3,228.76 |
| Rate for Payer: Aetna Commercial |
$1,320.05
|
| Rate for Payer: Aetna Medicare |
$1,092.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,312.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,312.52
|
| Rate for Payer: BCBS Complete |
$603.13
|
| Rate for Payer: BCBS MAPPO |
$1,050.02
|
| Rate for Payer: BCBS Trust/PPO |
$480.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,050.02
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,335.58
|
| Rate for Payer: Cofinity Commercial |
$1,087.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,050.02
|
| Rate for Payer: Healthscope Commercial |
$1,397.70
|
| Rate for Payer: Mclaren Medicaid |
$574.36
|
| Rate for Payer: Mclaren Medicare |
$1,050.02
|
| Rate for Payer: Meridian Medicaid |
$603.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,102.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,207.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,320.05
|
| Rate for Payer: PACE Medicare |
$997.52
|
| Rate for Payer: PACE SWMI |
$1,050.02
|
| Rate for Payer: PHP Commercial |
$1,320.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,050.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,228.76
|
| Rate for Payer: Priority Health Medicare |
$1,050.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,583.01
|
| Rate for Payer: Priority Health SBD |
$978.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,050.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,050.02
|
| Rate for Payer: UHC Exchange |
$260.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.52
|
| Rate for Payer: VA VA |
$1,050.02
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$169.76 |
| Max. Negotiated Rate |
$1,087.10 |
| Rate for Payer: Aetna Commercial |
$360.51
|
| Rate for Payer: BCBS Complete |
$178.25
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$467.43
|
| Rate for Payer: Priority Health Narrow Network |
$467.43
|
| Rate for Payer: Priority Health SBD |
$467.43
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
IP
|
$1,553.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$978.39 |
| Max. Negotiated Rate |
$1,397.70 |
| Rate for Payer: Aetna Commercial |
$1,320.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.45
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,087.10
|
| Rate for Payer: Cofinity Commercial |
$1,335.58
|
| Rate for Payer: Healthscope Commercial |
$1,397.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,320.05
|
| Rate for Payer: PHP Commercial |
$1,320.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health SBD |
$978.39
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
IP
|
$1,002.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$631.26 |
| Max. Negotiated Rate |
$901.80 |
| Rate for Payer: Aetna Commercial |
$851.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.30
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$701.40
|
| Rate for Payer: Cofinity Commercial |
$861.72
|
| Rate for Payer: Healthscope Commercial |
$901.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.70
|
| Rate for Payer: PHP Commercial |
$851.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health SBD |
$631.26
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,002.00
|
|
|
Service Code
|
HCPCS 45378
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$701.40 |
| Rate for Payer: Aetna Commercial |
$246.71
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS Trust/PPO |
$392.53
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Mclaren Medicaid |
$116.09
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: Priority Health SBD |
$318.68
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,002.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
45378
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$701.40 |
| Rate for Payer: Aetna Commercial |
$246.71
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS Trust/PPO |
$392.53
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Mclaren Medicaid |
$116.09
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: Priority Health SBD |
$318.68
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
OP
|
$1,002.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$178.46 |
| Max. Negotiated Rate |
$2,470.91 |
| Rate for Payer: Aetna Commercial |
$851.70
|
| Rate for Payer: Aetna Medicare |
$845.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.54
|
| Rate for Payer: BCBS Complete |
$467.12
|
| Rate for Payer: BCBS MAPPO |
$813.23
|
| Rate for Payer: BCBS Trust/PPO |
$617.33
|
| Rate for Payer: BCN Medicare Advantage |
$813.23
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$861.72
|
| Rate for Payer: Cofinity Commercial |
$701.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.23
|
| Rate for Payer: Healthscope Commercial |
$901.80
|
| Rate for Payer: Mclaren Medicaid |
$444.84
|
| Rate for Payer: Mclaren Medicare |
$813.23
|
| Rate for Payer: Meridian Medicaid |
$467.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$935.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.70
|
| Rate for Payer: PACE Medicare |
$772.57
|
| Rate for Payer: PACE SWMI |
$813.23
|
| Rate for Payer: PHP Commercial |
$851.70
|
| Rate for Payer: PHP Medicare Advantage |
$813.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,470.91
|
| Rate for Payer: Priority Health Medicare |
$813.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,976.73
|
| Rate for Payer: Priority Health SBD |
$631.26
|
| Rate for Payer: Railroad Medicare Medicare |
$813.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.23
|
| Rate for Payer: UHC Exchange |
$178.46
|
| Rate for Payer: UHC Medicare Advantage |
$837.63
|
| Rate for Payer: VA VA |
$813.23
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$1,002.00
|
|
|
Service Code
|
HCPCS 45390
|
| Min. Negotiated Rate |
$102.49 |
| Max. Negotiated Rate |
$701.40 |
| Rate for Payer: Aetna Commercial |
$441.91
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Mclaren Medicaid |
$208.53
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.68
|
| Rate for Payer: Priority Health Narrow Network |
$572.68
|
| Rate for Payer: Priority Health SBD |
$572.68
|
|
|
PR COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 45389
|
| Min. Negotiated Rate |
$181.69 |
| Max. Negotiated Rate |
$604.10 |
| Rate for Payer: Aetna Commercial |
$385.62
|
| Rate for Payer: BCBS Complete |
$190.77
|
| Rate for Payer: BCBS Trust/PPO |
$376.68
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Mclaren Medicaid |
$181.69
|
| Rate for Payer: Meridian Medicaid |
$190.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$500.36
|
| Rate for Payer: Priority Health Narrow Network |
$500.36
|
| Rate for Payer: Priority Health SBD |
$500.36
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Facility
|
OP
|
$1,169.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
45379
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$230.19 |
| Max. Negotiated Rate |
$3,228.76 |
| Rate for Payer: Aetna Commercial |
$993.65
|
| Rate for Payer: Aetna Medicare |
$1,092.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,312.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,312.52
|
| Rate for Payer: BCBS Complete |
$603.13
|
| Rate for Payer: BCBS MAPPO |
$1,050.02
|
| Rate for Payer: BCBS Trust/PPO |
$480.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,050.02
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cofinity Commercial |
$818.30
|
| Rate for Payer: Cofinity Commercial |
$1,005.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,050.02
|
| Rate for Payer: Healthscope Commercial |
$1,052.10
|
| Rate for Payer: Mclaren Medicaid |
$574.36
|
| Rate for Payer: Mclaren Medicare |
$1,050.02
|
| Rate for Payer: Meridian Medicaid |
$603.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,102.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,207.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$993.65
|
| Rate for Payer: PACE Medicare |
$997.52
|
| Rate for Payer: PACE SWMI |
$1,050.02
|
| Rate for Payer: PHP Commercial |
$993.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,050.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,228.76
|
| Rate for Payer: Priority Health Medicare |
$1,050.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,583.01
|
| Rate for Payer: Priority Health SBD |
$736.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,050.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,050.02
|
| Rate for Payer: UHC Exchange |
$230.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.52
|
| Rate for Payer: VA VA |
$1,050.02
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Facility
|
IP
|
$1,169.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
45379
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$736.47 |
| Max. Negotiated Rate |
$1,052.10 |
| Rate for Payer: Aetna Commercial |
$993.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.85
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cofinity Commercial |
$1,005.34
|
| Rate for Payer: Cofinity Commercial |
$818.30
|
| Rate for Payer: Healthscope Commercial |
$1,052.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$993.65
|
| Rate for Payer: PHP Commercial |
$993.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.30
|
| Rate for Payer: Priority Health SBD |
$736.47
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$1,169.00
|
|
|
Service Code
|
HCPCS 45379
|
| Min. Negotiated Rate |
$149.74 |
| Max. Negotiated Rate |
$818.30 |
| Rate for Payer: Aetna Commercial |
$317.33
|
| Rate for Payer: BCBS Complete |
$157.23
|
| Rate for Payer: BCBS Trust/PPO |
$260.98
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Mclaren Medicaid |
$149.74
|
| Rate for Payer: Meridian Medicaid |
$157.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.58
|
| Rate for Payer: Priority Health Narrow Network |
$411.58
|
| Rate for Payer: Priority Health SBD |
$411.58
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$1,169.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
45379
|
| Min. Negotiated Rate |
$149.74 |
| Max. Negotiated Rate |
$818.30 |
| Rate for Payer: Aetna Commercial |
$317.33
|
| Rate for Payer: BCBS Complete |
$157.23
|
| Rate for Payer: BCBS Trust/PPO |
$260.98
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Mclaren Medicaid |
$149.74
|
| Rate for Payer: Meridian Medicaid |
$157.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.58
|
| Rate for Payer: Priority Health Narrow Network |
$411.58
|
| Rate for Payer: Priority Health SBD |
$411.58
|
|
|
PR COLONOSCOPY STOMA ABLATION LESION
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 44401
|
| Min. Negotiated Rate |
$152.08 |
| Max. Negotiated Rate |
$3,324.06 |
| Rate for Payer: Aetna Commercial |
$321.78
|
| Rate for Payer: BCBS Complete |
$159.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,324.06
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Mclaren Medicaid |
$152.08
|
| Rate for Payer: Meridian Medicaid |
$159.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$835.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.05
|
| Rate for Payer: Priority Health Narrow Network |
$418.05
|
| Rate for Payer: Priority Health SBD |
$418.05
|
|
|
PR COLONOSCOPY STOMA CONTROL BLEEDING
|
Professional
|
Both
|
$1,573.00
|
|
|
Service Code
|
HCPCS 44391
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$3,239.54 |
| Rate for Payer: Aetna Commercial |
$306.27
|
| Rate for Payer: BCBS Complete |
$152.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,239.54
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Cash Price |
$1,258.40
|
| Rate for Payer: Mclaren Medicaid |
$144.84
|
| Rate for Payer: Meridian Medicaid |
$152.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$398.06
|
| Rate for Payer: Priority Health Narrow Network |
$398.06
|
| Rate for Payer: Priority Health SBD |
$398.06
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
44388
|
| Min. Negotiated Rate |
$623.07 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Aetna Commercial |
$840.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.85
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cofinity Commercial |
$850.54
|
| Rate for Payer: Cofinity Commercial |
$692.30
|
| Rate for Payer: Healthscope Commercial |
$890.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$840.65
|
| Rate for Payer: PHP Commercial |
$840.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.30
|
| Rate for Payer: Priority Health SBD |
$623.07
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$989.00
|
|
|
Service Code
|
HCPCS 44388
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$4,017.19 |
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,017.19
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Mclaren Medicaid |
$98.41
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.47
|
| Rate for Payer: Priority Health Narrow Network |
$270.47
|
| Rate for Payer: Priority Health SBD |
$270.47
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
44388
|
| Min. Negotiated Rate |
$151.28 |
| Max. Negotiated Rate |
$2,491.90 |
| Rate for Payer: Aetna Commercial |
$840.65
|
| Rate for Payer: Aetna Medicare |
$845.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.54
|
| Rate for Payer: BCBS Complete |
$467.12
|
| Rate for Payer: BCBS MAPPO |
$813.23
|
| Rate for Payer: BCBS Trust/PPO |
$633.66
|
| Rate for Payer: BCN Medicare Advantage |
$813.23
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cofinity Commercial |
$850.54
|
| Rate for Payer: Cofinity Commercial |
$692.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.23
|
| Rate for Payer: Healthscope Commercial |
$890.10
|
| Rate for Payer: Mclaren Medicaid |
$444.84
|
| Rate for Payer: Mclaren Medicare |
$813.23
|
| Rate for Payer: Meridian Medicaid |
$467.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$935.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$840.65
|
| Rate for Payer: PACE Medicare |
$772.57
|
| Rate for Payer: PACE SWMI |
$813.23
|
| Rate for Payer: PHP Commercial |
$840.65
|
| Rate for Payer: PHP Medicare Advantage |
$813.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,491.90
|
| Rate for Payer: Priority Health Medicare |
$813.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,993.52
|
| Rate for Payer: Priority Health SBD |
$623.07
|
| Rate for Payer: Railroad Medicare Medicare |
$813.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.23
|
| Rate for Payer: UHC Exchange |
$151.28
|
| Rate for Payer: UHC Medicare Advantage |
$837.63
|
| Rate for Payer: VA VA |
$813.23
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$989.00
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
44388
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$4,017.19 |
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,017.19
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Mclaren Medicaid |
$98.41
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.47
|
| Rate for Payer: Priority Health Narrow Network |
$270.47
|
| Rate for Payer: Priority Health SBD |
$270.47
|
|
|
PR COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 44392
|
| Min. Negotiated Rate |
$125.88 |
| Max. Negotiated Rate |
$3,079.46 |
| Rate for Payer: Aetna Commercial |
$264.41
|
| Rate for Payer: BCBS Complete |
$132.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.46
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Mclaren Medicaid |
$125.88
|
| Rate for Payer: Meridian Medicaid |
$132.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$345.14
|
| Rate for Payer: Priority Health Narrow Network |
$345.14
|
| Rate for Payer: Priority Health SBD |
$345.14
|
|
|
PR COLONOSCOPY STOMA W/BALLOON DILATION
|
Professional
|
Both
|
$1,030.00
|
|
|
Service Code
|
HCPCS 44405
|
| Min. Negotiated Rate |
$115.23 |
| Max. Negotiated Rate |
$4,654.32 |
| Rate for Payer: Aetna Commercial |
$242.93
|
| Rate for Payer: BCBS Complete |
$120.99
|
| Rate for Payer: BCBS Trust/PPO |
$4,654.32
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Cash Price |
$824.00
|
| Rate for Payer: Mclaren Medicaid |
$115.23
|
| Rate for Payer: Meridian Medicaid |
$120.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.73
|
| Rate for Payer: Priority Health Narrow Network |
$315.73
|
| Rate for Payer: Priority Health SBD |
$315.73
|
|
|
PR COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
44389
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$3,449.27 |
| Rate for Payer: Aetna Commercial |
$228.87
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,449.27
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Mclaren Medicaid |
$107.99
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$296.93
|
| Rate for Payer: Priority Health Narrow Network |
$296.93
|
| Rate for Payer: Priority Health SBD |
$296.93
|
|
|
PR COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$1,147.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
44389
|
| Min. Negotiated Rate |
$722.61 |
| Max. Negotiated Rate |
$1,032.30 |
| Rate for Payer: Aetna Commercial |
$974.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.55
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$802.90
|
| Rate for Payer: Cofinity Commercial |
$986.42
|
| Rate for Payer: Healthscope Commercial |
$1,032.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$974.95
|
| Rate for Payer: PHP Commercial |
$974.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health SBD |
$722.61
|
|
