|
PR COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R
|
Professional
|
Both
|
$460.00
|
|
|
Service Code
|
HCPCS 91117
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$299.00 |
| Rate for Payer: Aetna Commercial |
$170.39
|
| Rate for Payer: Aetna Medicare |
$132.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.39
|
| Rate for Payer: BCBS Complete |
$184.00
|
| Rate for Payer: BCBS MAPPO |
$127.16
|
| Rate for Payer: BCN Medicare Advantage |
$127.16
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cash Price |
$368.00
|
| Rate for Payer: Cofinity Commercial |
$183.11
|
| Rate for Payer: Cofinity Commercial |
$170.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.16
|
| Rate for Payer: Healthscope Commercial |
$203.46
|
| Rate for Payer: Healthscope Commercial |
$235.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.00
|
| Rate for Payer: Nomi Health Commercial |
$152.59
|
| Rate for Payer: PACE SWMI |
$127.16
|
| Rate for Payer: PHP Medicare Advantage |
$127.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.00
|
| Rate for Payer: Priority Health Medicare |
$127.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.16
|
| Rate for Payer: UHC Medicare Advantage |
$127.16
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Facility
|
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 45383
|
| Hospital Charge Code |
45383
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Aetna Commercial |
$1,286.05
|
| Rate for Payer: Aetna Medicare |
$756.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$983.45
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,059.10
|
| Rate for Payer: Cofinity Commercial |
$1,301.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Healthscope Commercial |
$1,361.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.05
|
| Rate for Payer: PHP Commercial |
$1,286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health SBD |
$953.19
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 45383
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$983.45 |
| Rate for Payer: Aetna Medicare |
$756.50
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Professional
|
Both
|
$1,513.00
|
|
|
Service Code
|
HCPCS 45383
|
| Hospital Charge Code |
45383
|
| Min. Negotiated Rate |
$605.20 |
| Max. Negotiated Rate |
$983.45 |
| Rate for Payer: Aetna Medicare |
$756.50
|
| Rate for Payer: BCBS Complete |
$605.20
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Facility
|
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 45383
|
| Hospital Charge Code |
45383
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$953.19 |
| Max. Negotiated Rate |
$1,361.70 |
| Rate for Payer: Aetna Commercial |
$1,286.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$983.45
|
| Rate for Payer: Cash Price |
$1,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,059.10
|
| Rate for Payer: Cofinity Commercial |
$1,301.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,059.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,210.40
|
| Rate for Payer: Healthscope Commercial |
$1,361.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.05
|
| Rate for Payer: PHP Commercial |
$1,286.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.45
|
| Rate for Payer: Priority Health SBD |
$953.19
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
OP
|
$1,313.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$616.36 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna Commercial |
$1,116.05
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.45
|
| 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 |
$1,050.40
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cofinity Commercial |
$1,129.18
|
| Rate for Payer: Cofinity Commercial |
$919.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$919.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$1,181.70
|
| 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 |
$1,116.05
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$1,116.05
|
| 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 |
$853.45
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$827.19
|
| 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 COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Professional
|
Both
|
$1,313.00
|
|
|
Service Code
|
HCPCS 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$222.82 |
| Max. Negotiated Rate |
$853.45 |
| Rate for Payer: Aetna Commercial |
$298.58
|
| Rate for Payer: Aetna Medicare |
$231.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.86
|
| Rate for Payer: BCBS Complete |
$525.20
|
| Rate for Payer: BCBS MAPPO |
$222.82
|
| Rate for Payer: BCN Medicare Advantage |
$222.82
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cofinity Commercial |
$320.86
|
| Rate for Payer: Cofinity Commercial |
$298.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.82
|
| Rate for Payer: Healthscope Commercial |
$356.51
|
| Rate for Payer: Healthscope Commercial |
$412.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.45
|
| Rate for Payer: Nomi Health Commercial |
$267.38
|
| Rate for Payer: PACE SWMI |
$222.82
|
| Rate for Payer: PHP Medicare Advantage |
$222.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.45
|
| Rate for Payer: Priority Health Medicare |
$222.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.82
|
| Rate for Payer: UHC Medicare Advantage |
$222.82
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
IP
|
$1,313.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$827.19 |
| Max. Negotiated Rate |
$1,181.70 |
| Rate for Payer: Aetna Commercial |
$1,116.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.45
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cofinity Commercial |
$1,129.18
|
| Rate for Payer: Cofinity Commercial |
$919.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$919.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.40
|
| Rate for Payer: Healthscope Commercial |
$1,181.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,116.05
|
| Rate for Payer: PHP Commercial |
$1,116.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.45
|
| Rate for Payer: Priority Health SBD |
$827.19
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Professional
|
Both
|
$1,313.00
|
|
|
Service Code
|
HCPCS 45398
|
| Min. Negotiated Rate |
$222.82 |
| Max. Negotiated Rate |
$853.45 |
| Rate for Payer: Aetna Commercial |
$298.58
|
| Rate for Payer: Aetna Medicare |
$231.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.86
|
| Rate for Payer: BCBS Complete |
$525.20
|
| Rate for Payer: BCBS MAPPO |
$222.82
|
| Rate for Payer: BCN Medicare Advantage |
$222.82
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cofinity Commercial |
$298.58
|
| Rate for Payer: Cofinity Commercial |
$320.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.82
|
| Rate for Payer: Healthscope Commercial |
$356.51
|
| Rate for Payer: Healthscope Commercial |
$412.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.45
|
| Rate for Payer: Nomi Health Commercial |
$267.38
|
| Rate for Payer: PACE SWMI |
$222.82
|
| Rate for Payer: PHP Medicare Advantage |
$222.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.45
|
| Rate for Payer: Priority Health Medicare |
$222.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.82
|
| Rate for Payer: UHC Medicare Advantage |
$222.82
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
OP
|
$812.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$511.56 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna Commercial |
$690.20
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.80
|
| 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 |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cofinity Commercial |
$568.40
|
| Rate for Payer: Cofinity Commercial |
$698.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$568.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$730.80
|
| 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 |
$690.20
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$690.20
|
| 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 |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$511.56
|
| 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 COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$812.00
|
|
|
Service Code
|
HCPCS 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$237.21 |
| Max. Negotiated Rate |
$527.80 |
| Rate for Payer: Aetna Commercial |
$317.86
|
| Rate for Payer: Aetna Medicare |
$246.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.58
|
| Rate for Payer: BCBS Complete |
$324.80
|
| Rate for Payer: BCBS MAPPO |
$237.21
|
| Rate for Payer: BCN Medicare Advantage |
$237.21
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cofinity Commercial |
$341.58
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.21
|
| Rate for Payer: Healthscope Commercial |
$379.54
|
| Rate for Payer: Healthscope Commercial |
$438.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$527.80
|
| Rate for Payer: Nomi Health Commercial |
$284.65
|
| Rate for Payer: PACE SWMI |
$237.21
|
| Rate for Payer: PHP Medicare Advantage |
$237.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$237.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.21
|
| Rate for Payer: UHC Medicare Advantage |
$237.21
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
IP
|
$812.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$511.56 |
| Max. Negotiated Rate |
$730.80 |
| Rate for Payer: Aetna Commercial |
$690.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.80
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cofinity Commercial |
$568.40
|
| Rate for Payer: Cofinity Commercial |
$698.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$568.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.60
|
| Rate for Payer: Healthscope Commercial |
$730.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.20
|
| Rate for Payer: PHP Commercial |
$690.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health SBD |
$511.56
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$812.00
|
|
|
Service Code
|
HCPCS 45393
|
| Min. Negotiated Rate |
$237.21 |
| Max. Negotiated Rate |
$527.80 |
| Rate for Payer: Aetna Commercial |
$317.86
|
| Rate for Payer: Aetna Medicare |
$246.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.86
|
| Rate for Payer: BCBS Complete |
$324.80
|
| Rate for Payer: BCBS MAPPO |
$237.21
|
| Rate for Payer: BCN Medicare Advantage |
$237.21
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cofinity Commercial |
$341.58
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.21
|
| Rate for Payer: Healthscope Commercial |
$438.84
|
| Rate for Payer: Healthscope Commercial |
$379.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$527.80
|
| Rate for Payer: Nomi Health Commercial |
$284.65
|
| Rate for Payer: PACE SWMI |
$237.21
|
| Rate for Payer: PHP Medicare Advantage |
$237.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health Medicare |
$237.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.21
|
| Rate for Payer: UHC Medicare Advantage |
$237.21
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$254.83 |
| Max. Negotiated Rate |
$1,029.60 |
| Rate for Payer: Aetna Commercial |
$341.47
|
| Rate for Payer: Aetna Medicare |
$265.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.96
|
| Rate for Payer: BCBS Complete |
$633.60
|
| Rate for Payer: BCBS MAPPO |
$254.83
|
| Rate for Payer: BCN Medicare Advantage |
$254.83
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$366.96
|
| Rate for Payer: Cofinity Commercial |
$341.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.83
|
| Rate for Payer: Healthscope Commercial |
$407.73
|
| Rate for Payer: Healthscope Commercial |
$471.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.60
|
| Rate for Payer: Nomi Health Commercial |
$305.80
|
| Rate for Payer: PACE SWMI |
$254.83
|
| Rate for Payer: PHP Medicare Advantage |
$254.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: Priority Health Medicare |
$254.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.83
|
| Rate for Payer: UHC Medicare Advantage |
$254.83
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 45388
|
| Min. Negotiated Rate |
$254.83 |
| Max. Negotiated Rate |
$1,029.60 |
| Rate for Payer: Aetna Commercial |
$341.47
|
| Rate for Payer: Aetna Medicare |
$265.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.47
|
| Rate for Payer: BCBS Complete |
$633.60
|
| Rate for Payer: BCBS MAPPO |
$254.83
|
| Rate for Payer: BCN Medicare Advantage |
$254.83
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$366.96
|
| Rate for Payer: Cofinity Commercial |
$341.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.83
|
| Rate for Payer: Healthscope Commercial |
$407.73
|
| Rate for Payer: Healthscope Commercial |
$471.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.60
|
| Rate for Payer: Nomi Health Commercial |
$305.80
|
| Rate for Payer: PACE SWMI |
$254.83
|
| Rate for Payer: PHP Medicare Advantage |
$254.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: Priority Health Medicare |
$254.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.83
|
| Rate for Payer: UHC Medicare Advantage |
$254.83
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
IP
|
$1,584.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$997.92 |
| Max. Negotiated Rate |
$1,425.60 |
| Rate for Payer: Aetna Commercial |
$1,346.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,362.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,108.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,267.20
|
| Rate for Payer: Healthscope Commercial |
$1,425.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,346.40
|
| Rate for Payer: PHP Commercial |
$1,346.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: Priority Health SBD |
$997.92
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
OP
|
$1,584.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$616.36 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna Commercial |
$1,346.40
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.60
|
| 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 |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$1,362.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,108.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,267.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$1,425.60
|
| 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 |
$1,346.40
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$1,346.40
|
| 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 |
$1,029.60
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$997.92
|
| 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 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$476.60 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| 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 |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| 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 |
$868.70
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$868.70
|
| 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 |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$643.86
|
| 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 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
45378
|
| Min. Negotiated Rate |
$174.51 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$181.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.84
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCN Medicare Advantage |
$174.51
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$251.29
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.51
|
| Rate for Payer: Healthscope Commercial |
$279.22
|
| Rate for Payer: Healthscope Commercial |
$322.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$664.30
|
| Rate for Payer: Nomi Health Commercial |
$209.41
|
| Rate for Payer: PACE SWMI |
$174.51
|
| Rate for Payer: PHP Medicare Advantage |
$174.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$643.86 |
| Max. Negotiated Rate |
$919.80 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health SBD |
$643.86
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45378
|
| Min. Negotiated Rate |
$174.51 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$181.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.84
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCN Medicare Advantage |
$174.51
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$251.29
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.51
|
| Rate for Payer: Healthscope Commercial |
$322.84
|
| Rate for Payer: Healthscope Commercial |
$279.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$664.30
|
| Rate for Payer: Nomi Health Commercial |
$209.41
|
| Rate for Payer: PACE SWMI |
$174.51
|
| Rate for Payer: PHP Medicare Advantage |
$174.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
45390
|
| Min. Negotiated Rate |
$643.86 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$643.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
45390
|
| Min. Negotiated Rate |
$643.86 |
| Max. Negotiated Rate |
$919.80 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health SBD |
$643.86
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45390
|
| Min. Negotiated Rate |
$312.19 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$418.33
|
| Rate for Payer: Aetna Medicare |
$324.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.33
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$312.19
|
| Rate for Payer: BCN Medicare Advantage |
$312.19
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$449.55
|
| Rate for Payer: Cofinity Commercial |
$418.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.19
|
| Rate for Payer: Healthscope Commercial |
$499.50
|
| Rate for Payer: Healthscope Commercial |
$577.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$664.30
|
| Rate for Payer: Nomi Health Commercial |
$374.63
|
| Rate for Payer: PACE SWMI |
$312.19
|
| Rate for Payer: PHP Medicare Advantage |
$312.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$312.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.19
|
| Rate for Payer: UHC Medicare Advantage |
$312.19
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
45390
|
| Min. Negotiated Rate |
$312.19 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$418.33
|
| Rate for Payer: Aetna Medicare |
$324.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$418.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.55
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$312.19
|
| Rate for Payer: BCN Medicare Advantage |
$312.19
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$449.55
|
| Rate for Payer: Cofinity Commercial |
$418.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.19
|
| Rate for Payer: Healthscope Commercial |
$499.50
|
| Rate for Payer: Healthscope Commercial |
$577.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$664.30
|
| Rate for Payer: Nomi Health Commercial |
$374.63
|
| Rate for Payer: PACE SWMI |
$312.19
|
| Rate for Payer: PHP Medicare Advantage |
$312.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$312.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.19
|
| Rate for Payer: UHC Medicare Advantage |
$312.19
|
|
