|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
OP
|
$1,406.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$209.48 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Commercial |
$1,195.10
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$494.36
|
| Rate for Payer: BCN Commercial |
$494.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$984.20
|
| Rate for Payer: Cofinity Commercial |
$1,209.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$984.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,265.40
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.10
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,195.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$885.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.48
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$650.40
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 45381
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$35,039.00 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Cofinity Commercial |
$254.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.86
|
| Rate for Payer: Healthscope Commercial |
$351.24
|
| Rate for Payer: Healthscope Commercial |
$303.78
|
| Rate for Payer: Mclaren Medicaid |
$126.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.35
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,039.00
|
| Rate for Payer: Nomi Health Commercial |
$227.83
|
| Rate for Payer: PACE SWMI |
$189.86
|
| Rate for Payer: PHP Medicare Advantage |
$189.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.59
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: Priority Health Narrow Network |
$352.59
|
| Rate for Payer: Priority Health SBD |
$352.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Exchange |
$497.88
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 45391
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$45,072.00 |
| Rate for Payer: Aetna Commercial |
$324.52
|
| Rate for Payer: Aetna Medicare |
$251.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.74
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCBS MAPPO |
$242.18
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$242.18
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cofinity Commercial |
$348.74
|
| Rate for Payer: Cofinity Commercial |
$324.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.18
|
| Rate for Payer: Healthscope Commercial |
$448.03
|
| Rate for Payer: Healthscope Commercial |
$387.49
|
| Rate for Payer: Mclaren Medicaid |
$162.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.29
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,072.00
|
| Rate for Payer: Nomi Health Commercial |
$290.62
|
| Rate for Payer: PACE SWMI |
$242.18
|
| Rate for Payer: PHP Medicare Advantage |
$242.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.81
|
| Rate for Payer: Priority Health Medicare |
$242.18
|
| Rate for Payer: Priority Health Narrow Network |
$452.81
|
| Rate for Payer: Priority Health SBD |
$452.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.18
|
| Rate for Payer: UHC Exchange |
$343.70
|
| Rate for Payer: UHC Medicare Advantage |
$242.18
|
| Rate for Payer: UHCCP Medicaid |
$162.09
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45384
|
| Hospital Charge Code |
45384
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$39,978.00 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare |
$225.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.18
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$216.55
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$717.86
|
| Rate for Payer: BCN Medicare Advantage |
$216.55
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$311.83
|
| Rate for Payer: Cofinity Commercial |
$290.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.55
|
| Rate for Payer: Healthscope Commercial |
$346.48
|
| Rate for Payer: Healthscope Commercial |
$400.62
|
| Rate for Payer: Mclaren Medicaid |
$144.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.38
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,978.00
|
| Rate for Payer: Nomi Health Commercial |
$259.86
|
| Rate for Payer: PACE SWMI |
$216.55
|
| Rate for Payer: PHP Medicare Advantage |
$216.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.11
|
| Rate for Payer: Priority Health Medicare |
$216.55
|
| Rate for Payer: Priority Health Narrow Network |
$402.11
|
| Rate for Payer: Priority Health SBD |
$402.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.55
|
| Rate for Payer: UHC Exchange |
$599.04
|
| Rate for Payer: UHC Medicare Advantage |
$216.55
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Facility
|
OP
|
$1,448.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
45384
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$240.05 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$494.36
|
| Rate for Payer: BCN Commercial |
$494.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Cofinity Commercial |
$1,013.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$912.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.05
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$650.40
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Facility
|
IP
|
$1,448.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
45384
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$912.24 |
| Max. Negotiated Rate |
$1,303.20 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.20
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health SBD |
$912.24
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45384
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$39,978.00 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare |
$225.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.83
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$216.55
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$717.86
|
| Rate for Payer: BCN Medicare Advantage |
$216.55
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$311.83
|
| Rate for Payer: Cofinity Commercial |
$290.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.55
|
| Rate for Payer: Healthscope Commercial |
$400.62
|
| Rate for Payer: Healthscope Commercial |
$346.48
|
| Rate for Payer: Mclaren Medicaid |
$144.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.38
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,978.00
|
| Rate for Payer: Nomi Health Commercial |
$259.86
|
| Rate for Payer: PACE SWMI |
$216.55
|
| Rate for Payer: PHP Medicare Advantage |
$216.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.11
|
| Rate for Payer: Priority Health Medicare |
$216.55
|
| Rate for Payer: Priority Health Narrow Network |
$402.11
|
| Rate for Payer: Priority Health SBD |
$402.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.55
|
| Rate for Payer: UHC Exchange |
$599.04
|
| Rate for Payer: UHC Medicare Advantage |
$216.55
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45385
|
| Min. Negotiated Rate |
$103.02 |
| Max. Negotiated Rate |
$44,433.00 |
| Rate for Payer: Aetna Commercial |
$320.53
|
| Rate for Payer: Aetna Medicare |
$248.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.45
|
| Rate for Payer: BCBS Complete |
$167.96
|
| Rate for Payer: BCBS MAPPO |
$239.20
|
| Rate for Payer: BCBS Trust/PPO |
$103.02
|
| Rate for Payer: BCN Commercial |
$665.09
|
| Rate for Payer: BCN Medicare Advantage |
$239.20
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$344.45
|
| Rate for Payer: Cofinity Commercial |
$320.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.20
|
| Rate for Payer: Healthscope Commercial |
$442.52
|
| Rate for Payer: Healthscope Commercial |
$382.72
|
| Rate for Payer: Mclaren Medicaid |
$159.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.16
|
| Rate for Payer: Meridian Medicaid |
$167.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,433.00
|
| Rate for Payer: Nomi Health Commercial |
$287.04
|
| Rate for Payer: PACE SWMI |
$239.20
|
| Rate for Payer: PHP Medicare Advantage |
$239.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.84
|
| Rate for Payer: Priority Health Medicare |
$239.20
|
| Rate for Payer: Priority Health Narrow Network |
$446.84
|
| Rate for Payer: Priority Health SBD |
$446.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.20
|
| Rate for Payer: UHC Exchange |
$609.21
|
| Rate for Payer: UHC Medicare Advantage |
$239.20
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
45385
|
| Min. Negotiated Rate |
$103.02 |
| Max. Negotiated Rate |
$44,433.00 |
| Rate for Payer: Aetna Commercial |
$320.53
|
| Rate for Payer: Aetna Medicare |
$248.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.45
|
| Rate for Payer: BCBS Complete |
$167.96
|
| Rate for Payer: BCBS MAPPO |
$239.20
|
| Rate for Payer: BCBS Trust/PPO |
$103.02
|
| Rate for Payer: BCN Commercial |
$665.09
|
| Rate for Payer: BCN Medicare Advantage |
$239.20
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$344.45
|
| Rate for Payer: Cofinity Commercial |
$320.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.20
|
| Rate for Payer: Healthscope Commercial |
$442.52
|
| Rate for Payer: Healthscope Commercial |
$382.72
|
| Rate for Payer: Mclaren Medicaid |
$159.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.16
|
| Rate for Payer: Meridian Medicaid |
$167.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,433.00
|
| Rate for Payer: Nomi Health Commercial |
$287.04
|
| Rate for Payer: PACE SWMI |
$239.20
|
| Rate for Payer: PHP Medicare Advantage |
$239.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.84
|
| Rate for Payer: Priority Health Medicare |
$239.20
|
| Rate for Payer: Priority Health Narrow Network |
$446.84
|
| Rate for Payer: Priority Health SBD |
$446.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.20
|
| Rate for Payer: UHC Exchange |
$609.21
|
| Rate for Payer: UHC Medicare Advantage |
$239.20
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Facility
|
IP
|
$1,448.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
45385
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$912.24 |
| Max. Negotiated Rate |
$1,303.20 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.20
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health SBD |
$912.24
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Facility
|
OP
|
$1,448.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
45385
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$265.70 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$494.36
|
| Rate for Payer: BCN Commercial |
$494.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Cofinity Commercial |
$1,013.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$912.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.70
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$650.40
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL
|
Professional
|
Both
|
$995.00
|
|
|
Service Code
|
HCPCS 45392
|
| Min. Negotiated Rate |
$191.06 |
| Max. Negotiated Rate |
$53,206.00 |
| Rate for Payer: Aetna Commercial |
$382.68
|
| Rate for Payer: Aetna Medicare |
$297.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.24
|
| Rate for Payer: BCBS Complete |
$200.61
|
| Rate for Payer: BCBS MAPPO |
$285.58
|
| Rate for Payer: BCBS Trust/PPO |
$308.53
|
| Rate for Payer: BCN Commercial |
$435.90
|
| Rate for Payer: BCN Medicare Advantage |
$285.58
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cash Price |
$796.00
|
| Rate for Payer: Cofinity Commercial |
$411.24
|
| Rate for Payer: Cofinity Commercial |
$382.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.58
|
| Rate for Payer: Healthscope Commercial |
$528.32
|
| Rate for Payer: Healthscope Commercial |
$456.93
|
| Rate for Payer: Mclaren Medicaid |
$191.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.86
|
| Rate for Payer: Meridian Medicaid |
$200.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,206.00
|
| Rate for Payer: Nomi Health Commercial |
$342.70
|
| Rate for Payer: PACE SWMI |
$285.58
|
| Rate for Payer: PHP Medicare Advantage |
$285.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.56
|
| Rate for Payer: Priority Health Medicare |
$285.58
|
| Rate for Payer: Priority Health Narrow Network |
$534.56
|
| Rate for Payer: Priority Health SBD |
$534.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.58
|
| Rate for Payer: UHC Exchange |
$431.18
|
| Rate for Payer: UHC Medicare Advantage |
$285.58
|
| Rate for Payer: UHCCP Medicaid |
$191.06
|
|
|
PR COMM SVCS BY RHC/FQHC 5 MIN
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS G0071
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$3,447.00 |
| Rate for Payer: Aetna Commercial |
$23.13
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.13
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.92
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,447.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.52
|
| Rate for Payer: Priority Health Narrow Network |
$23.52
|
| Rate for Payer: Priority Health SBD |
$23.52
|
|
|
PR COMPLETE REPLACEMENT PICC RS&I
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 36584
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$10,330.00 |
| Rate for Payer: Aetna Commercial |
$74.81
|
| Rate for Payer: Aetna Medicare |
$58.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.40
|
| Rate for Payer: BCBS Complete |
$38.91
|
| Rate for Payer: BCBS MAPPO |
$55.83
|
| Rate for Payer: BCBS Trust/PPO |
$79.77
|
| Rate for Payer: BCN Commercial |
$480.86
|
| Rate for Payer: BCN Medicare Advantage |
$55.83
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Cofinity Commercial |
$80.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.83
|
| Rate for Payer: Healthscope Commercial |
$89.33
|
| Rate for Payer: Healthscope Commercial |
$103.29
|
| Rate for Payer: Mclaren Medicaid |
$37.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.62
|
| Rate for Payer: Meridian Medicaid |
$38.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,330.00
|
| Rate for Payer: Nomi Health Commercial |
$67.00
|
| Rate for Payer: PACE SWMI |
$55.83
|
| Rate for Payer: PHP Medicare Advantage |
$55.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.94
|
| Rate for Payer: Priority Health Medicare |
$55.83
|
| Rate for Payer: Priority Health Narrow Network |
$90.94
|
| Rate for Payer: Priority Health SBD |
$90.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.83
|
| Rate for Payer: UHC Exchange |
$344.12
|
| Rate for Payer: UHC Medicare Advantage |
$55.83
|
| Rate for Payer: UHCCP Medicaid |
$37.06
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 93303
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$31,172.00 |
| Rate for Payer: Aetna Commercial |
$260.50
|
| Rate for Payer: Aetna Medicare |
$202.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.94
|
| Rate for Payer: BCBS Complete |
$40.26
|
| Rate for Payer: BCBS MAPPO |
$194.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,712.22
|
| Rate for Payer: BCN Commercial |
$322.04
|
| Rate for Payer: BCN Medicare Advantage |
$194.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$279.94
|
| Rate for Payer: Cofinity Commercial |
$260.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.40
|
| Rate for Payer: Healthscope Commercial |
$359.64
|
| Rate for Payer: Healthscope Commercial |
$311.04
|
| Rate for Payer: Mclaren Medicaid |
$38.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.12
|
| Rate for Payer: Meridian Medicaid |
$40.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,172.00
|
| Rate for Payer: Nomi Health Commercial |
$233.28
|
| Rate for Payer: PACE SWMI |
$194.40
|
| Rate for Payer: PHP Medicare Advantage |
$194.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.81
|
| Rate for Payer: Priority Health Medicare |
$194.40
|
| Rate for Payer: Priority Health Narrow Network |
$309.81
|
| Rate for Payer: Priority Health SBD |
$84.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.40
|
| Rate for Payer: UHC Exchange |
$275.50
|
| Rate for Payer: UHC Medicare Advantage |
$194.40
|
| Rate for Payer: UHCCP Medicaid |
$38.34
|
|
|
PR COMPLEX CHRONIC CARE MGMT SVC 1ST 60 MIN CAL MO
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 99487
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$13,329.00 |
| Rate for Payer: Aetna Commercial |
$114.68
|
| Rate for Payer: Aetna Medicare |
$89.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.24
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$85.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,901.95
|
| Rate for Payer: BCN Commercial |
$140.79
|
| Rate for Payer: BCN Medicare Advantage |
$85.58
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$123.24
|
| Rate for Payer: Cofinity Commercial |
$114.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.58
|
| Rate for Payer: Healthscope Commercial |
$136.93
|
| Rate for Payer: Healthscope Commercial |
$158.32
|
| Rate for Payer: Mclaren Medicaid |
$57.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.86
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,329.00
|
| Rate for Payer: Nomi Health Commercial |
$102.70
|
| Rate for Payer: PACE SWMI |
$85.58
|
| Rate for Payer: PHP Medicare Advantage |
$85.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.26
|
| Rate for Payer: Priority Health Medicare |
$85.58
|
| Rate for Payer: Priority Health Narrow Network |
$120.26
|
| Rate for Payer: Priority Health SBD |
$120.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.58
|
| Rate for Payer: UHC Medicare Advantage |
$85.58
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
|
|
PR COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE
|
Professional
|
Both
|
$685.00
|
|
|
Service Code
|
HCPCS 51727
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$62,345.00 |
| Rate for Payer: Aetna Commercial |
$414.02
|
| Rate for Payer: Aetna Medicare |
$321.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.92
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$308.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,367.38
|
| Rate for Payer: BCN Commercial |
$536.08
|
| Rate for Payer: BCN Medicare Advantage |
$308.97
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cash Price |
$548.00
|
| Rate for Payer: Cofinity Commercial |
$444.92
|
| Rate for Payer: Cofinity Commercial |
$414.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$494.35
|
| Rate for Payer: Healthscope Commercial |
$571.59
|
| Rate for Payer: Mclaren Medicaid |
$66.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.42
|
| Rate for Payer: Meridian Medicaid |
$70.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,345.00
|
| Rate for Payer: Nomi Health Commercial |
$370.76
|
| Rate for Payer: PACE SWMI |
$308.97
|
| Rate for Payer: PHP Medicare Advantage |
$308.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.80
|
| Rate for Payer: Priority Health Medicare |
$308.97
|
| Rate for Payer: Priority Health Narrow Network |
$584.80
|
| Rate for Payer: Priority Health SBD |
$166.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.97
|
| Rate for Payer: UHC Medicare Advantage |
$308.97
|
| Rate for Payer: UHCCP Medicaid |
$66.67
|
|
|
PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 51728
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$62,149.00 |
| Rate for Payer: Aetna Commercial |
$411.59
|
| Rate for Payer: Aetna Medicare |
$319.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.31
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$307.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,796.82
|
| Rate for Payer: BCN Commercial |
$534.61
|
| Rate for Payer: BCN Medicare Advantage |
$307.16
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$442.31
|
| Rate for Payer: Cofinity Commercial |
$411.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.16
|
| Rate for Payer: Healthscope Commercial |
$491.46
|
| Rate for Payer: Healthscope Commercial |
$568.25
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.52
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,149.00
|
| Rate for Payer: Nomi Health Commercial |
$368.59
|
| Rate for Payer: PACE SWMI |
$307.16
|
| Rate for Payer: PHP Medicare Advantage |
$307.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$581.07
|
| Rate for Payer: Priority Health Medicare |
$307.16
|
| Rate for Payer: Priority Health Narrow Network |
$581.07
|
| Rate for Payer: Priority Health SBD |
$162.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$307.16
|
| Rate for Payer: UHC Medicare Advantage |
$307.16
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR COMPLEX E/M VISIT ADD ON
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS G2211
|
| Min. Negotiated Rate |
$15.26 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: Aetna Medicare |
$15.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.45
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$15.26
|
| Rate for Payer: BCN Medicare Advantage |
$15.26
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$21.97
|
| Rate for Payer: Cofinity Commercial |
$20.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.26
|
| Rate for Payer: Healthscope Commercial |
$24.42
|
| Rate for Payer: Healthscope Commercial |
$28.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Nomi Health Commercial |
$18.31
|
| Rate for Payer: PACE SWMI |
$15.26
|
| Rate for Payer: PHP Medicare Advantage |
$15.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.32
|
| Rate for Payer: Priority Health Medicare |
$15.26
|
| Rate for Payer: Priority Health Narrow Network |
$18.32
|
| Rate for Payer: Priority Health SBD |
$18.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.26
|
| Rate for Payer: UHC Medicare Advantage |
$15.26
|
|
|
PR COMPLEX IMPLANT REMOVAL, BILATERAL
|
Professional
|
Both
|
$4,304.00
|
|
|
Service Code
|
HCPCS 00564
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$2,797.60 |
| Rate for Payer: Aetna Medicare |
$2,152.00
|
| Rate for Payer: BCBS Complete |
$1,721.60
|
| Rate for Payer: Cash Price |
$3,443.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,797.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.60
|
|
|
PR COMPLEX UROFLOMETRY
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 51741
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$2,933.12 |
| Rate for Payer: Aetna Commercial |
$17.97
|
| Rate for Payer: Aetna Medicare |
$13.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.97
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$13.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,933.12
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: BCN Medicare Advantage |
$13.41
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$19.31
|
| Rate for Payer: Cofinity Commercial |
$17.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.41
|
| Rate for Payer: Healthscope Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.81
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.08
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,457.00
|
| Rate for Payer: Nomi Health Commercial |
$16.09
|
| Rate for Payer: PACE SWMI |
$13.41
|
| Rate for Payer: PHP Medicare Advantage |
$13.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.90
|
| Rate for Payer: Priority Health Medicare |
$13.41
|
| Rate for Payer: Priority Health Narrow Network |
$22.90
|
| Rate for Payer: Priority Health SBD |
$13.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.41
|
| Rate for Payer: UHC Exchange |
$96.55
|
| Rate for Payer: UHC Medicare Advantage |
$13.41
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
PR COMPL OPH XM&EVAL GENERAL ANES W/WO MNPJ GLOBE
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 92018
|
| Min. Negotiated Rate |
$89.03 |
| Max. Negotiated Rate |
$20,108.00 |
| Rate for Payer: Aetna Commercial |
$176.06
|
| Rate for Payer: Aetna Medicare |
$136.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.20
|
| Rate for Payer: BCBS Complete |
$93.48
|
| Rate for Payer: BCBS MAPPO |
$131.39
|
| Rate for Payer: BCBS Trust/PPO |
$7,723.22
|
| Rate for Payer: BCN Commercial |
$146.17
|
| Rate for Payer: BCN Medicare Advantage |
$131.39
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$189.20
|
| Rate for Payer: Cofinity Commercial |
$176.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.39
|
| Rate for Payer: Healthscope Commercial |
$243.07
|
| Rate for Payer: Healthscope Commercial |
$210.22
|
| Rate for Payer: Mclaren Medicaid |
$89.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.96
|
| Rate for Payer: Meridian Medicaid |
$93.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,108.00
|
| Rate for Payer: Nomi Health Commercial |
$157.67
|
| Rate for Payer: PACE SWMI |
$131.39
|
| Rate for Payer: PHP Medicare Advantage |
$131.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.66
|
| Rate for Payer: Priority Health Medicare |
$131.39
|
| Rate for Payer: Priority Health Narrow Network |
$170.66
|
| Rate for Payer: Priority Health SBD |
$170.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.39
|
| Rate for Payer: UHC Exchange |
$147.15
|
| Rate for Payer: UHC Medicare Advantage |
$131.39
|
| Rate for Payer: UHCCP Medicaid |
$89.03
|
|
|
PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 51729
|
| Min. Negotiated Rate |
$79.45 |
| Max. Negotiated Rate |
$65,992.00 |
| Rate for Payer: Aetna Commercial |
$438.09
|
| Rate for Payer: Aetna Medicare |
$340.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.78
|
| Rate for Payer: BCBS Complete |
$83.42
|
| Rate for Payer: BCBS MAPPO |
$326.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,879.24
|
| Rate for Payer: BCN Commercial |
$565.89
|
| Rate for Payer: BCN Medicare Advantage |
$326.93
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$470.78
|
| Rate for Payer: Cofinity Commercial |
$438.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.93
|
| Rate for Payer: Healthscope Commercial |
$523.09
|
| Rate for Payer: Healthscope Commercial |
$604.82
|
| Rate for Payer: Mclaren Medicaid |
$79.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.28
|
| Rate for Payer: Meridian Medicaid |
$83.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65,992.00
|
| Rate for Payer: Nomi Health Commercial |
$392.32
|
| Rate for Payer: PACE SWMI |
$326.93
|
| Rate for Payer: PHP Medicare Advantage |
$326.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.02
|
| Rate for Payer: Priority Health Medicare |
$326.93
|
| Rate for Payer: Priority Health Narrow Network |
$613.02
|
| Rate for Payer: Priority Health SBD |
$197.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.93
|
| Rate for Payer: UHC Medicare Advantage |
$326.93
|
| Rate for Payer: UHCCP Medicaid |
$79.45
|
|
|
PR COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$10,302.00
|
|
|
Service Code
|
HCPCS 61697
|
| Min. Negotiated Rate |
$736.98 |
| Max. Negotiated Rate |
$765,850.00 |
| Rate for Payer: Aetna Commercial |
$5,598.91
|
| Rate for Payer: Aetna Medicare |
$4,345.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,598.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,016.74
|
| Rate for Payer: BCBS Complete |
$2,866.52
|
| Rate for Payer: BCBS MAPPO |
$4,178.29
|
| Rate for Payer: BCBS Trust/PPO |
$736.98
|
| Rate for Payer: BCN Commercial |
$8,609.74
|
| Rate for Payer: BCN Medicare Advantage |
$4,178.29
|
| Rate for Payer: Cash Price |
$8,241.60
|
| Rate for Payer: Cash Price |
$8,241.60
|
| Rate for Payer: Cofinity Commercial |
$6,016.74
|
| Rate for Payer: Cofinity Commercial |
$5,598.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,178.29
|
| Rate for Payer: Healthscope Commercial |
$7,729.84
|
| Rate for Payer: Healthscope Commercial |
$6,685.26
|
| Rate for Payer: Mclaren Medicaid |
$2,730.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,387.20
|
| Rate for Payer: Meridian Medicaid |
$2,866.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765,850.00
|
| Rate for Payer: Nomi Health Commercial |
$5,013.95
|
| Rate for Payer: PACE SWMI |
$4,178.29
|
| Rate for Payer: PHP Medicare Advantage |
$4,178.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,730.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,696.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,271.60
|
| Rate for Payer: Priority Health Medicare |
$4,178.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,271.60
|
| Rate for Payer: Priority Health SBD |
$7,271.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,252.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,178.29
|
| Rate for Payer: UHC Exchange |
$4,252.43
|
| Rate for Payer: UHC Medicare Advantage |
$4,178.29
|
| Rate for Payer: UHCCP Medicaid |
$2,730.02
|
|
|
PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 92557
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$4,641.00 |
| Rate for Payer: Aetna Commercial |
$40.05
|
| Rate for Payer: Aetna Medicare |
$31.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.04
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$196.00
|
| Rate for Payer: BCN Commercial |
$53.75
|
| Rate for Payer: BCN Medicare Advantage |
$29.89
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$43.04
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.89
|
| Rate for Payer: Healthscope Commercial |
$55.30
|
| Rate for Payer: Healthscope Commercial |
$47.82
|
| Rate for Payer: Mclaren Medicaid |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.38
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,641.00
|
| Rate for Payer: Nomi Health Commercial |
$35.87
|
| Rate for Payer: PACE SWMI |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$29.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.52
|
| Rate for Payer: Priority Health Medicare |
$29.89
|
| Rate for Payer: Priority Health Narrow Network |
$42.52
|
| Rate for Payer: Priority Health SBD |
$42.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.89
|
| Rate for Payer: UHC Exchange |
$59.05
|
| Rate for Payer: UHC Medicare Advantage |
$29.89
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
|
