|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,761.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,683.93 |
| Max. Negotiated Rate |
$2,484.90 |
| Rate for Payer: Aetna Commercial |
$2,346.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,133.70
|
| Rate for Payer: BCN Commercial |
$2,133.70
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$2,374.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,208.80
|
| Rate for Payer: Healthscope Commercial |
$2,484.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,070.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,346.85
|
| Rate for Payer: PHP Commercial |
$2,346.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,402.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,683.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,429.68
|
| Rate for Payer: UHC Core |
$2,305.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,070.75
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$1,932.70 |
| Rate for Payer: Aetna Commercial |
$1,453.30
|
| Rate for Payer: Aetna Medicare |
$1,127.93
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS MAPPO |
$1,084.55
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,084.55
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,561.75
|
| Rate for Payer: Cofinity Commercial |
$1,453.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,084.55
|
| Rate for Payer: Mclaren Medicaid |
$696.72
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,138.78
|
| Rate for Payer: PACE SWMI |
$1,084.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,084.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.26
|
| Rate for Payer: Priority Health Medicare |
$1,084.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,913.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,084.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,117.09
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,761.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$655.74 |
| Max. Negotiated Rate |
$2,484.90 |
| Rate for Payer: Aetna Commercial |
$2,346.85
|
| Rate for Payer: Aetna Medicare |
$717.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$862.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$862.81
|
| Rate for Payer: BCBS Complete |
$1,104.40
|
| Rate for Payer: BCBS MAPPO |
$690.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,146.68
|
| Rate for Payer: BCN Commercial |
$2,146.68
|
| Rate for Payer: BCN Medicare Advantage |
$690.25
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$2,374.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,208.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$690.25
|
| Rate for Payer: Healthscope Commercial |
$2,484.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,070.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$724.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$793.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,346.85
|
| Rate for Payer: PACE Senior Care Partners |
$655.74
|
| Rate for Payer: PACE SWMI |
$690.25
|
| Rate for Payer: PHP Commercial |
$2,346.85
|
| Rate for Payer: PHP Medicare Advantage |
$690.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,402.07
|
| Rate for Payer: Priority Health Medicare |
$690.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,683.93
|
| Rate for Payer: Railroad Medicare Medicare |
$690.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,429.68
|
| Rate for Payer: UHC Core |
$2,305.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$690.25
|
| Rate for Payer: UHC Medicare Advantage |
$710.96
|
| Rate for Payer: VA VA |
$690.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,070.75
|
|
|
PR ENTERORRHAPHY MULTIPLE PERFORATIONS
|
Professional
|
Both
|
$3,021.00
|
|
|
Service Code
|
HCPCS 44603
|
| Min. Negotiated Rate |
$220.30 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,149.61
|
| Rate for Payer: Aetna Medicare |
$1,668.36
|
| Rate for Payer: BCBS Complete |
$1,079.56
|
| Rate for Payer: BCBS MAPPO |
$1,604.19
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: BCN Commercial |
$2,349.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,604.19
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cofinity Commercial |
$2,310.03
|
| Rate for Payer: Cofinity Commercial |
$2,149.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,604.19
|
| Rate for Payer: Mclaren Medicaid |
$1,028.15
|
| Rate for Payer: Meridian Medicaid |
$1,079.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,684.40
|
| Rate for Payer: PACE SWMI |
$1,604.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,604.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,028.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,114.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,826.39
|
| Rate for Payer: Priority Health Medicare |
$1,604.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,826.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,604.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,604.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,652.32
|
|
|
PR ENTERORRHAPHY SINGLE PERFORATION
|
Professional
|
Both
|
$2,377.00
|
|
|
Service Code
|
HCPCS 44602
|
| Min. Negotiated Rate |
$894.81 |
| Max. Negotiated Rate |
$2,461.85 |
| Rate for Payer: Aetna Commercial |
$1,875.49
|
| Rate for Payer: Aetna Medicare |
$1,455.60
|
| Rate for Payer: BCBS Complete |
$939.55
|
| Rate for Payer: BCBS MAPPO |
$1,399.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.39
|
| Rate for Payer: BCN Commercial |
$2,046.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,399.62
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cofinity Commercial |
$1,875.49
|
| Rate for Payer: Cofinity Commercial |
$2,015.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,399.62
|
| Rate for Payer: Mclaren Medicaid |
$894.81
|
| Rate for Payer: Meridian Medicaid |
$939.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,469.60
|
| Rate for Payer: PACE SWMI |
$1,399.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,399.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,663.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,461.85
|
| Rate for Payer: Priority Health Medicare |
$1,399.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,399.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,441.61
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 44377
|
| Min. Negotiated Rate |
$187.65 |
| Max. Negotiated Rate |
$1,573.28 |
| Rate for Payer: Aetna Commercial |
$389.56
|
| Rate for Payer: Aetna Medicare |
$302.35
|
| Rate for Payer: BCBS Complete |
$197.03
|
| Rate for Payer: BCBS MAPPO |
$290.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.28
|
| Rate for Payer: BCN Commercial |
$428.57
|
| Rate for Payer: BCN Medicare Advantage |
$290.72
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cofinity Commercial |
$418.64
|
| Rate for Payer: Cofinity Commercial |
$389.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.72
|
| Rate for Payer: Mclaren Medicaid |
$187.65
|
| Rate for Payer: Meridian Medicaid |
$197.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$305.26
|
| Rate for Payer: PACE SWMI |
$290.72
|
| Rate for Payer: PHP Medicare Advantage |
$290.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.65
|
| Rate for Payer: Priority Health Medicare |
$290.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.72
|
| Rate for Payer: UHC Medicare Advantage |
$299.44
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 44376
|
| Min. Negotiated Rate |
$177.86 |
| Max. Negotiated Rate |
$1,925.65 |
| Rate for Payer: Aetna Commercial |
$369.33
|
| Rate for Payer: Aetna Medicare |
$286.64
|
| Rate for Payer: BCBS Complete |
$186.75
|
| Rate for Payer: BCBS MAPPO |
$275.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,925.65
|
| Rate for Payer: BCN Commercial |
$406.58
|
| Rate for Payer: BCN Medicare Advantage |
$275.62
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$396.89
|
| Rate for Payer: Cofinity Commercial |
$369.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.62
|
| Rate for Payer: Mclaren Medicaid |
$177.86
|
| Rate for Payer: Meridian Medicaid |
$186.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$289.40
|
| Rate for Payer: PACE SWMI |
$275.62
|
| Rate for Payer: PHP Medicare Advantage |
$275.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.19
|
| Rate for Payer: Priority Health Medicare |
$275.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$489.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.62
|
| Rate for Payer: UHC Medicare Advantage |
$283.89
|
|
|
PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44369
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$319.00
|
| Rate for Payer: Aetna Medicare |
$247.58
|
| Rate for Payer: BCBS Complete |
$161.70
|
| Rate for Payer: BCBS MAPPO |
$238.06
|
| Rate for Payer: BCBS Trust/PPO |
$593.28
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$238.06
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$342.81
|
| Rate for Payer: Cofinity Commercial |
$319.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.06
|
| Rate for Payer: Mclaren Medicaid |
$154.00
|
| Rate for Payer: Meridian Medicaid |
$161.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.96
|
| Rate for Payer: PACE SWMI |
$238.06
|
| Rate for Payer: PHP Medicare Advantage |
$238.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.75
|
| Rate for Payer: Priority Health Medicare |
$238.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.06
|
| Rate for Payer: UHC Medicare Advantage |
$245.20
|
|
|
PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 44373
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$1,809.96 |
| Rate for Payer: Aetna Commercial |
$249.48
|
| Rate for Payer: Aetna Medicare |
$193.63
|
| Rate for Payer: BCBS Complete |
$126.14
|
| Rate for Payer: BCBS MAPPO |
$186.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.96
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$186.18
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cofinity Commercial |
$268.10
|
| Rate for Payer: Cofinity Commercial |
$249.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.18
|
| Rate for Payer: Mclaren Medicaid |
$120.13
|
| Rate for Payer: Meridian Medicaid |
$126.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.49
|
| Rate for Payer: PACE SWMI |
$186.18
|
| Rate for Payer: PHP Medicare Advantage |
$186.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.45
|
| Rate for Payer: Priority Health Medicare |
$186.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.18
|
| Rate for Payer: UHC Medicare Advantage |
$191.77
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 44378
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$499.75
|
| Rate for Payer: Aetna Medicare |
$387.87
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS MAPPO |
$372.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$549.76
|
| Rate for Payer: BCN Medicare Advantage |
$372.95
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$537.05
|
| Rate for Payer: Cofinity Commercial |
$499.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.95
|
| Rate for Payer: Mclaren Medicaid |
$240.90
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.60
|
| Rate for Payer: PACE SWMI |
$372.95
|
| Rate for Payer: PHP Medicare Advantage |
$372.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.47
|
| Rate for Payer: Priority Health Medicare |
$372.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.95
|
| Rate for Payer: UHC Medicare Advantage |
$384.14
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
IP
|
$1,518.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$925.83 |
| Max. Negotiated Rate |
$1,366.20 |
| Rate for Payer: Aetna Commercial |
$1,290.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.11
|
| Rate for Payer: BCN Commercial |
$1,173.11
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$1,305.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.40
|
| Rate for Payer: Healthscope Commercial |
$1,366.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.30
|
| Rate for Payer: PHP Commercial |
$1,290.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,320.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$925.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,335.84
|
| Rate for Payer: UHC Core |
$1,267.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.50
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
OP
|
$1,518.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$360.52 |
| Max. Negotiated Rate |
$1,366.20 |
| Rate for Payer: Aetna Commercial |
$1,290.30
|
| Rate for Payer: Aetna Medicare |
$394.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$474.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$474.38
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$379.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.24
|
| Rate for Payer: BCN Commercial |
$1,180.24
|
| Rate for Payer: BCN Medicare Advantage |
$379.50
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$1,305.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.50
|
| Rate for Payer: Healthscope Commercial |
$1,366.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.50
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$398.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$436.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.30
|
| Rate for Payer: PACE Senior Care Partners |
$360.52
|
| Rate for Payer: PACE SWMI |
$379.50
|
| Rate for Payer: PHP Commercial |
$1,290.30
|
| Rate for Payer: PHP Medicare Advantage |
$379.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,320.66
|
| Rate for Payer: Priority Health Medicare |
$379.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$925.83
|
| Rate for Payer: Railroad Medicare Medicare |
$379.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,335.84
|
| Rate for Payer: UHC Core |
$1,267.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.50
|
| Rate for Payer: UHC Medicare Advantage |
$390.88
|
| Rate for Payer: VA VA |
$379.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.50
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$499.75
|
| Rate for Payer: Aetna Medicare |
$387.87
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS MAPPO |
$372.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$549.76
|
| Rate for Payer: BCN Medicare Advantage |
$372.95
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$537.05
|
| Rate for Payer: Cofinity Commercial |
$499.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.95
|
| Rate for Payer: Mclaren Medicaid |
$240.90
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.60
|
| Rate for Payer: PACE SWMI |
$372.95
|
| Rate for Payer: PHP Medicare Advantage |
$372.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.47
|
| Rate for Payer: Priority Health Medicare |
$372.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.95
|
| Rate for Payer: UHC Medicare Advantage |
$384.14
|
|
|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: Aetna Commercial |
$346.56
|
| Rate for Payer: Aetna Medicare |
$268.98
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS MAPPO |
$258.63
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: BCN Commercial |
$382.15
|
| Rate for Payer: BCN Medicare Advantage |
$258.63
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$372.43
|
| Rate for Payer: Cofinity Commercial |
$346.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.63
|
| Rate for Payer: Mclaren Medicaid |
$167.63
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.56
|
| Rate for Payer: PACE SWMI |
$258.63
|
| Rate for Payer: PHP Medicare Advantage |
$258.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$459.80
|
| Rate for Payer: Priority Health Medicare |
$258.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$459.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.63
|
| Rate for Payer: UHC Medicare Advantage |
$266.39
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,292.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$150.38 |
| Max. Negotiated Rate |
$904.40 |
| Rate for Payer: Aetna Commercial |
$311.86
|
| Rate for Payer: Aetna Medicare |
$242.04
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS MAPPO |
$232.73
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$232.73
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cofinity Commercial |
$335.13
|
| Rate for Payer: Cofinity Commercial |
$311.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.73
|
| Rate for Payer: Mclaren Medicaid |
$150.38
|
| Rate for Payer: Meridian Medicaid |
$157.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.37
|
| Rate for Payer: PACE SWMI |
$232.73
|
| Rate for Payer: PHP Medicare Advantage |
$232.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$904.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.35
|
| Rate for Payer: Priority Health Medicare |
$232.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.73
|
| Rate for Payer: UHC Medicare Advantage |
$239.71
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,502.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$1,943.09 |
| Rate for Payer: Aetna Commercial |
$531.28
|
| Rate for Payer: Aetna Medicare |
$412.34
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS MAPPO |
$396.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.09
|
| Rate for Payer: BCN Commercial |
$584.95
|
| Rate for Payer: BCN Medicare Advantage |
$396.48
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cofinity Commercial |
$570.93
|
| Rate for Payer: Cofinity Commercial |
$531.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.48
|
| Rate for Payer: Mclaren Medicaid |
$256.88
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.30
|
| Rate for Payer: PACE SWMI |
$396.48
|
| Rate for Payer: PHP Medicare Advantage |
$396.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.80
|
| Rate for Payer: Priority Health Medicare |
$396.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.48
|
| Rate for Payer: UHC Medicare Advantage |
$408.37
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 44372
|
| Min. Negotiated Rate |
$150.38 |
| Max. Negotiated Rate |
$645.40 |
| Rate for Payer: Aetna Commercial |
$311.98
|
| Rate for Payer: Aetna Medicare |
$242.13
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS MAPPO |
$232.82
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$343.05
|
| Rate for Payer: BCN Medicare Advantage |
$232.82
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$335.26
|
| Rate for Payer: Cofinity Commercial |
$311.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.82
|
| Rate for Payer: Mclaren Medicaid |
$150.38
|
| Rate for Payer: Meridian Medicaid |
$157.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.46
|
| Rate for Payer: PACE SWMI |
$232.82
|
| Rate for Payer: PHP Medicare Advantage |
$232.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$645.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$412.76
|
| Rate for Payer: Priority Health Medicare |
$232.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.82
|
| Rate for Payer: UHC Medicare Advantage |
$239.80
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$955.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$120.35 |
| Max. Negotiated Rate |
$668.50 |
| Rate for Payer: Aetna Commercial |
$249.19
|
| Rate for Payer: Aetna Medicare |
$193.40
|
| Rate for Payer: BCBS Complete |
$126.37
|
| Rate for Payer: BCBS MAPPO |
$185.96
|
| Rate for Payer: BCBS Trust/PPO |
$283.17
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$185.96
|
| Rate for Payer: Cash Price |
$764.00
|
| Rate for Payer: Cash Price |
$764.00
|
| Rate for Payer: Cofinity Commercial |
$267.78
|
| Rate for Payer: Cofinity Commercial |
$249.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.96
|
| Rate for Payer: Mclaren Medicaid |
$120.35
|
| Rate for Payer: Meridian Medicaid |
$126.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.26
|
| Rate for Payer: PACE SWMI |
$185.96
|
| Rate for Payer: PHP Medicare Advantage |
$185.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.45
|
| Rate for Payer: Priority Health Medicare |
$185.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.96
|
| Rate for Payer: UHC Medicare Advantage |
$191.54
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna Medicare |
$183.34
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$176.29
|
| Rate for Payer: BCBS Trust/PPO |
$740.68
|
| Rate for Payer: BCN Commercial |
$260.46
|
| Rate for Payer: BCN Medicare Advantage |
$176.29
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$253.86
|
| Rate for Payer: Cofinity Commercial |
$236.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.29
|
| Rate for Payer: Mclaren Medicaid |
$114.59
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.10
|
| Rate for Payer: PACE SWMI |
$176.29
|
| Rate for Payer: PHP Medicare Advantage |
$176.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.39
|
| Rate for Payer: Priority Health Medicare |
$176.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$313.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.29
|
| Rate for Payer: UHC Medicare Advantage |
$181.58
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$265.61
|
| Rate for Payer: Aetna Medicare |
$206.15
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS MAPPO |
$198.22
|
| Rate for Payer: BCBS Trust/PPO |
$700.00
|
| Rate for Payer: BCN Commercial |
$292.72
|
| Rate for Payer: BCN Medicare Advantage |
$198.22
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$265.61
|
| Rate for Payer: Cofinity Commercial |
$285.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.22
|
| Rate for Payer: Mclaren Medicaid |
$128.23
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.13
|
| Rate for Payer: PACE SWMI |
$198.22
|
| Rate for Payer: PHP Medicare Advantage |
$198.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.19
|
| Rate for Payer: Priority Health Medicare |
$198.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.22
|
| Rate for Payer: UHC Medicare Advantage |
$204.17
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,710.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$620.26 |
| Max. Negotiated Rate |
$1,897.00 |
| Rate for Payer: Aetna Commercial |
$1,295.81
|
| Rate for Payer: Aetna Medicare |
$1,005.70
|
| Rate for Payer: BCBS Complete |
$651.27
|
| Rate for Payer: BCBS MAPPO |
$967.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,724.90
|
| Rate for Payer: BCN Commercial |
$1,418.63
|
| Rate for Payer: BCN Medicare Advantage |
$967.02
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cash Price |
$2,168.00
|
| Rate for Payer: Cofinity Commercial |
$1,392.51
|
| Rate for Payer: Cofinity Commercial |
$1,295.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.02
|
| Rate for Payer: Mclaren Medicaid |
$620.26
|
| Rate for Payer: Meridian Medicaid |
$651.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,015.37
|
| Rate for Payer: PACE SWMI |
$967.02
|
| Rate for Payer: PHP Medicare Advantage |
$967.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,706.89
|
| Rate for Payer: Priority Health Medicare |
$967.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,706.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$967.02
|
| Rate for Payer: UHC Medicare Advantage |
$996.03
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$2,888.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$621.96 |
| Max. Negotiated Rate |
$2,324.52 |
| Rate for Payer: Aetna Commercial |
$1,296.69
|
| Rate for Payer: Aetna Medicare |
$1,006.39
|
| Rate for Payer: BCBS Complete |
$653.06
|
| Rate for Payer: BCBS MAPPO |
$967.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$1,420.10
|
| Rate for Payer: BCN Medicare Advantage |
$967.68
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cash Price |
$2,310.40
|
| Rate for Payer: Cofinity Commercial |
$1,393.46
|
| Rate for Payer: Cofinity Commercial |
$1,296.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.68
|
| Rate for Payer: Mclaren Medicaid |
$621.96
|
| Rate for Payer: Meridian Medicaid |
$653.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,016.06
|
| Rate for Payer: PACE SWMI |
$967.68
|
| Rate for Payer: PHP Medicare Advantage |
$967.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,021.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,708.65
|
| Rate for Payer: Priority Health Medicare |
$967.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,708.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$967.68
|
| Rate for Payer: UHC Medicare Advantage |
$996.71
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,953.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$153.79 |
| Max. Negotiated Rate |
$1,367.10 |
| Rate for Payer: Aetna Commercial |
$324.19
|
| Rate for Payer: Aetna Medicare |
$251.61
|
| Rate for Payer: BCBS Complete |
$161.48
|
| Rate for Payer: BCBS MAPPO |
$241.93
|
| Rate for Payer: BCBS Trust/PPO |
$726.94
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$241.93
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cofinity Commercial |
$348.38
|
| Rate for Payer: Cofinity Commercial |
$324.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.93
|
| Rate for Payer: Mclaren Medicaid |
$153.79
|
| Rate for Payer: Meridian Medicaid |
$161.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.03
|
| Rate for Payer: PACE SWMI |
$241.93
|
| Rate for Payer: PHP Medicare Advantage |
$241.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,367.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.34
|
| Rate for Payer: Priority Health Medicare |
$241.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.93
|
| Rate for Payer: UHC Medicare Advantage |
$249.19
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$4,928.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$240.38 |
| Max. Negotiated Rate |
$4,992.47 |
| Rate for Payer: Aetna Commercial |
$3,804.43
|
| Rate for Payer: Aetna Medicare |
$2,952.70
|
| Rate for Payer: BCBS Complete |
$1,906.62
|
| Rate for Payer: BCBS MAPPO |
$2,839.13
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$4,149.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,839.13
|
| Rate for Payer: Cash Price |
$3,942.40
|
| Rate for Payer: Cash Price |
$3,942.40
|
| Rate for Payer: Cofinity Commercial |
$4,088.35
|
| Rate for Payer: Cofinity Commercial |
$3,804.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,839.13
|
| Rate for Payer: Mclaren Medicaid |
$1,815.83
|
| Rate for Payer: Meridian Medicaid |
$1,906.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,981.09
|
| Rate for Payer: PACE SWMI |
$2,839.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,839.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,815.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,449.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,992.47
|
| Rate for Payer: Priority Health Medicare |
$2,839.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,992.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,839.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,839.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,924.30
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,247.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,573.22 |
| Max. Negotiated Rate |
$4,324.53 |
| Rate for Payer: Aetna Commercial |
$3,292.59
|
| Rate for Payer: Aetna Medicare |
$2,555.45
|
| Rate for Payer: BCBS Complete |
$1,651.88
|
| Rate for Payer: BCBS MAPPO |
$2,457.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.09
|
| Rate for Payer: BCN Commercial |
$3,594.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,457.16
|
| Rate for Payer: Cash Price |
$3,397.60
|
| Rate for Payer: Cash Price |
$3,397.60
|
| Rate for Payer: Cofinity Commercial |
$3,538.31
|
| Rate for Payer: Cofinity Commercial |
$3,292.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,457.16
|
| Rate for Payer: Mclaren Medicaid |
$1,573.22
|
| Rate for Payer: Meridian Medicaid |
$1,651.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,580.02
|
| Rate for Payer: PACE SWMI |
$2,457.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,457.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,324.53
|
| Rate for Payer: Priority Health Medicare |
$2,457.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,324.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,457.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,457.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,530.87
|
|
