|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
OP
|
$1,424.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$338.20 |
| Max. Negotiated Rate |
$1,281.60 |
| Rate for Payer: Aetna Commercial |
$1,210.40
|
| Rate for Payer: Aetna Medicare |
$370.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$445.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$445.00
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$356.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,170.67
|
| Rate for Payer: BCN Commercial |
$1,107.16
|
| Rate for Payer: BCN Medicare Advantage |
$356.00
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,224.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.00
|
| Rate for Payer: Healthscope Commercial |
$1,281.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,068.00
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.80
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$409.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,210.40
|
| Rate for Payer: Nomi Health Commercial |
$1,167.68
|
| Rate for Payer: PACE Senior Care Partners |
$338.20
|
| Rate for Payer: PACE SWMI |
$356.00
|
| Rate for Payer: PHP Commercial |
$1,210.40
|
| Rate for Payer: PHP Medicare Advantage |
$356.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,238.88
|
| Rate for Payer: Priority Health Medicare |
$359.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$954.08
|
| Rate for Payer: Railroad Medicare Medicare |
$356.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,253.12
|
| Rate for Payer: UHC Core |
$1,189.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.00
|
| Rate for Payer: UHC Exchange |
$356.00
|
| Rate for Payer: UHC Medicare Advantage |
$356.00
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$356.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,068.00
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
IP
|
$1,424.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$925.60 |
| Max. Negotiated Rate |
$1,281.60 |
| Rate for Payer: Aetna Commercial |
$1,210.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,162.41
|
| Rate for Payer: BCN Commercial |
$1,100.47
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,224.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.20
|
| Rate for Payer: Healthscope Commercial |
$1,281.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,068.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,210.40
|
| Rate for Payer: Nomi Health Commercial |
$1,167.68
|
| Rate for Payer: PHP Commercial |
$1,210.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,238.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$954.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,253.12
|
| Rate for Payer: UHC Core |
$1,189.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,068.00
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$979.31 |
| Rate for Payer: Aetna Commercial |
$326.41
|
| Rate for Payer: Aetna Medicare |
$253.33
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$243.59
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: BCN Medicare Advantage |
$243.59
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$350.77
|
| Rate for Payer: Cofinity Commercial |
$326.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.59
|
| Rate for Payer: Mclaren Medicaid |
$162.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.77
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Nomi Health Commercial |
$292.31
|
| Rate for Payer: PACE SWMI |
$243.59
|
| Rate for Payer: PHP Medicare Advantage |
$243.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO |
$454.60
|
| Rate for Payer: Priority Health Medicare |
$246.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$454.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.59
|
| Rate for Payer: UHC Exchange |
$243.59
|
| Rate for Payer: UHC Medicare Advantage |
$243.59
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Facility
|
OP
|
$1,320.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$313.50 |
| Max. Negotiated Rate |
$1,188.00 |
| Rate for Payer: Aetna Commercial |
$1,122.00
|
| Rate for Payer: Aetna Medicare |
$343.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$412.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$412.50
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$330.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.17
|
| Rate for Payer: BCN Commercial |
$1,026.30
|
| Rate for Payer: BCN Medicare Advantage |
$330.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,135.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.00
|
| Rate for Payer: Healthscope Commercial |
$1,188.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.00
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.50
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$379.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.00
|
| Rate for Payer: Nomi Health Commercial |
$1,082.40
|
| Rate for Payer: PACE Senior Care Partners |
$313.50
|
| Rate for Payer: PACE SWMI |
$330.00
|
| Rate for Payer: PHP Commercial |
$1,122.00
|
| Rate for Payer: PHP Medicare Advantage |
$330.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,148.40
|
| Rate for Payer: Priority Health Medicare |
$333.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.40
|
| Rate for Payer: Railroad Medicare Medicare |
$330.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,161.60
|
| Rate for Payer: UHC Core |
$1,102.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.00
|
| Rate for Payer: UHC Exchange |
$330.00
|
| Rate for Payer: UHC Medicare Advantage |
$330.00
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$330.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.00
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$898.67 |
| Rate for Payer: Aetna Commercial |
$268.59
|
| Rate for Payer: Aetna Medicare |
$208.46
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$200.44
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$200.44
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$288.63
|
| Rate for Payer: Cofinity Commercial |
$268.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.44
|
| Rate for Payer: Mclaren Medicaid |
$133.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.46
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Nomi Health Commercial |
$240.53
|
| Rate for Payer: PACE SWMI |
$200.44
|
| Rate for Payer: PHP Medicare Advantage |
$200.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO |
$372.88
|
| Rate for Payer: Priority Health Medicare |
$202.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.44
|
| Rate for Payer: UHC Exchange |
$200.44
|
| Rate for Payer: UHC Medicare Advantage |
$200.44
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$898.67 |
| Rate for Payer: Aetna Commercial |
$268.59
|
| Rate for Payer: Aetna Medicare |
$208.46
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$200.44
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$200.44
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$288.63
|
| Rate for Payer: Cofinity Commercial |
$268.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.44
|
| Rate for Payer: Mclaren Medicaid |
$133.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.46
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Nomi Health Commercial |
$240.53
|
| Rate for Payer: PACE SWMI |
$200.44
|
| Rate for Payer: PHP Medicare Advantage |
$200.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO |
$372.88
|
| Rate for Payer: Priority Health Medicare |
$202.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.44
|
| Rate for Payer: UHC Exchange |
$200.44
|
| Rate for Payer: UHC Medicare Advantage |
$200.44
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Facility
|
IP
|
$1,320.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$858.00 |
| Max. Negotiated Rate |
$1,188.00 |
| Rate for Payer: Aetna Commercial |
$1,122.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.52
|
| Rate for Payer: BCN Commercial |
$1,020.10
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,135.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.00
|
| Rate for Payer: Healthscope Commercial |
$1,188.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.00
|
| Rate for Payer: Nomi Health Commercial |
$1,082.40
|
| Rate for Payer: PHP Commercial |
$1,122.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,148.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$884.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,161.60
|
| Rate for Payer: UHC Core |
$1,102.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.00
|
|
|
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 |
$913.90 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| 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: 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: 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 |
$352.59
|
| Rate for Payer: Priority Health Medicare |
$191.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Exchange |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
IP
|
$1,406.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$913.90 |
| Max. Negotiated Rate |
$1,265.40 |
| Rate for Payer: Aetna Commercial |
$1,195.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.72
|
| Rate for Payer: BCN Commercial |
$1,086.56
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,209.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Healthscope Commercial |
$1,265.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,054.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.10
|
| Rate for Payer: Nomi Health Commercial |
$1,152.92
|
| Rate for Payer: PHP Commercial |
$1,195.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,223.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.28
|
| Rate for Payer: UHC Core |
$1,174.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,054.50
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
45381
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$913.90 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| 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: 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: 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 |
$352.59
|
| Rate for Payer: Priority Health Medicare |
$191.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Exchange |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
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 |
$333.92 |
| Max. Negotiated Rate |
$1,265.40 |
| Rate for Payer: Aetna Commercial |
$1,195.10
|
| Rate for Payer: Aetna Medicare |
$365.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$439.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$439.38
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$351.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.87
|
| Rate for Payer: BCN Commercial |
$1,093.16
|
| Rate for Payer: BCN Medicare Advantage |
$351.50
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,209.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.50
|
| Rate for Payer: Healthscope Commercial |
$1,265.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,054.50
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.08
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.10
|
| Rate for Payer: Nomi Health Commercial |
$1,152.92
|
| Rate for Payer: PACE Senior Care Partners |
$333.92
|
| Rate for Payer: PACE SWMI |
$351.50
|
| Rate for Payer: PHP Commercial |
$1,195.10
|
| Rate for Payer: PHP Medicare Advantage |
$351.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,223.22
|
| Rate for Payer: Priority Health Medicare |
$355.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.02
|
| Rate for Payer: Railroad Medicare Medicare |
$351.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,237.28
|
| Rate for Payer: UHC Core |
$1,174.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.50
|
| Rate for Payer: UHC Exchange |
$351.50
|
| Rate for Payer: UHC Medicare Advantage |
$351.50
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$351.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,054.50
|
|
|
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 |
$452.81 |
| Rate for Payer: Aetna Commercial |
$324.52
|
| Rate for Payer: Aetna Medicare |
$251.87
|
| 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: 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: 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 |
$452.81
|
| Rate for Payer: Priority Health Medicare |
$244.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$452.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.18
|
| Rate for Payer: UHC Exchange |
$242.18
|
| 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 |
$941.20 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare |
$225.21
|
| 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: 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: 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 |
$402.11
|
| Rate for Payer: Priority Health Medicare |
$218.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.55
|
| Rate for Payer: UHC Exchange |
$216.55
|
| 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
|
IP
|
$1,448.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
45384
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$941.20 |
| Max. Negotiated Rate |
$1,303.20 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.00
|
| Rate for Payer: BCN Commercial |
$1,119.01
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$1,187.36
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,259.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$970.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.24
|
| Rate for Payer: UHC Core |
$1,209.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.00
|
|
|
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 |
$343.90 |
| Max. Negotiated Rate |
$1,303.20 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna Medicare |
$376.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$452.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$452.50
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$362.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.40
|
| Rate for Payer: BCN Commercial |
$1,125.82
|
| Rate for Payer: BCN Medicare Advantage |
$362.00
|
| 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: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.00
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.00
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.10
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$416.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$1,187.36
|
| Rate for Payer: PACE Senior Care Partners |
$343.90
|
| Rate for Payer: PACE SWMI |
$362.00
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: PHP Medicare Advantage |
$362.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,259.76
|
| Rate for Payer: Priority Health Medicare |
$365.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$970.16
|
| Rate for Payer: Railroad Medicare Medicare |
$362.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.24
|
| Rate for Payer: UHC Core |
$1,209.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.00
|
| Rate for Payer: UHC Exchange |
$362.00
|
| Rate for Payer: UHC Medicare Advantage |
$362.00
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$362.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.00
|
|
|
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 |
$941.20 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare |
$225.21
|
| 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: 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: 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 |
$402.11
|
| Rate for Payer: Priority Health Medicare |
$218.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.55
|
| Rate for Payer: UHC Exchange |
$216.55
|
| 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 |
$941.20 |
| Rate for Payer: Aetna Commercial |
$320.53
|
| Rate for Payer: Aetna Medicare |
$248.77
|
| 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: 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: 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 |
$446.84
|
| Rate for Payer: Priority Health Medicare |
$241.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.20
|
| Rate for Payer: UHC Exchange |
$239.20
|
| 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 |
$941.20 |
| Rate for Payer: Aetna Commercial |
$320.53
|
| Rate for Payer: Aetna Medicare |
$248.77
|
| 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: 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: 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 |
$446.84
|
| Rate for Payer: Priority Health Medicare |
$241.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.20
|
| Rate for Payer: UHC Exchange |
$239.20
|
| 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 |
$941.20 |
| Max. Negotiated Rate |
$1,303.20 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.00
|
| Rate for Payer: BCN Commercial |
$1,119.01
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$1,187.36
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,259.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$970.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.24
|
| Rate for Payer: UHC Core |
$1,209.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.00
|
|
|
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 |
$343.90 |
| Max. Negotiated Rate |
$1,303.20 |
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna Medicare |
$376.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$452.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$452.50
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$362.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.40
|
| Rate for Payer: BCN Commercial |
$1,125.82
|
| Rate for Payer: BCN Medicare Advantage |
$362.00
|
| 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: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.00
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.00
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.10
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$416.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$1,187.36
|
| Rate for Payer: PACE Senior Care Partners |
$343.90
|
| Rate for Payer: PACE SWMI |
$362.00
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: PHP Medicare Advantage |
$362.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,259.76
|
| Rate for Payer: Priority Health Medicare |
$365.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$970.16
|
| Rate for Payer: Railroad Medicare Medicare |
$362.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.24
|
| Rate for Payer: UHC Core |
$1,209.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.00
|
| Rate for Payer: UHC Exchange |
$362.00
|
| Rate for Payer: UHC Medicare Advantage |
$362.00
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$362.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.00
|
|
|
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 |
$646.75 |
| Rate for Payer: Aetna Commercial |
$382.68
|
| Rate for Payer: Aetna Medicare |
$297.00
|
| 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 |
$382.68
|
| Rate for Payer: Cofinity Commercial |
$411.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.58
|
| 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: 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 |
$534.56
|
| Rate for Payer: Priority Health Medicare |
$288.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$534.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.58
|
| Rate for Payer: UHC Exchange |
$285.58
|
| 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 |
$1,575.92 |
| Rate for Payer: Aetna Commercial |
$23.13
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| 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: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO |
$23.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.52
|
|
|
PR COMPLETE REPLACEMENT PICC RS&I
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 36584
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$480.86 |
| Rate for Payer: Aetna Commercial |
$74.81
|
| Rate for Payer: Aetna Medicare |
$58.06
|
| 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 |
$80.40
|
| Rate for Payer: Cofinity Commercial |
$74.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.83
|
| 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: 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 |
$90.94
|
| Rate for Payer: Priority Health Medicare |
$56.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.83
|
| Rate for Payer: UHC Exchange |
$55.83
|
| 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 |
$1,712.22 |
| Rate for Payer: Aetna Commercial |
$260.50
|
| Rate for Payer: Aetna Medicare |
$202.18
|
| 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: 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: 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 |
$84.75
|
| Rate for Payer: Priority Health Medicare |
$196.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.40
|
| Rate for Payer: UHC Exchange |
$194.40
|
| 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 |
$2,901.95 |
| Rate for Payer: Aetna Commercial |
$114.68
|
| Rate for Payer: Aetna Medicare |
$89.00
|
| 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: 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: 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 |
$120.26
|
| Rate for Payer: Priority Health Medicare |
$86.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.58
|
| Rate for Payer: UHC Exchange |
$85.58
|
| Rate for Payer: UHC Medicare Advantage |
$85.58
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
|
