|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$145.00 |
| Max. Negotiated Rate |
$241.15 |
| Rate for Payer: Aetna Commercial |
$194.30
|
| Rate for Payer: Aetna Medicare |
$150.80
|
| Rate for Payer: BCBS Complete |
$148.40
|
| Rate for Payer: BCBS MAPPO |
$145.00
|
| Rate for Payer: BCN Medicare Advantage |
$145.00
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$194.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.25
|
| Rate for Payer: Nomi Health Commercial |
$174.00
|
| Rate for Payer: PACE SWMI |
$145.00
|
| Rate for Payer: PHP Medicare Advantage |
$145.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health Medicare |
$146.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.00
|
| Rate for Payer: UHC Exchange |
$145.00
|
| Rate for Payer: UHC Medicare Advantage |
$145.00
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45340
|
| Min. Negotiated Rate |
$73.32 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: Aetna Medicare |
$76.25
|
| Rate for Payer: BCBS Complete |
$128.80
|
| Rate for Payer: BCBS MAPPO |
$73.32
|
| Rate for Payer: BCN Medicare Advantage |
$73.32
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.99
|
| Rate for Payer: Nomi Health Commercial |
$87.98
|
| Rate for Payer: PACE SWMI |
$73.32
|
| Rate for Payer: PHP Medicare Advantage |
$73.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Medicare |
$74.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.32
|
| Rate for Payer: UHC Exchange |
$73.32
|
| Rate for Payer: UHC Medicare Advantage |
$73.32
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX
|
Professional
|
Both
|
$807.00
|
|
|
Service Code
|
HCPCS 45342
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$524.55 |
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna Medicare |
$166.82
|
| Rate for Payer: BCBS Complete |
$322.80
|
| Rate for Payer: BCBS MAPPO |
$160.40
|
| Rate for Payer: BCN Medicare Advantage |
$160.40
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cofinity Commercial |
$230.98
|
| Rate for Payer: Cofinity Commercial |
$214.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.42
|
| Rate for Payer: Nomi Health Commercial |
$192.48
|
| Rate for Payer: PACE SWMI |
$160.40
|
| Rate for Payer: PHP Medicare Advantage |
$160.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.55
|
| Rate for Payer: Priority Health Medicare |
$162.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.40
|
| Rate for Payer: UHC Exchange |
$160.40
|
| Rate for Payer: UHC Medicare Advantage |
$160.40
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$222.95 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$71.32
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$69.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Exchange |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$81.46 |
| Max. Negotiated Rate |
$692.17 |
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna Medicare |
$89.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.19
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$85.75
|
| Rate for Payer: BCBS Trust/PPO |
$281.98
|
| Rate for Payer: BCN Commercial |
$266.68
|
| Rate for Payer: BCN Medicare Advantage |
$85.75
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.75
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.04
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$281.26
|
| Rate for Payer: PACE Senior Care Partners |
$81.46
|
| Rate for Payer: PACE SWMI |
$85.75
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: PHP Medicare Advantage |
$85.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health HMO/PPO |
$298.41
|
| Rate for Payer: Priority Health Medicare |
$86.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$229.81
|
| Rate for Payer: Railroad Medicare Medicare |
$85.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.84
|
| Rate for Payer: UHC Core |
$286.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.75
|
| Rate for Payer: UHC Exchange |
$85.75
|
| Rate for Payer: UHC Medicare Advantage |
$85.75
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$85.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$222.95 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: BCBS Trust/PPO |
$279.99
|
| Rate for Payer: BCN Commercial |
$265.07
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$281.26
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health HMO/PPO |
$298.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$229.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.84
|
| Rate for Payer: UHC Core |
$286.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$222.95 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$71.32
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$69.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Exchange |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$95.10 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$127.43
|
| Rate for Payer: Aetna Medicare |
$98.90
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$95.10
|
| Rate for Payer: BCN Medicare Advantage |
$95.10
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.86
|
| Rate for Payer: Nomi Health Commercial |
$114.12
|
| Rate for Payer: PACE SWMI |
$95.10
|
| Rate for Payer: PHP Medicare Advantage |
$95.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$96.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.10
|
| Rate for Payer: UHC Exchange |
$95.10
|
| Rate for Payer: UHC Medicare Advantage |
$95.10
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$99.25 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.21
|
| Rate for Payer: Nomi Health Commercial |
$119.10
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$100.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Exchange |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$895.16 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna Medicare |
$135.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.50
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$130.00
|
| Rate for Payer: BCBS Trust/PPO |
$427.49
|
| Rate for Payer: BCN Commercial |
$404.30
|
| Rate for Payer: BCN Medicare Advantage |
$130.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.00
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.50
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: Nomi Health Commercial |
$426.40
|
| Rate for Payer: PACE Senior Care Partners |
$123.50
|
| Rate for Payer: PACE SWMI |
$130.00
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: PHP Medicare Advantage |
$130.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO |
$452.40
|
| Rate for Payer: Priority Health Medicare |
$131.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.40
|
| Rate for Payer: Railroad Medicare Medicare |
$130.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.60
|
| Rate for Payer: UHC Core |
$434.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.00
|
| Rate for Payer: UHC Exchange |
$130.00
|
| Rate for Payer: UHC Medicare Advantage |
$130.00
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$130.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.00
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 45332
|
| Min. Negotiated Rate |
$99.25 |
| Max. Negotiated Rate |
$338.00 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.21
|
| Rate for Payer: Nomi Health Commercial |
$119.10
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health Medicare |
$100.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Exchange |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: BCBS Trust/PPO |
$424.48
|
| Rate for Payer: BCN Commercial |
$401.86
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: Nomi Health Commercial |
$426.40
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO |
$452.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.60
|
| Rate for Payer: UHC Core |
$434.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.00
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$178.36 |
| Max. Negotiated Rate |
$692.17 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna Medicare |
$195.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$234.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$234.69
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$187.75
|
| Rate for Payer: BCBS Trust/PPO |
$617.40
|
| Rate for Payer: BCN Commercial |
$583.90
|
| Rate for Payer: BCN Medicare Advantage |
$187.75
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.75
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.14
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PACE Senior Care Partners |
$178.36
|
| Rate for Payer: PACE SWMI |
$187.75
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: PHP Medicare Advantage |
$187.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Medicare |
$189.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: Railroad Medicare Medicare |
$187.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.88
|
| Rate for Payer: UHC Core |
$627.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.75
|
| Rate for Payer: UHC Exchange |
$187.75
|
| Rate for Payer: UHC Medicare Advantage |
$187.75
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$187.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45333
|
| Min. Negotiated Rate |
$89.22 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$119.55
|
| Rate for Payer: Aetna Medicare |
$92.79
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$89.22
|
| Rate for Payer: BCN Medicare Advantage |
$89.22
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$128.48
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.68
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE SWMI |
$89.22
|
| Rate for Payer: PHP Medicare Advantage |
$89.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$90.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.22
|
| Rate for Payer: UHC Exchange |
$89.22
|
| Rate for Payer: UHC Medicare Advantage |
$89.22
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$89.22 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$119.55
|
| Rate for Payer: Aetna Medicare |
$92.79
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: BCBS MAPPO |
$89.22
|
| Rate for Payer: BCN Medicare Advantage |
$89.22
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$128.48
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.68
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE SWMI |
$89.22
|
| Rate for Payer: PHP Medicare Advantage |
$89.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health Medicare |
$90.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.22
|
| Rate for Payer: UHC Exchange |
$89.22
|
| Rate for Payer: UHC Medicare Advantage |
$89.22
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$488.15 |
| Max. Negotiated Rate |
$675.90 |
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: BCBS Trust/PPO |
$613.04
|
| Rate for Payer: BCN Commercial |
$580.37
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: Nomi Health Commercial |
$615.82
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO |
$653.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.88
|
| Rate for Payer: UHC Core |
$627.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SIGMOIDOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 45345
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
|
|
PR SIGMOIDOSCOPY W/STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS G6023
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
|
|
PR SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 93278
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$41.59 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$30.04
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: Nomi Health Commercial |
$34.66
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Medicare |
$29.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Exchange |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$28.88
|
|
|
PR SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 51725
|
| Min. Negotiated Rate |
$188.87 |
| Max. Negotiated Rate |
$349.05 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: BCBS Complete |
$214.80
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health Medicare |
$190.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Exchange |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
|
|
PR SIMPLE IMPLANT REMOVAL, BILATERAL
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 00522
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$612.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Medicare |
$765.00
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
|
|
PR SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$9,729.00
|
|
|
Service Code
|
HCPCS 61700
|
| Min. Negotiated Rate |
$3,376.65 |
| Max. Negotiated Rate |
$6,323.85 |
| Rate for Payer: Aetna Commercial |
$4,524.71
|
| Rate for Payer: Aetna Medicare |
$3,511.72
|
| Rate for Payer: BCBS Complete |
$3,891.60
|
| Rate for Payer: BCBS MAPPO |
$3,376.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,376.65
|
| Rate for Payer: Cash Price |
$7,783.20
|
| Rate for Payer: Cash Price |
$7,783.20
|
| Rate for Payer: Cofinity Commercial |
$4,862.38
|
| Rate for Payer: Cofinity Commercial |
$4,524.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,376.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,545.48
|
| Rate for Payer: Nomi Health Commercial |
$4,051.98
|
| Rate for Payer: PACE SWMI |
$3,376.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,376.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,323.85
|
| Rate for Payer: Priority Health Medicare |
$3,410.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,376.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,376.65
|
| Rate for Payer: UHC Exchange |
$3,376.65
|
| Rate for Payer: UHC Medicare Advantage |
$3,376.65
|
|
|
PR SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$8,669.00
|
|
|
Service Code
|
HCPCS 61702
|
| Min. Negotiated Rate |
$3,467.60 |
| Max. Negotiated Rate |
$5,735.58 |
| Rate for Payer: Aetna Commercial |
$5,337.27
|
| Rate for Payer: Aetna Medicare |
$4,142.36
|
| Rate for Payer: BCBS Complete |
$3,467.60
|
| Rate for Payer: BCBS MAPPO |
$3,983.04
|
| Rate for Payer: BCN Medicare Advantage |
$3,983.04
|
| Rate for Payer: Cash Price |
$6,935.20
|
| Rate for Payer: Cash Price |
$6,935.20
|
| Rate for Payer: Cofinity Commercial |
$5,735.58
|
| Rate for Payer: Cofinity Commercial |
$5,337.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,983.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,182.19
|
| Rate for Payer: Nomi Health Commercial |
$4,779.65
|
| Rate for Payer: PACE SWMI |
$3,983.04
|
| Rate for Payer: PHP Medicare Advantage |
$3,983.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,634.85
|
| Rate for Payer: Priority Health Medicare |
$4,022.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,983.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,983.04
|
| Rate for Payer: UHC Exchange |
$3,983.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,983.04
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 12016
|
| Min. Negotiated Rate |
$124.65 |
| Max. Negotiated Rate |
$431.60 |
| Rate for Payer: Aetna Commercial |
$167.03
|
| Rate for Payer: Aetna Medicare |
$129.64
|
| Rate for Payer: BCBS Complete |
$265.60
|
| Rate for Payer: BCBS MAPPO |
$124.65
|
| Rate for Payer: BCN Medicare Advantage |
$124.65
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$179.50
|
| Rate for Payer: Cofinity Commercial |
$167.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$149.58
|
| Rate for Payer: PACE SWMI |
$124.65
|
| Rate for Payer: PHP Medicare Advantage |
$124.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health Medicare |
$125.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.65
|
| Rate for Payer: UHC Exchange |
$124.65
|
| Rate for Payer: UHC Medicare Advantage |
$124.65
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 12017
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$216.55 |
| Rate for Payer: Aetna Commercial |
$201.51
|
| Rate for Payer: Aetna Medicare |
$156.40
|
| Rate for Payer: BCBS Complete |
$130.00
|
| Rate for Payer: BCBS MAPPO |
$150.38
|
| Rate for Payer: BCN Medicare Advantage |
$150.38
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$216.55
|
| Rate for Payer: Cofinity Commercial |
$201.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.90
|
| Rate for Payer: Nomi Health Commercial |
$180.46
|
| Rate for Payer: PACE SWMI |
$150.38
|
| Rate for Payer: PHP Medicare Advantage |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health Medicare |
$151.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.38
|
| Rate for Payer: UHC Exchange |
$150.38
|
| Rate for Payer: UHC Medicare Advantage |
$150.38
|
|
