|
PR SHORTENING TENDON EXTENSOR HAND/FINGER EACH
|
Professional
|
Both
|
$1,184.00
|
|
|
Service Code
|
HCPCS 26477
|
| Min. Negotiated Rate |
$408.32 |
| Max. Negotiated Rate |
$974.84 |
| Rate for Payer: Aetna Commercial |
$822.68
|
| Rate for Payer: BCBS Complete |
$428.74
|
| Rate for Payer: BCBS Trust/PPO |
$974.19
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Meridian Medicaid |
$428.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$974.84
|
| Rate for Payer: Priority Health Narrow Network |
$974.84
|
| Rate for Payer: Priority Health SBD |
$974.84
|
| Rate for Payer: UMR Bronson Commercial |
$544.64
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$35.93 |
| Max. Negotiated Rate |
$873.81 |
| Rate for Payer: Aetna Commercial |
$153.65
|
| Rate for Payer: BCBS Complete |
$124.40
|
| Rate for Payer: BCBS Trust/PPO |
$873.81
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.93
|
| Rate for Payer: Priority Health Narrow Network |
$35.93
|
| Rate for Payer: Priority Health SBD |
$208.41
|
| Rate for Payer: UMR Bronson Commercial |
$143.06
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$222.77 |
| Rate for Payer: Aetna Commercial |
$150.85
|
| Rate for Payer: Aetna Commercial |
$150.85
|
| Rate for Payer: BCBS Complete |
$112.80
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.48
|
| Rate for Payer: Priority Health Narrow Network |
$35.48
|
| Rate for Payer: Priority Health Narrow Network |
$35.48
|
| Rate for Payer: Priority Health SBD |
$222.77
|
| Rate for Payer: Priority Health SBD |
$222.77
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
| Rate for Payer: UMR Bronson Commercial |
$129.72
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$1,239.39 |
| Rate for Payer: Aetna Commercial |
$166.52
|
| Rate for Payer: BCBS Complete |
$128.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.39
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.28
|
| Rate for Payer: Priority Health Narrow Network |
$37.28
|
| Rate for Payer: Priority Health SBD |
$238.94
|
| Rate for Payer: UMR Bronson Commercial |
$147.66
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 95938
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$556.30 |
| Rate for Payer: Aetna Commercial |
$379.87
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.29
|
| Rate for Payer: Priority Health Narrow Network |
$59.29
|
| Rate for Payer: Priority Health SBD |
$488.66
|
| Rate for Payer: UMR Bronson Commercial |
$55.20
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$68.44
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.45
|
| Rate for Payer: Priority Health Narrow Network |
$76.45
|
| Rate for Payer: Priority Health SBD |
$76.45
|
| Rate for Payer: UMR Bronson Commercial |
$83.26
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$182.70 |
| Rate for Payer: Aetna Commercial |
$80.68
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.66
|
| Rate for Payer: Priority Health Narrow Network |
$91.66
|
| Rate for Payer: Priority Health SBD |
$91.66
|
| Rate for Payer: UMR Bronson Commercial |
$120.06
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$126.10
|
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$131.46
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$135.80
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$122.22
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$49.77
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$71.78
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
11301
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$507.28 |
| Rate for Payer: Aetna Commercial |
$55.41
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$507.28
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.48
|
| Rate for Payer: Priority Health Narrow Network |
$62.48
|
| Rate for Payer: Priority Health SBD |
$62.48
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$85.36 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Aetna American Axle |
$126.10
|
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.10
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$135.80
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health SBD |
$122.22
|
| Rate for Payer: UMR Bronson Commercial |
$85.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$507.28 |
| Rate for Payer: Aetna Commercial |
$55.41
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$507.28
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.48
|
| Rate for Payer: Priority Health Narrow Network |
$62.48
|
| Rate for Payer: Priority Health SBD |
$62.48
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$2,827.44 |
| Rate for Payer: Aetna Commercial |
$76.99
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.31
|
| Rate for Payer: Priority Health Narrow Network |
$86.31
|
| Rate for Payer: Priority Health SBD |
$86.31
|
| Rate for Payer: UMR Bronson Commercial |
$115.92
|
|
|
PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 11302
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$160.30 |
| Rate for Payer: Aetna Commercial |
$65.07
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.75
|
| Rate for Payer: Priority Health Narrow Network |
$72.75
|
| Rate for Payer: Priority Health SBD |
$72.75
|
| Rate for Payer: UMR Bronson Commercial |
$105.34
|
|
|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$223.01 |
| Max. Negotiated Rate |
$782.41 |
| Rate for Payer: Aetna Commercial |
$447.54
|
| Rate for Payer: BCBS Complete |
$234.16
|
| Rate for Payer: BCBS Trust/PPO |
$782.41
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Meridian Medicaid |
$234.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.73
|
| Rate for Payer: Priority Health Narrow Network |
$609.73
|
| Rate for Payer: Priority Health SBD |
$609.73
|
| Rate for Payer: UMR Bronson Commercial |
$352.82
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,001.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$170.19 |
| Max. Negotiated Rate |
$700.70 |
| Rate for Payer: Aetna Commercial |
$339.73
|
| Rate for Payer: BCBS Complete |
$178.70
|
| Rate for Payer: BCBS Trust/PPO |
$395.70
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Meridian Medicaid |
$178.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.91
|
| Rate for Payer: Priority Health Narrow Network |
$463.91
|
| Rate for Payer: Priority Health SBD |
$463.91
|
| Rate for Payer: UMR Bronson Commercial |
$460.46
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$292.22 |
| Rate for Payer: Aetna Commercial |
$215.99
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS Trust/PPO |
$237.74
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.22
|
| Rate for Payer: Priority Health Narrow Network |
$292.22
|
| Rate for Payer: Priority Health SBD |
$292.22
|
| Rate for Payer: UMR Bronson Commercial |
$189.06
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$515.20 |
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
| Rate for Payer: UMR Bronson Commercial |
$338.56
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$518.70 |
| Rate for Payer: Aetna Commercial |
$213.21
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS Trust/PPO |
$333.36
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.53
|
| Rate for Payer: Priority Health Narrow Network |
$277.53
|
| Rate for Payer: Priority Health SBD |
$277.53
|
| Rate for Payer: UMR Bronson Commercial |
$340.86
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$457.80 |
| Rate for Payer: Aetna Commercial |
$155.42
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.44
|
| Rate for Payer: Priority Health Narrow Network |
$203.44
|
| Rate for Payer: Priority Health SBD |
$203.44
|
| Rate for Payer: UMR Bronson Commercial |
$300.84
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$107.36 |
| Max. Negotiated Rate |
$219.60 |
| Rate for Payer: Aetna American Axle |
$158.60
|
| Rate for Payer: Aetna Commercial |
$207.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.60
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$209.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Healthscope Commercial |
$219.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: PHP Commercial |
$207.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health SBD |
$153.72
|
| Rate for Payer: UMR Bronson Commercial |
$107.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.00
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$239.85 |
| Rate for Payer: Aetna Commercial |
$73.39
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS Trust/PPO |
$239.85
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.60
|
| Rate for Payer: Priority Health Narrow Network |
$97.60
|
| Rate for Payer: Priority Health SBD |
$97.60
|
| Rate for Payer: UMR Bronson Commercial |
$112.24
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$2,557.47 |
| Rate for Payer: Aetna American Axle |
$158.60
|
| Rate for Payer: Aetna Commercial |
$207.40
|
| Rate for Payer: Aetna Medicare |
$844.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$888.71
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$209.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$219.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.00
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$207.40
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
| Rate for Payer: Priority Health SBD |
$153.72
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: UMR Bronson Commercial |
$90.28
|
| Rate for Payer: VA VA |
$812.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.00
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$239.85 |
| Rate for Payer: Aetna Commercial |
$73.39
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS Trust/PPO |
$239.85
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.60
|
| Rate for Payer: Priority Health Narrow Network |
$97.60
|
| Rate for Payer: Priority Health SBD |
$97.60
|
| Rate for Payer: UMR Bronson Commercial |
$112.24
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$291.09 |
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS Trust/PPO |
$291.09
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.43
|
| Rate for Payer: Priority Health Narrow Network |
$213.43
|
| Rate for Payer: Priority Health SBD |
$213.43
|
| Rate for Payer: UMR Bronson Commercial |
$133.86
|
|
|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$265.17 |
| Rate for Payer: Aetna Commercial |
$205.04
|
| Rate for Payer: BCBS Complete |
$101.77
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Meridian Medicaid |
$101.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.17
|
| Rate for Payer: Priority Health Narrow Network |
$265.17
|
| Rate for Payer: Priority Health SBD |
$265.17
|
| Rate for Payer: UMR Bronson Commercial |
$167.44
|
|
