|
PR COLPOCENTESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 57020
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$144.35 |
| Rate for Payer: Aetna Commercial |
$92.29
|
| Rate for Payer: Aetna Medicare |
$71.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.17
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$68.87
|
| Rate for Payer: BCN Commercial |
$118.03
|
| Rate for Payer: BCN Medicare Advantage |
$68.87
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$92.29
|
| Rate for Payer: Cofinity Commercial |
$99.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.31
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.76
|
| Rate for Payer: Nomi Health Commercial |
$82.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.75
|
| Rate for Payer: PACE SWMI |
$68.87
|
| Rate for Payer: PHP Commercial |
$96.42
|
| Rate for Payer: PHP Medicare Advantage |
$68.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$119.53
|
| Rate for Payer: Priority Health Medicare |
$68.87
|
| Rate for Payer: Priority Health SBD |
$119.53
|
| Rate for Payer: Priority Health Tiered Network |
$119.53
|
| Rate for Payer: Railroad Medicare Medicare |
$68.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.35
|
| Rate for Payer: UHC Core |
$144.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$68.87
|
| Rate for Payer: UHC Exchange |
$144.35
|
| Rate for Payer: UHC Medicaid |
$43.88
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
| Rate for Payer: UMR Bronson Commercial |
$81.42
|
|
|
PR COLPOCLEISIS LE FORT TYPE
|
Professional
|
Both
|
$2,715.00
|
|
|
Service Code
|
HCPCS 57120
|
| Min. Negotiated Rate |
$302.03 |
| Max. Negotiated Rate |
$2,036.25 |
| Rate for Payer: Aetna Commercial |
$623.73
|
| Rate for Payer: Aetna Medicare |
$484.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.28
|
| Rate for Payer: BCBS Complete |
$317.13
|
| Rate for Payer: BCBS MAPPO |
$465.47
|
| Rate for Payer: BCN Commercial |
$797.27
|
| Rate for Payer: BCN Medicare Advantage |
$465.47
|
| Rate for Payer: Cash Price |
$2,172.00
|
| Rate for Payer: Cash Price |
$2,172.00
|
| Rate for Payer: Cofinity Commercial |
$623.73
|
| Rate for Payer: Cofinity Commercial |
$670.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.74
|
| Rate for Payer: Meridian Medicaid |
$317.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.02
|
| Rate for Payer: Nomi Health Commercial |
$558.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,036.25
|
| Rate for Payer: PACE SWMI |
$465.47
|
| Rate for Payer: PHP Commercial |
$651.66
|
| Rate for Payer: PHP Medicare Advantage |
$465.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$302.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$807.46
|
| Rate for Payer: Priority Health Medicare |
$465.47
|
| Rate for Payer: Priority Health SBD |
$807.46
|
| Rate for Payer: Priority Health Tiered Network |
$807.46
|
| Rate for Payer: Railroad Medicare Medicare |
$465.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.98
|
| Rate for Payer: UHC Core |
$918.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.47
|
| Rate for Payer: UHC Exchange |
$918.98
|
| Rate for Payer: UHC Medicaid |
$302.03
|
| Rate for Payer: UHCCP Medicaid |
$302.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,248.90
|
|
|
PR COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU
|
Professional
|
Both
|
$1,111.00
|
|
|
Service Code
|
HCPCS 57210
|
| Min. Negotiated Rate |
$226.42 |
| Max. Negotiated Rate |
$833.25 |
| Rate for Payer: Aetna Commercial |
$465.82
|
| Rate for Payer: Aetna Medicare |
$361.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.59
|
| Rate for Payer: BCBS Complete |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$347.63
|
| Rate for Payer: BCN Commercial |
$590.60
|
| Rate for Payer: BCN Medicare Advantage |
$347.63
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Cash Price |
$888.80
|
| Rate for Payer: Cofinity Commercial |
$465.82
|
| Rate for Payer: Cofinity Commercial |
$500.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.01
|
| Rate for Payer: Meridian Medicaid |
$237.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$382.39
|
| Rate for Payer: Nomi Health Commercial |
$417.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.25
|
| Rate for Payer: PACE SWMI |
$347.63
|
| Rate for Payer: PHP Commercial |
$486.68
|
| Rate for Payer: PHP Medicare Advantage |
$347.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$598.16
|
| Rate for Payer: Priority Health Medicare |
$347.63
|
| Rate for Payer: Priority Health SBD |
$598.16
|
| Rate for Payer: Priority Health Tiered Network |
$598.16
|
| Rate for Payer: Railroad Medicare Medicare |
$347.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.24
|
| Rate for Payer: UHC Core |
$671.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$347.63
|
| Rate for Payer: UHC Exchange |
$671.24
|
| Rate for Payer: UHC Medicaid |
$226.42
|
| Rate for Payer: UHCCP Medicaid |
$226.42
|
| Rate for Payer: UMR Bronson Commercial |
$511.06
|
|
|
PR COLPOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,166.00
|
|
|
Service Code
|
HCPCS 57280
|
| Min. Negotiated Rate |
$546.35 |
| Max. Negotiated Rate |
$1,703.48 |
| Rate for Payer: Aetna Commercial |
$1,137.62
|
| Rate for Payer: Aetna Medicare |
$882.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,137.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,222.52
|
| Rate for Payer: BCBS Complete |
$573.67
|
| Rate for Payer: BCBS MAPPO |
$848.97
|
| Rate for Payer: BCN Commercial |
$1,446.14
|
| Rate for Payer: BCN Medicare Advantage |
$848.97
|
| Rate for Payer: Cash Price |
$1,732.80
|
| Rate for Payer: Cash Price |
$1,732.80
|
| Rate for Payer: Cofinity Commercial |
$1,137.62
|
| Rate for Payer: Cofinity Commercial |
$1,222.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$891.42
|
| Rate for Payer: Meridian Medicaid |
$573.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$933.87
|
| Rate for Payer: Nomi Health Commercial |
$1,018.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,624.50
|
| Rate for Payer: PACE SWMI |
$848.97
|
| Rate for Payer: PHP Commercial |
$1,188.56
|
| Rate for Payer: PHP Medicare Advantage |
$848.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,464.62
|
| Rate for Payer: Priority Health Medicare |
$848.97
|
| Rate for Payer: Priority Health SBD |
$1,464.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,464.62
|
| Rate for Payer: Railroad Medicare Medicare |
$848.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,703.48
|
| Rate for Payer: UHC Core |
$1,703.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$848.97
|
| Rate for Payer: UHC Exchange |
$1,703.48
|
| Rate for Payer: UHC Medicaid |
$546.35
|
| Rate for Payer: UHCCP Medicaid |
$546.35
|
| Rate for Payer: UMR Bronson Commercial |
$996.36
|
|
|
PR COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$2,192.00
|
|
|
Service Code
|
HCPCS 57282
|
| Min. Negotiated Rate |
$392.35 |
| Max. Negotiated Rate |
$1,644.00 |
| Rate for Payer: Aetna Commercial |
$814.93
|
| Rate for Payer: Aetna Medicare |
$632.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.75
|
| Rate for Payer: BCBS Complete |
$411.97
|
| Rate for Payer: BCBS MAPPO |
$608.16
|
| Rate for Payer: BCN Commercial |
$1,040.28
|
| Rate for Payer: BCN Medicare Advantage |
$608.16
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cofinity Commercial |
$814.93
|
| Rate for Payer: Cofinity Commercial |
$875.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$608.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$638.57
|
| Rate for Payer: Meridian Medicaid |
$411.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$668.98
|
| Rate for Payer: Nomi Health Commercial |
$729.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,644.00
|
| Rate for Payer: PACE SWMI |
$608.16
|
| Rate for Payer: PHP Commercial |
$851.42
|
| Rate for Payer: PHP Medicare Advantage |
$608.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,053.58
|
| Rate for Payer: Priority Health Medicare |
$608.16
|
| Rate for Payer: Priority Health SBD |
$1,053.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,053.58
|
| Rate for Payer: Railroad Medicare Medicare |
$608.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.98
|
| Rate for Payer: UHC Core |
$920.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$608.16
|
| Rate for Payer: UHC Exchange |
$920.98
|
| Rate for Payer: UHC Medicaid |
$392.35
|
| Rate for Payer: UHCCP Medicaid |
$392.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,008.32
|
|
|
PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 57283
|
| Min. Negotiated Rate |
$394.69 |
| Max. Negotiated Rate |
$1,235.16 |
| Rate for Payer: Aetna Commercial |
$820.32
|
| Rate for Payer: Aetna Medicare |
$636.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.54
|
| Rate for Payer: BCBS Complete |
$414.42
|
| Rate for Payer: BCBS MAPPO |
$612.18
|
| Rate for Payer: BCN Commercial |
$1,048.75
|
| Rate for Payer: BCN Medicare Advantage |
$612.18
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$820.32
|
| Rate for Payer: Cofinity Commercial |
$881.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$612.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.79
|
| Rate for Payer: Meridian Medicaid |
$414.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$673.40
|
| Rate for Payer: Nomi Health Commercial |
$734.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.25
|
| Rate for Payer: PACE SWMI |
$612.18
|
| Rate for Payer: PHP Commercial |
$857.05
|
| Rate for Payer: PHP Medicare Advantage |
$612.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,062.16
|
| Rate for Payer: Priority Health Medicare |
$612.18
|
| Rate for Payer: Priority Health SBD |
$1,062.16
|
| Rate for Payer: Priority Health Tiered Network |
$1,062.16
|
| Rate for Payer: Railroad Medicare Medicare |
$612.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,235.16
|
| Rate for Payer: UHC Core |
$1,235.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$612.18
|
| Rate for Payer: UHC Exchange |
$1,235.16
|
| Rate for Payer: UHC Medicaid |
$394.69
|
| Rate for Payer: UHCCP Medicaid |
$394.69
|
| Rate for Payer: UMR Bronson Commercial |
$551.54
|
|
|
PR COLPORRHAPHY SUTURE INJURY VAGINA
|
Professional
|
Both
|
$901.00
|
|
|
Service Code
|
HCPCS 57200
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$675.75 |
| Rate for Payer: Aetna Commercial |
$397.19
|
| Rate for Payer: Aetna Medicare |
$308.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.83
|
| Rate for Payer: BCBS Complete |
$203.97
|
| Rate for Payer: BCBS MAPPO |
$296.41
|
| Rate for Payer: BCN Commercial |
$499.97
|
| Rate for Payer: BCN Medicare Advantage |
$296.41
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cash Price |
$720.80
|
| Rate for Payer: Cofinity Commercial |
$397.19
|
| Rate for Payer: Cofinity Commercial |
$426.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.23
|
| Rate for Payer: Meridian Medicaid |
$203.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.05
|
| Rate for Payer: Nomi Health Commercial |
$355.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$675.75
|
| Rate for Payer: PACE SWMI |
$296.41
|
| Rate for Payer: PHP Commercial |
$414.97
|
| Rate for Payer: PHP Medicare Advantage |
$296.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$506.37
|
| Rate for Payer: Priority Health Medicare |
$296.41
|
| Rate for Payer: Priority Health SBD |
$506.37
|
| Rate for Payer: Priority Health Tiered Network |
$506.37
|
| Rate for Payer: Railroad Medicare Medicare |
$296.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.07
|
| Rate for Payer: UHC Core |
$554.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$296.41
|
| Rate for Payer: UHC Exchange |
$554.07
|
| Rate for Payer: UHC Medicaid |
$194.26
|
| Rate for Payer: UHCCP Medicaid |
$194.26
|
| Rate for Payer: UMR Bronson Commercial |
$414.46
|
|
|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna Commercial |
$158.17
|
| Rate for Payer: Aetna Medicare |
$122.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.98
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$118.04
|
| Rate for Payer: BCN Commercial |
$157.87
|
| Rate for Payer: BCN Medicare Advantage |
$118.04
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$158.17
|
| Rate for Payer: Cofinity Commercial |
$169.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.94
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.84
|
| Rate for Payer: Nomi Health Commercial |
$141.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.00
|
| Rate for Payer: PACE SWMI |
$118.04
|
| Rate for Payer: PHP Commercial |
$165.26
|
| Rate for Payer: PHP Medicare Advantage |
$118.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.74
|
| Rate for Payer: Priority Health Medicare |
$118.04
|
| Rate for Payer: Priority Health SBD |
$202.74
|
| Rate for Payer: Priority Health Tiered Network |
$202.74
|
| Rate for Payer: Railroad Medicare Medicare |
$118.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.89
|
| Rate for Payer: UHC Core |
$237.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.04
|
| Rate for Payer: UHC Exchange |
$237.89
|
| Rate for Payer: UHC Medicaid |
$75.83
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
| Rate for Payer: UMR Bronson Commercial |
$171.12
|
|
|
PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 57456
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$281.25 |
| Rate for Payer: Aetna Commercial |
$119.30
|
| Rate for Payer: Aetna Medicare |
$92.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.20
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$89.03
|
| Rate for Payer: BCN Commercial |
$118.20
|
| Rate for Payer: BCN Medicare Advantage |
$89.03
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$119.30
|
| Rate for Payer: Cofinity Commercial |
$128.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.48
|
| Rate for Payer: Meridian Medicaid |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.93
|
| Rate for Payer: Nomi Health Commercial |
$106.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE SWMI |
$89.03
|
| Rate for Payer: PHP Commercial |
$124.64
|
| Rate for Payer: PHP Medicare Advantage |
$89.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$151.80
|
| Rate for Payer: Priority Health Medicare |
$89.03
|
| Rate for Payer: Priority Health SBD |
$151.80
|
| Rate for Payer: Priority Health Tiered Network |
$151.80
|
| Rate for Payer: Railroad Medicare Medicare |
$89.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.86
|
| Rate for Payer: UHC Core |
$180.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.03
|
| Rate for Payer: UHC Exchange |
$180.86
|
| Rate for Payer: UHC Medicaid |
$56.87
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
| Rate for Payer: UMR Bronson Commercial |
$172.50
|
|
|
PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Professional
|
Both
|
$287.00
|
|
|
Service Code
|
HCPCS 57452
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$215.25 |
| Rate for Payer: Aetna Commercial |
$109.13
|
| Rate for Payer: Aetna Medicare |
$84.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.27
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCBS MAPPO |
$81.44
|
| Rate for Payer: BCN Commercial |
$107.60
|
| Rate for Payer: BCN Medicare Advantage |
$81.44
|
| Rate for Payer: Cash Price |
$229.60
|
| Rate for Payer: Cash Price |
$229.60
|
| Rate for Payer: Cofinity Commercial |
$109.13
|
| Rate for Payer: Cofinity Commercial |
$117.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.51
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.58
|
| Rate for Payer: Nomi Health Commercial |
$97.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.25
|
| Rate for Payer: PACE SWMI |
$81.44
|
| Rate for Payer: PHP Commercial |
$114.02
|
| Rate for Payer: PHP Medicare Advantage |
$81.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$138.19
|
| Rate for Payer: Priority Health Medicare |
$81.44
|
| Rate for Payer: Priority Health SBD |
$138.19
|
| Rate for Payer: Priority Health Tiered Network |
$138.19
|
| Rate for Payer: Railroad Medicare Medicare |
$81.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.97
|
| Rate for Payer: UHC Core |
$160.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$81.44
|
| Rate for Payer: UHC Exchange |
$160.97
|
| Rate for Payer: UHC Medicaid |
$52.61
|
| Rate for Payer: UHCCP Medicaid |
$52.61
|
| Rate for Payer: UMR Bronson Commercial |
$132.02
|
|
|
PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX
|
Professional
|
Both
|
$375.00
|
|
|
Service Code
|
HCPCS 57455
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$281.25 |
| Rate for Payer: Aetna Commercial |
$129.14
|
| Rate for Payer: Aetna Medicare |
$100.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.77
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$96.37
|
| Rate for Payer: BCN Commercial |
$128.41
|
| Rate for Payer: BCN Medicare Advantage |
$96.37
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$129.14
|
| Rate for Payer: Cofinity Commercial |
$138.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.19
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.01
|
| Rate for Payer: Nomi Health Commercial |
$115.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE SWMI |
$96.37
|
| Rate for Payer: PHP Commercial |
$134.92
|
| Rate for Payer: PHP Medicare Advantage |
$96.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$164.92
|
| Rate for Payer: Priority Health Medicare |
$96.37
|
| Rate for Payer: Priority Health SBD |
$164.92
|
| Rate for Payer: Priority Health Tiered Network |
$164.92
|
| Rate for Payer: Railroad Medicare Medicare |
$96.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.54
|
| Rate for Payer: UHC Core |
$195.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.37
|
| Rate for Payer: UHC Exchange |
$195.54
|
| Rate for Payer: UHC Medicaid |
$61.56
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
| Rate for Payer: UMR Bronson Commercial |
$172.50
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$989.00
|
|
|
Service Code
|
HCPCS 57461
|
| Min. Negotiated Rate |
$103.09 |
| Max. Negotiated Rate |
$741.75 |
| Rate for Payer: Aetna Commercial |
$216.58
|
| Rate for Payer: Aetna Medicare |
$168.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.75
|
| Rate for Payer: BCBS Complete |
$108.24
|
| Rate for Payer: BCBS MAPPO |
$161.63
|
| Rate for Payer: BCN Commercial |
$273.89
|
| Rate for Payer: BCN Medicare Advantage |
$161.63
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cash Price |
$791.20
|
| Rate for Payer: Cofinity Commercial |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$232.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.71
|
| Rate for Payer: Meridian Medicaid |
$108.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.79
|
| Rate for Payer: Nomi Health Commercial |
$193.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.75
|
| Rate for Payer: PACE SWMI |
$161.63
|
| Rate for Payer: PHP Commercial |
$226.28
|
| Rate for Payer: PHP Medicare Advantage |
$161.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$277.40
|
| Rate for Payer: Priority Health Medicare |
$161.63
|
| Rate for Payer: Priority Health SBD |
$277.40
|
| Rate for Payer: Priority Health Tiered Network |
$277.40
|
| Rate for Payer: Railroad Medicare Medicare |
$161.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.86
|
| Rate for Payer: UHC Core |
$330.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.63
|
| Rate for Payer: UHC Exchange |
$330.86
|
| Rate for Payer: UHC Medicaid |
$103.09
|
| Rate for Payer: UHCCP Medicaid |
$103.09
|
| Rate for Payer: UMR Bronson Commercial |
$454.94
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$666.00
|
|
|
Service Code
|
HCPCS 57460
|
| Min. Negotiated Rate |
$90.31 |
| Max. Negotiated Rate |
$499.50 |
| Rate for Payer: Aetna Commercial |
$188.65
|
| Rate for Payer: Aetna Medicare |
$146.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.72
|
| Rate for Payer: BCBS Complete |
$94.83
|
| Rate for Payer: BCBS MAPPO |
$140.78
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: BCN Medicare Advantage |
$140.78
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cofinity Commercial |
$188.65
|
| Rate for Payer: Cofinity Commercial |
$202.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.82
|
| Rate for Payer: Meridian Medicaid |
$94.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.86
|
| Rate for Payer: Nomi Health Commercial |
$168.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$499.50
|
| Rate for Payer: PACE SWMI |
$140.78
|
| Rate for Payer: PHP Commercial |
$197.09
|
| Rate for Payer: PHP Medicare Advantage |
$140.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$242.60
|
| Rate for Payer: Priority Health Medicare |
$140.78
|
| Rate for Payer: Priority Health SBD |
$242.60
|
| Rate for Payer: Priority Health Tiered Network |
$242.60
|
| Rate for Payer: Railroad Medicare Medicare |
$140.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.19
|
| Rate for Payer: UHC Core |
$285.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.78
|
| Rate for Payer: UHC Exchange |
$285.19
|
| Rate for Payer: UHC Medicaid |
$90.31
|
| Rate for Payer: UHCCP Medicaid |
$90.31
|
| Rate for Payer: UMR Bronson Commercial |
$306.36
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 57420
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Aetna Commercial |
$108.27
|
| Rate for Payer: Aetna Medicare |
$84.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.35
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$80.80
|
| Rate for Payer: BCN Commercial |
$134.95
|
| Rate for Payer: BCN Medicare Advantage |
$80.80
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$108.27
|
| Rate for Payer: Cofinity Commercial |
$116.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.84
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.88
|
| Rate for Payer: Nomi Health Commercial |
$96.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.50
|
| Rate for Payer: PACE SWMI |
$80.80
|
| Rate for Payer: PHP Commercial |
$113.12
|
| Rate for Payer: PHP Medicare Advantage |
$80.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$136.68
|
| Rate for Payer: Priority Health Medicare |
$80.80
|
| Rate for Payer: Priority Health SBD |
$136.68
|
| Rate for Payer: Priority Health Tiered Network |
$136.68
|
| Rate for Payer: Railroad Medicare Medicare |
$80.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.45
|
| Rate for Payer: UHC Core |
$160.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.80
|
| Rate for Payer: UHC Exchange |
$160.45
|
| Rate for Payer: UHC Medicaid |
$51.76
|
| Rate for Payer: UHCCP Medicaid |
$51.76
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 57421
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$235.50 |
| Rate for Payer: Aetna Commercial |
$146.06
|
| Rate for Payer: Aetna Medicare |
$113.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.96
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$109.00
|
| Rate for Payer: BCN Commercial |
$182.76
|
| Rate for Payer: BCN Medicare Advantage |
$109.00
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$146.06
|
| Rate for Payer: Cofinity Commercial |
$156.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.45
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.90
|
| Rate for Payer: Nomi Health Commercial |
$130.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$109.00
|
| Rate for Payer: PHP Commercial |
$152.60
|
| Rate for Payer: PHP Medicare Advantage |
$109.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$185.09
|
| Rate for Payer: Priority Health Medicare |
$109.00
|
| Rate for Payer: Priority Health SBD |
$185.09
|
| Rate for Payer: Priority Health Tiered Network |
$185.09
|
| Rate for Payer: Railroad Medicare Medicare |
$109.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.57
|
| Rate for Payer: UHC Core |
$217.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.00
|
| Rate for Payer: UHC Exchange |
$217.57
|
| Rate for Payer: UHC Medicaid |
$69.65
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
| Rate for Payer: UMR Bronson Commercial |
$144.44
|
|
|
PR COLPOSCOPY VULVA
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 56820
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$100.65
|
| Rate for Payer: Aetna Medicare |
$78.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.16
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$75.11
|
| Rate for Payer: BCN Commercial |
$125.99
|
| Rate for Payer: BCN Medicare Advantage |
$75.11
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$100.65
|
| Rate for Payer: Cofinity Commercial |
$108.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.87
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.62
|
| Rate for Payer: Nomi Health Commercial |
$90.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$75.11
|
| Rate for Payer: PHP Commercial |
$105.15
|
| Rate for Payer: PHP Medicare Advantage |
$75.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.60
|
| Rate for Payer: Priority Health Medicare |
$75.11
|
| Rate for Payer: Priority Health SBD |
$127.60
|
| Rate for Payer: Priority Health Tiered Network |
$127.60
|
| Rate for Payer: Railroad Medicare Medicare |
$75.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.19
|
| Rate for Payer: UHC Core |
$151.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.11
|
| Rate for Payer: UHC Exchange |
$151.19
|
| Rate for Payer: UHC Medicaid |
$48.14
|
| Rate for Payer: UHCCP Medicaid |
$48.14
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$106.69 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$235.30
|
| Rate for Payer: Aetna Commercial |
$307.70
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$106.69
|
| Rate for Payer: BCN Commercial |
$106.69
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Advantage |
$253.40
|
| Rate for Payer: Cofinity Commercial |
$311.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$325.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.50
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.70
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.50
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$307.70
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$228.06
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$133.94
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.50
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
HCPCS 56821
|
| Min. Negotiated Rate |
$64.54 |
| Max. Negotiated Rate |
$271.50 |
| Rate for Payer: Aetna Commercial |
$135.27
|
| Rate for Payer: Aetna Medicare |
$104.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.37
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS MAPPO |
$100.95
|
| Rate for Payer: BCN Commercial |
$169.81
|
| Rate for Payer: BCN Medicare Advantage |
$100.95
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$135.27
|
| Rate for Payer: Cofinity Commercial |
$145.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.00
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.05
|
| Rate for Payer: Nomi Health Commercial |
$121.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.50
|
| Rate for Payer: PACE SWMI |
$100.95
|
| Rate for Payer: PHP Commercial |
$141.33
|
| Rate for Payer: PHP Medicare Advantage |
$100.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.98
|
| Rate for Payer: Priority Health Medicare |
$100.95
|
| Rate for Payer: Priority Health SBD |
$171.98
|
| Rate for Payer: Priority Health Tiered Network |
$171.98
|
| Rate for Payer: Railroad Medicare Medicare |
$100.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.24
|
| Rate for Payer: UHC Core |
$202.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.95
|
| Rate for Payer: UHC Exchange |
$202.24
|
| Rate for Payer: UHC Medicaid |
$64.54
|
| Rate for Payer: UHCCP Medicaid |
$64.54
|
| Rate for Payer: UMR Bronson Commercial |
$166.52
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$159.28 |
| Max. Negotiated Rate |
$325.80 |
| Rate for Payer: Aetna American Axle |
$235.30
|
| Rate for Payer: Aetna Commercial |
$307.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.30
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Advantage |
$253.40
|
| Rate for Payer: Cofinity Commercial |
$311.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$289.60
|
| Rate for Payer: Healthscope Commercial |
$325.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$253.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.50
|
| Rate for Payer: PHP Commercial |
$307.70
|
| Rate for Payer: Priority Health SBD |
$228.06
|
| Rate for Payer: UMR Bronson Commercial |
$159.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.50
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
HCPCS 56821
|
| Hospital Charge Code |
56821
|
| Min. Negotiated Rate |
$64.54 |
| Max. Negotiated Rate |
$271.50 |
| Rate for Payer: Aetna Commercial |
$135.27
|
| Rate for Payer: Aetna Medicare |
$104.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.37
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS MAPPO |
$100.95
|
| Rate for Payer: BCN Commercial |
$169.81
|
| Rate for Payer: BCN Medicare Advantage |
$100.95
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Cofinity Commercial |
$135.27
|
| Rate for Payer: Cofinity Commercial |
$145.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.00
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.05
|
| Rate for Payer: Nomi Health Commercial |
$121.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.50
|
| Rate for Payer: PACE SWMI |
$100.95
|
| Rate for Payer: PHP Commercial |
$141.33
|
| Rate for Payer: PHP Medicare Advantage |
$100.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.98
|
| Rate for Payer: Priority Health Medicare |
$100.95
|
| Rate for Payer: Priority Health SBD |
$171.98
|
| Rate for Payer: Priority Health Tiered Network |
$171.98
|
| Rate for Payer: Railroad Medicare Medicare |
$100.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.24
|
| Rate for Payer: UHC Core |
$202.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.95
|
| Rate for Payer: UHC Exchange |
$202.24
|
| Rate for Payer: UHC Medicaid |
$64.54
|
| Rate for Payer: UHCCP Medicaid |
$64.54
|
| Rate for Payer: UMR Bronson Commercial |
$166.52
|
|
|
PR COLPOTOMY W/DRAINAGE PELVIC ABSCESS
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 57010
|
| Min. Negotiated Rate |
$260.50 |
| Max. Negotiated Rate |
$786.24 |
| Rate for Payer: Aetna Commercial |
$537.05
|
| Rate for Payer: Aetna Medicare |
$416.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.12
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS MAPPO |
$400.78
|
| Rate for Payer: BCN Commercial |
$687.71
|
| Rate for Payer: BCN Medicare Advantage |
$400.78
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$537.05
|
| Rate for Payer: Cofinity Commercial |
$577.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.82
|
| Rate for Payer: Meridian Medicaid |
$273.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.86
|
| Rate for Payer: Nomi Health Commercial |
$480.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$774.75
|
| Rate for Payer: PACE SWMI |
$400.78
|
| Rate for Payer: PHP Commercial |
$561.09
|
| Rate for Payer: PHP Medicare Advantage |
$400.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$696.51
|
| Rate for Payer: Priority Health Medicare |
$400.78
|
| Rate for Payer: Priority Health SBD |
$696.51
|
| Rate for Payer: Priority Health Tiered Network |
$696.51
|
| Rate for Payer: Railroad Medicare Medicare |
$400.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$786.24
|
| Rate for Payer: UHC Core |
$786.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$400.78
|
| Rate for Payer: UHC Exchange |
$786.24
|
| Rate for Payer: UHC Medicaid |
$260.50
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
| Rate for Payer: UMR Bronson Commercial |
$475.18
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,467.00
|
|
|
Service Code
|
HCPCS 45382
|
| Min. Negotiated Rate |
$144.63 |
| Max. Negotiated Rate |
$1,100.25 |
| Rate for Payer: Aetna Commercial |
$299.97
|
| Rate for Payer: Aetna Medicare |
$232.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.36
|
| Rate for Payer: BCBS Complete |
$151.86
|
| Rate for Payer: BCBS MAPPO |
$223.86
|
| Rate for Payer: BCN Commercial |
$380.96
|
| Rate for Payer: BCN Medicare Advantage |
$223.86
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cofinity Commercial |
$299.97
|
| Rate for Payer: Cofinity Commercial |
$322.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.05
|
| Rate for Payer: Meridian Medicaid |
$151.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$246.25
|
| Rate for Payer: Nomi Health Commercial |
$268.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,100.25
|
| Rate for Payer: PACE SWMI |
$223.86
|
| Rate for Payer: PHP Commercial |
$313.40
|
| Rate for Payer: PHP Medicare Advantage |
$223.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$464.17
|
| Rate for Payer: Priority Health Medicare |
$223.86
|
| Rate for Payer: Priority Health SBD |
$464.17
|
| Rate for Payer: Priority Health Tiered Network |
$464.17
|
| Rate for Payer: Railroad Medicare Medicare |
$223.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.36
|
| Rate for Payer: UHC Core |
$457.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.86
|
| Rate for Payer: UHC Exchange |
$457.36
|
| Rate for Payer: UHC Medicaid |
$144.63
|
| Rate for Payer: UHCCP Medicaid |
$144.63
|
| Rate for Payer: UMR Bronson Commercial |
$674.82
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,360.00
|
|
|
Service Code
|
HCPCS 45386
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$1,020.00 |
| Rate for Payer: Aetna Commercial |
$247.83
|
| Rate for Payer: Aetna Medicare |
$192.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.33
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$184.95
|
| Rate for Payer: BCN Commercial |
$313.23
|
| Rate for Payer: BCN Medicare Advantage |
$184.95
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cash Price |
$1,088.00
|
| Rate for Payer: Cofinity Commercial |
$247.83
|
| Rate for Payer: Cofinity Commercial |
$266.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.20
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.44
|
| Rate for Payer: Nomi Health Commercial |
$221.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,020.00
|
| Rate for Payer: PACE SWMI |
$184.95
|
| Rate for Payer: PHP Commercial |
$258.93
|
| Rate for Payer: PHP Medicare Advantage |
$184.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$381.65
|
| Rate for Payer: Priority Health Medicare |
$184.95
|
| Rate for Payer: Priority Health SBD |
$381.65
|
| Rate for Payer: Priority Health Tiered Network |
$381.65
|
| Rate for Payer: Railroad Medicare Medicare |
$184.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.51
|
| Rate for Payer: UHC Core |
$373.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$184.95
|
| Rate for Payer: UHC Exchange |
$373.51
|
| Rate for Payer: UHC Medicaid |
$119.49
|
| Rate for Payer: UHCCP Medicaid |
$119.49
|
| Rate for Payer: UMR Bronson Commercial |
$625.60
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
OP
|
$1,448.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$535.76 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna American Axle |
$941.20
|
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Advantage |
$1,013.60
|
| 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 |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,013.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.00
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.00
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$912.24
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: UMR Bronson Commercial |
$535.76
|
| Rate for Payer: VA VA |
$1,192.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.00
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45381
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$1,086.00 |
| Rate for Payer: Aetna Commercial |
$234.97
|
| Rate for Payer: Aetna Medicare |
$182.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.50
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$175.35
|
| Rate for Payer: BCN Commercial |
$296.80
|
| Rate for Payer: BCN Medicare Advantage |
$175.35
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$234.97
|
| Rate for Payer: Cofinity Commercial |
$252.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.12
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.88
|
| Rate for Payer: Nomi Health Commercial |
$210.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.00
|
| Rate for Payer: PACE SWMI |
$175.35
|
| Rate for Payer: PHP Commercial |
$245.49
|
| Rate for Payer: PHP Medicare Advantage |
$175.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$361.64
|
| Rate for Payer: Priority Health Medicare |
$175.35
|
| Rate for Payer: Priority Health SBD |
$361.64
|
| Rate for Payer: Priority Health Tiered Network |
$361.64
|
| Rate for Payer: Railroad Medicare Medicare |
$175.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.85
|
| Rate for Payer: UHC Core |
$353.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.35
|
| Rate for Payer: UHC Exchange |
$353.85
|
| Rate for Payer: UHC Medicaid |
$113.32
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
| Rate for Payer: UMR Bronson Commercial |
$666.08
|
|
