|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
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
|
|
|
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 W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX
|
Professional
|
Both
|
$560.00
|
|
|
Service Code
|
HCPCS 45391
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$461.75 |
| Rate for Payer: Aetna Commercial |
$298.98
|
| Rate for Payer: Aetna Medicare |
$232.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.29
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$223.12
|
| Rate for Payer: BCN Commercial |
$378.96
|
| Rate for Payer: BCN Medicare Advantage |
$223.12
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$298.98
|
| Rate for Payer: Cofinity Commercial |
$321.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.28
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$245.43
|
| Rate for Payer: Nomi Health Commercial |
$267.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$420.00
|
| Rate for Payer: PACE SWMI |
$223.12
|
| Rate for Payer: PHP Commercial |
$312.37
|
| Rate for Payer: PHP Medicare Advantage |
$223.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$461.75
|
| Rate for Payer: Priority Health Medicare |
$223.12
|
| Rate for Payer: Priority Health SBD |
$461.75
|
| Rate for Payer: Priority Health Tiered Network |
$461.75
|
| Rate for Payer: Railroad Medicare Medicare |
$223.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.26
|
| Rate for Payer: UHC Core |
$454.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.12
|
| Rate for Payer: UHC Exchange |
$454.26
|
| Rate for Payer: UHC Medicaid |
$144.20
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
| Rate for Payer: UMR Bronson Commercial |
$257.60
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Facility
|
IP
|
$1,491.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
45384
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$656.04 |
| Max. Negotiated Rate |
$1,341.90 |
| Rate for Payer: Aetna American Axle |
$969.15
|
| Rate for Payer: Aetna Commercial |
$1,267.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.15
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Advantage |
$1,043.70
|
| Rate for Payer: Cofinity Commercial |
$1,282.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,192.80
|
| Rate for Payer: Healthscope Commercial |
$1,341.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,043.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PHP Commercial |
$1,267.35
|
| Rate for Payer: Priority Health SBD |
$939.33
|
| Rate for Payer: UMR Bronson Commercial |
$656.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.25
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,491.00
|
|
|
Service Code
|
HCPCS 45384
|
| Hospital Charge Code |
45384
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$1,118.25 |
| Rate for Payer: Aetna Commercial |
$270.21
|
| Rate for Payer: Aetna Medicare |
$209.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.38
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS MAPPO |
$201.65
|
| Rate for Payer: BCN Commercial |
$337.13
|
| Rate for Payer: BCN Medicare Advantage |
$201.65
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Commercial |
$270.21
|
| Rate for Payer: Cofinity Commercial |
$290.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.73
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.81
|
| Rate for Payer: Nomi Health Commercial |
$241.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PACE SWMI |
$201.65
|
| Rate for Payer: PHP Commercial |
$282.31
|
| Rate for Payer: PHP Medicare Advantage |
$201.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$410.78
|
| Rate for Payer: Priority Health Medicare |
$201.65
|
| Rate for Payer: Priority Health SBD |
$410.78
|
| Rate for Payer: Priority Health Tiered Network |
$410.78
|
| Rate for Payer: Railroad Medicare Medicare |
$201.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.91
|
| Rate for Payer: UHC Core |
$403.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.65
|
| Rate for Payer: UHC Exchange |
$403.91
|
| Rate for Payer: UHC Medicaid |
$129.72
|
| Rate for Payer: UHCCP Medicaid |
$129.72
|
| Rate for Payer: UMR Bronson Commercial |
$685.86
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Facility
|
OP
|
$1,491.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
45384
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$551.67 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna American Axle |
$969.15
|
| Rate for Payer: Aetna Commercial |
$1,267.35
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.15
|
| 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 |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Advantage |
$1,043.70
|
| Rate for Payer: Cofinity Commercial |
$1,282.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,341.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,043.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.25
|
| 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 |
$1,267.35
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,267.35
|
| 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 |
$939.33
|
| 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 |
$551.67
|
| Rate for Payer: VA VA |
$1,192.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.25
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,491.00
|
|
|
Service Code
|
HCPCS 45384
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$1,118.25 |
| Rate for Payer: Aetna Commercial |
$270.21
|
| Rate for Payer: Aetna Medicare |
$209.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.38
|
| Rate for Payer: BCBS Complete |
$136.21
|
| Rate for Payer: BCBS MAPPO |
$201.65
|
| Rate for Payer: BCN Commercial |
$337.13
|
| Rate for Payer: BCN Medicare Advantage |
$201.65
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Commercial |
$270.21
|
| Rate for Payer: Cofinity Commercial |
$290.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.73
|
| Rate for Payer: Meridian Medicaid |
$136.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.81
|
| Rate for Payer: Nomi Health Commercial |
$241.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PACE SWMI |
$201.65
|
| Rate for Payer: PHP Commercial |
$282.31
|
| Rate for Payer: PHP Medicare Advantage |
$201.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$410.78
|
| Rate for Payer: Priority Health Medicare |
$201.65
|
| Rate for Payer: Priority Health SBD |
$410.78
|
| Rate for Payer: Priority Health Tiered Network |
$410.78
|
| Rate for Payer: Railroad Medicare Medicare |
$201.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.91
|
| Rate for Payer: UHC Core |
$403.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.65
|
| Rate for Payer: UHC Exchange |
$403.91
|
| Rate for Payer: UHC Medicaid |
$129.72
|
| Rate for Payer: UHCCP Medicaid |
$129.72
|
| Rate for Payer: UMR Bronson Commercial |
$685.86
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$1,491.00
|
|
|
Service Code
|
HCPCS 45385
|
| Hospital Charge Code |
45385
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$1,118.25 |
| Rate for Payer: Aetna Commercial |
$295.67
|
| Rate for Payer: Aetna Medicare |
$229.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.74
|
| Rate for Payer: BCBS Complete |
$149.62
|
| Rate for Payer: BCBS MAPPO |
$220.65
|
| Rate for Payer: BCN Commercial |
$373.98
|
| Rate for Payer: BCN Medicare Advantage |
$220.65
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Commercial |
$295.67
|
| Rate for Payer: Cofinity Commercial |
$317.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.68
|
| Rate for Payer: Meridian Medicaid |
$149.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.72
|
| Rate for Payer: Nomi Health Commercial |
$264.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PACE SWMI |
$220.65
|
| Rate for Payer: PHP Commercial |
$308.91
|
| Rate for Payer: PHP Medicare Advantage |
$220.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$455.67
|
| Rate for Payer: Priority Health Medicare |
$220.65
|
| Rate for Payer: Priority Health SBD |
$455.67
|
| Rate for Payer: Priority Health Tiered Network |
$455.67
|
| Rate for Payer: Railroad Medicare Medicare |
$220.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.46
|
| Rate for Payer: UHC Core |
$449.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.65
|
| Rate for Payer: UHC Exchange |
$449.46
|
| Rate for Payer: UHC Medicaid |
$142.50
|
| Rate for Payer: UHCCP Medicaid |
$142.50
|
| Rate for Payer: UMR Bronson Commercial |
$685.86
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Professional
|
Both
|
$1,491.00
|
|
|
Service Code
|
HCPCS 45385
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$1,118.25 |
| Rate for Payer: Aetna Commercial |
$295.67
|
| Rate for Payer: Aetna Medicare |
$229.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.74
|
| Rate for Payer: BCBS Complete |
$149.62
|
| Rate for Payer: BCBS MAPPO |
$220.65
|
| Rate for Payer: BCN Commercial |
$373.98
|
| Rate for Payer: BCN Medicare Advantage |
$220.65
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Commercial |
$295.67
|
| Rate for Payer: Cofinity Commercial |
$317.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.68
|
| Rate for Payer: Meridian Medicaid |
$149.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.72
|
| Rate for Payer: Nomi Health Commercial |
$264.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PACE SWMI |
$220.65
|
| Rate for Payer: PHP Commercial |
$308.91
|
| Rate for Payer: PHP Medicare Advantage |
$220.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$455.67
|
| Rate for Payer: Priority Health Medicare |
$220.65
|
| Rate for Payer: Priority Health SBD |
$455.67
|
| Rate for Payer: Priority Health Tiered Network |
$455.67
|
| Rate for Payer: Railroad Medicare Medicare |
$220.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.46
|
| Rate for Payer: UHC Core |
$449.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.65
|
| Rate for Payer: UHC Exchange |
$449.46
|
| Rate for Payer: UHC Medicaid |
$142.50
|
| Rate for Payer: UHCCP Medicaid |
$142.50
|
| Rate for Payer: UMR Bronson Commercial |
$685.86
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Facility
|
OP
|
$1,491.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
45385
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$551.67 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna American Axle |
$969.15
|
| Rate for Payer: Aetna Commercial |
$1,267.35
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.15
|
| 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 |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Advantage |
$1,043.70
|
| Rate for Payer: Cofinity Commercial |
$1,282.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,192.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,341.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,043.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.25
|
| 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 |
$1,267.35
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,267.35
|
| 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 |
$939.33
|
| 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 |
$551.67
|
| Rate for Payer: VA VA |
$1,192.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.25
|
|
|
PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ
|
Facility
|
IP
|
$1,491.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
45385
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$656.04 |
| Max. Negotiated Rate |
$1,341.90 |
| Rate for Payer: Aetna American Axle |
$969.15
|
| Rate for Payer: Aetna Commercial |
$1,267.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.15
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cofinity Advantage |
$1,043.70
|
| Rate for Payer: Cofinity Commercial |
$1,282.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,192.80
|
| Rate for Payer: Healthscope Commercial |
$1,341.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,043.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,118.25
|
| Rate for Payer: PHP Commercial |
$1,267.35
|
| Rate for Payer: Priority Health SBD |
$939.33
|
| Rate for Payer: UMR Bronson Commercial |
$656.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.25
|
|
|
PR COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL
|
Professional
|
Both
|
$1,025.00
|
|
|
Service Code
|
HCPCS 45392
|
| Min. Negotiated Rate |
$169.55 |
| Max. Negotiated Rate |
$768.75 |
| Rate for Payer: Aetna Commercial |
$352.04
|
| Rate for Payer: Aetna Medicare |
$273.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.32
|
| Rate for Payer: BCBS Complete |
$178.03
|
| Rate for Payer: BCBS MAPPO |
$262.72
|
| Rate for Payer: BCN Commercial |
$446.69
|
| Rate for Payer: BCN Medicare Advantage |
$262.72
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cash Price |
$820.00
|
| Rate for Payer: Cofinity Commercial |
$352.04
|
| Rate for Payer: Cofinity Commercial |
$378.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.86
|
| Rate for Payer: Meridian Medicaid |
$178.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$288.99
|
| Rate for Payer: Nomi Health Commercial |
$315.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$768.75
|
| Rate for Payer: PACE SWMI |
$262.72
|
| Rate for Payer: PHP Commercial |
$367.81
|
| Rate for Payer: PHP Medicare Advantage |
$262.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$544.26
|
| Rate for Payer: Priority Health Medicare |
$262.72
|
| Rate for Payer: Priority Health SBD |
$544.26
|
| Rate for Payer: Priority Health Tiered Network |
$544.26
|
| Rate for Payer: Railroad Medicare Medicare |
$262.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.00
|
| Rate for Payer: UHC Core |
$537.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$262.72
|
| Rate for Payer: UHC Exchange |
$537.00
|
| Rate for Payer: UHC Medicaid |
$169.55
|
| Rate for Payer: UHCCP Medicaid |
$169.55
|
| Rate for Payer: UMR Bronson Commercial |
$471.50
|
|
|
PR COMM SVCS BY RHC/FQHC 5 MIN
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS G0071
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$23.13
|
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.13
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
PR COMPLETE REPLACEMENT PICC RS&I
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 36584
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$67.92
|
| Rate for Payer: Aetna Medicare |
$52.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.99
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$50.69
|
| Rate for Payer: BCN Commercial |
$86.65
|
| Rate for Payer: BCN Medicare Advantage |
$50.69
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$72.99
|
| Rate for Payer: Cofinity Commercial |
$67.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.22
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.76
|
| Rate for Payer: Nomi Health Commercial |
$60.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$50.69
|
| Rate for Payer: PHP Commercial |
$70.97
|
| Rate for Payer: PHP Medicare Advantage |
$50.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.17
|
| Rate for Payer: Priority Health Medicare |
$50.69
|
| Rate for Payer: Priority Health SBD |
$93.17
|
| Rate for Payer: Priority Health Tiered Network |
$93.17
|
| Rate for Payer: Railroad Medicare Medicare |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.38
|
| Rate for Payer: UHC Core |
$106.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.69
|
| Rate for Payer: UHC Exchange |
$106.38
|
| Rate for Payer: UHC Medicaid |
$32.38
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
| Rate for Payer: UMR Bronson Commercial |
$190.44
|
|
|
PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 93303
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$356.58 |
| Rate for Payer: Aetna Commercial |
$275.32
|
| Rate for Payer: Aetna Medicare |
$213.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.86
|
| Rate for Payer: BCBS MAPPO |
$205.46
|
| Rate for Payer: BCN Commercial |
$321.20
|
| Rate for Payer: BCN Medicare Advantage |
$205.46
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$275.32
|
| Rate for Payer: Cofinity Commercial |
$295.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.01
|
| Rate for Payer: Nomi Health Commercial |
$246.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.50
|
| Rate for Payer: PACE SWMI |
$205.46
|
| Rate for Payer: PHP Commercial |
$287.64
|
| Rate for Payer: PHP Medicare Advantage |
$205.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$305.28
|
| Rate for Payer: Priority Health Medicare |
$205.46
|
| Rate for Payer: Priority Health SBD |
$305.28
|
| Rate for Payer: Priority Health Tiered Network |
$305.28
|
| Rate for Payer: Railroad Medicare Medicare |
$205.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.58
|
| Rate for Payer: UHC Core |
$356.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$205.46
|
| Rate for Payer: UHC Exchange |
$356.58
|
| Rate for Payer: UMR Bronson Commercial |
$172.04
|
|
|
PR COMPLEX CHRONIC CARE MGMT SVC 1ST 60 MIN CAL MO
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 99487
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$147.84 |
| Rate for Payer: Aetna Commercial |
$105.15
|
| Rate for Payer: Aetna Medicare |
$81.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.00
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$78.47
|
| Rate for Payer: BCN Commercial |
$147.84
|
| Rate for Payer: BCN Medicare Advantage |
$78.47
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$113.00
|
| Rate for Payer: Cofinity Commercial |
$105.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.39
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.32
|
| Rate for Payer: Nomi Health Commercial |
$94.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.75
|
| Rate for Payer: PACE SWMI |
$78.47
|
| Rate for Payer: PHP Commercial |
$109.86
|
| Rate for Payer: PHP Medicare Advantage |
$78.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.49
|
| Rate for Payer: Priority Health Medicare |
$78.47
|
| Rate for Payer: Priority Health SBD |
$120.49
|
| Rate for Payer: Priority Health Tiered Network |
$120.49
|
| Rate for Payer: Railroad Medicare Medicare |
$78.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.01
|
| Rate for Payer: UHC Core |
$74.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.47
|
| Rate for Payer: UHC Exchange |
$74.01
|
| Rate for Payer: UHC Medicaid |
$50.48
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
| Rate for Payer: UMR Bronson Commercial |
$51.98
|
|
|
PR COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 51727
|
| Min. Negotiated Rate |
$310.07 |
| Max. Negotiated Rate |
$580.17 |
| Rate for Payer: Aetna Commercial |
$415.49
|
| Rate for Payer: Aetna Medicare |
$322.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.50
|
| Rate for Payer: BCBS MAPPO |
$310.07
|
| Rate for Payer: BCN Commercial |
$508.43
|
| Rate for Payer: BCN Medicare Advantage |
$310.07
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$415.49
|
| Rate for Payer: Cofinity Commercial |
$446.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.08
|
| Rate for Payer: Nomi Health Commercial |
$372.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.50
|
| Rate for Payer: PACE SWMI |
$310.07
|
| Rate for Payer: PHP Commercial |
$434.10
|
| Rate for Payer: PHP Medicare Advantage |
$310.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$553.86
|
| Rate for Payer: Priority Health Medicare |
$310.07
|
| Rate for Payer: Priority Health SBD |
$553.86
|
| Rate for Payer: Priority Health Tiered Network |
$553.86
|
| Rate for Payer: Railroad Medicare Medicare |
$310.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.17
|
| Rate for Payer: UHC Core |
$580.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.07
|
| Rate for Payer: UHC Exchange |
$580.17
|
| Rate for Payer: UMR Bronson Commercial |
$324.76
|
|
|
PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 51728
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$586.90 |
| Rate for Payer: Aetna Commercial |
$422.05
|
| Rate for Payer: Aetna Medicare |
$327.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.54
|
| Rate for Payer: BCBS MAPPO |
$314.96
|
| Rate for Payer: BCN Commercial |
$505.95
|
| Rate for Payer: BCN Medicare Advantage |
$314.96
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$453.54
|
| Rate for Payer: Cofinity Commercial |
$422.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.46
|
| Rate for Payer: Nomi Health Commercial |
$377.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.00
|
| Rate for Payer: PACE SWMI |
$314.96
|
| Rate for Payer: PHP Commercial |
$440.94
|
| Rate for Payer: PHP Medicare Advantage |
$314.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$551.14
|
| Rate for Payer: Priority Health Medicare |
$314.96
|
| Rate for Payer: Priority Health SBD |
$551.14
|
| Rate for Payer: Priority Health Tiered Network |
$551.14
|
| Rate for Payer: Railroad Medicare Medicare |
$314.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.90
|
| Rate for Payer: UHC Core |
$586.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$314.96
|
| Rate for Payer: UHC Exchange |
$586.90
|
| Rate for Payer: UMR Bronson Commercial |
$312.80
|
|
|
PR COMPLEX E/M VISIT ADD ON
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS G2211
|
| Min. Negotiated Rate |
$14.22 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$19.05
|
| Rate for Payer: Aetna Medicare |
$14.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.48
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$14.22
|
| Rate for Payer: BCN Commercial |
$15.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.22
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$19.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.64
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PACE SWMI |
$14.22
|
| Rate for Payer: PHP Commercial |
$19.91
|
| Rate for Payer: PHP Medicare Advantage |
$14.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$14.22
|
| Rate for Payer: Priority Health SBD |
$18.20
|
| Rate for Payer: Priority Health Tiered Network |
$18.20
|
| Rate for Payer: Railroad Medicare Medicare |
$14.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC Core |
$24.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.22
|
| Rate for Payer: UHC Exchange |
$24.50
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
PR COMPLEX IMPLANT REMOVAL, BILATERAL
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Aetna Medicare |
$1,802.50
|
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,658.30
|
|
|
PR COMPLEX UROFLOMETRY
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 51741
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$131.25 |
| Rate for Payer: Aetna Commercial |
$19.75
|
| Rate for Payer: Aetna Medicare |
$15.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.23
|
| Rate for Payer: BCBS MAPPO |
$14.74
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: BCN Medicare Advantage |
$14.74
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$19.75
|
| Rate for Payer: Cofinity Commercial |
$21.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.21
|
| Rate for Payer: Nomi Health Commercial |
$17.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: PACE SWMI |
$14.74
|
| Rate for Payer: PHP Commercial |
$20.64
|
| Rate for Payer: PHP Medicare Advantage |
$14.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.33
|
| Rate for Payer: Priority Health Medicare |
$14.74
|
| Rate for Payer: Priority Health SBD |
$23.33
|
| Rate for Payer: Priority Health Tiered Network |
$23.33
|
| Rate for Payer: Railroad Medicare Medicare |
$14.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.62
|
| Rate for Payer: UHC Core |
$24.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.74
|
| Rate for Payer: UHC Exchange |
$24.62
|
| Rate for Payer: UMR Bronson Commercial |
$80.50
|
|
|
PR COMPL OPH XM&EVAL GENERAL ANES W/WO MNPJ GLOBE
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 92018
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$179.80 |
| Rate for Payer: Aetna Commercial |
$149.09
|
| Rate for Payer: Aetna Medicare |
$115.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.21
|
| Rate for Payer: BCBS Complete |
$75.82
|
| Rate for Payer: BCBS MAPPO |
$111.26
|
| Rate for Payer: BCN Commercial |
$151.83
|
| Rate for Payer: BCN Medicare Advantage |
$111.26
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$160.21
|
| Rate for Payer: Cofinity Commercial |
$149.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.82
|
| Rate for Payer: Meridian Medicaid |
$75.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.39
|
| Rate for Payer: Nomi Health Commercial |
$133.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.00
|
| Rate for Payer: PACE SWMI |
$111.26
|
| Rate for Payer: PHP Commercial |
$155.76
|
| Rate for Payer: PHP Medicare Advantage |
$111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.11
|
| Rate for Payer: Priority Health Medicare |
$111.26
|
| Rate for Payer: Priority Health SBD |
$178.11
|
| Rate for Payer: Priority Health Tiered Network |
$178.11
|
| Rate for Payer: Railroad Medicare Medicare |
$111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.80
|
| Rate for Payer: UHC Core |
$179.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.26
|
| Rate for Payer: UHC Exchange |
$179.80
|
| Rate for Payer: UHC Medicaid |
$72.21
|
| Rate for Payer: UHCCP Medicaid |
$72.21
|
| Rate for Payer: UMR Bronson Commercial |
$101.20
|
|
|
PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL
|
Professional
|
Both
|
$737.00
|
|
|
Service Code
|
HCPCS 51729
|
| Min. Negotiated Rate |
$332.60 |
| Max. Negotiated Rate |
$627.90 |
| Rate for Payer: Aetna Commercial |
$445.68
|
| Rate for Payer: Aetna Medicare |
$345.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.94
|
| Rate for Payer: BCBS MAPPO |
$332.60
|
| Rate for Payer: BCN Commercial |
$535.83
|
| Rate for Payer: BCN Medicare Advantage |
$332.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cash Price |
$589.60
|
| Rate for Payer: Cofinity Commercial |
$445.68
|
| Rate for Payer: Cofinity Commercial |
$478.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.86
|
| Rate for Payer: Nomi Health Commercial |
$399.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$552.75
|
| Rate for Payer: PACE SWMI |
$332.60
|
| Rate for Payer: PHP Commercial |
$465.64
|
| Rate for Payer: PHP Medicare Advantage |
$332.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$583.69
|
| Rate for Payer: Priority Health Medicare |
$332.60
|
| Rate for Payer: Priority Health SBD |
$583.69
|
| Rate for Payer: Priority Health Tiered Network |
$583.69
|
| Rate for Payer: Railroad Medicare Medicare |
$332.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.90
|
| Rate for Payer: UHC Core |
$627.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.60
|
| Rate for Payer: UHC Exchange |
$627.90
|
| Rate for Payer: UMR Bronson Commercial |
$339.02
|
|
|
PR COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$10,611.00
|
|
|
Service Code
|
HCPCS 61697
|
| Min. Negotiated Rate |
$2,553.66 |
| Max. Negotiated Rate |
$8,817.75 |
| Rate for Payer: Aetna Commercial |
$5,391.37
|
| Rate for Payer: Aetna Medicare |
$4,184.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,391.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,793.71
|
| Rate for Payer: BCBS Complete |
$2,681.34
|
| Rate for Payer: BCBS MAPPO |
$4,023.41
|
| Rate for Payer: BCN Commercial |
$8,817.75
|
| Rate for Payer: BCN Medicare Advantage |
$4,023.41
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cash Price |
$8,488.80
|
| Rate for Payer: Cofinity Commercial |
$5,793.71
|
| Rate for Payer: Cofinity Commercial |
$5,391.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,023.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,224.58
|
| Rate for Payer: Meridian Medicaid |
$2,681.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,425.75
|
| Rate for Payer: Nomi Health Commercial |
$4,828.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,958.25
|
| Rate for Payer: PACE SWMI |
$4,023.41
|
| Rate for Payer: PHP Commercial |
$5,632.77
|
| Rate for Payer: PHP Medicare Advantage |
$4,023.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,553.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,413.29
|
| Rate for Payer: Priority Health Medicare |
$4,023.41
|
| Rate for Payer: Priority Health SBD |
$7,413.29
|
| Rate for Payer: Priority Health Tiered Network |
$7,413.29
|
| Rate for Payer: Railroad Medicare Medicare |
$4,023.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,514.26
|
| Rate for Payer: UHC Core |
$7,514.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,023.41
|
| Rate for Payer: UHC Exchange |
$7,514.26
|
| Rate for Payer: UHC Medicaid |
$2,553.66
|
| Rate for Payer: UHCCP Medicaid |
$2,553.66
|
| Rate for Payer: UMR Bronson Commercial |
$4,881.06
|
|
|
PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92557
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: Aetna Commercial |
$33.90
|
| Rate for Payer: Aetna Medicare |
$26.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.43
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$25.30
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.30
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$33.90
|
| Rate for Payer: Cofinity Commercial |
$36.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.57
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.83
|
| Rate for Payer: Nomi Health Commercial |
$30.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE SWMI |
$25.30
|
| Rate for Payer: PHP Commercial |
$35.42
|
| Rate for Payer: PHP Medicare Advantage |
$25.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.63
|
| Rate for Payer: Priority Health Medicare |
$25.30
|
| Rate for Payer: Priority Health SBD |
$43.63
|
| Rate for Payer: Priority Health Tiered Network |
$43.63
|
| Rate for Payer: Railroad Medicare Medicare |
$25.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.55
|
| Rate for Payer: UHC Core |
$52.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.30
|
| Rate for Payer: UHC Exchange |
$52.55
|
| Rate for Payer: UHC Medicaid |
$16.40
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
|
