|
PR COCHLEAR DEVICE/SOFT BAND FITTING FEE
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 00593
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Medicare |
$255.00
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: UMR Bronson Commercial |
$234.60
|
|
|
PR COCM BY RHC/FQHC 60 MIN MO
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS G0512
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$230.10 |
| Rate for Payer: Aetna Medicare |
$177.00
|
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.10
|
| Rate for Payer: UMR Bronson Commercial |
$162.84
|
|
|
PR CO DIFFUSING CAPACITY
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 94729
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$72.32 |
| Rate for Payer: Aetna Commercial |
$67.29
|
| Rate for Payer: Aetna Commercial |
$67.29
|
| Rate for Payer: Aetna Medicare |
$52.23
|
| Rate for Payer: Aetna Medicare |
$52.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.29
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$50.22
|
| Rate for Payer: BCBS MAPPO |
$50.22
|
| Rate for Payer: BCN Medicare Advantage |
$50.22
|
| Rate for Payer: BCN Medicare Advantage |
$50.22
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$67.29
|
| Rate for Payer: Cofinity Commercial |
$67.29
|
| Rate for Payer: Cofinity Commercial |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.73
|
| Rate for Payer: Nomi Health Commercial |
$60.26
|
| Rate for Payer: Nomi Health Commercial |
$60.26
|
| Rate for Payer: PACE SWMI |
$50.22
|
| Rate for Payer: PACE SWMI |
$50.22
|
| Rate for Payer: PHP Commercial |
$70.31
|
| Rate for Payer: PHP Commercial |
$70.31
|
| Rate for Payer: PHP Medicare Advantage |
$50.22
|
| Rate for Payer: PHP Medicare Advantage |
$50.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.05
|
| Rate for Payer: Priority Health Medicare |
$50.22
|
| Rate for Payer: Priority Health Medicare |
$50.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.22
|
| Rate for Payer: UHC Medicare Advantage |
$50.22
|
| Rate for Payer: UHC Medicare Advantage |
$50.22
|
| Rate for Payer: UMR Bronson Commercial |
$71.76
|
| Rate for Payer: UMR Bronson Commercial |
$7.82
|
|
|
PR COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST
|
Professional
|
Both
|
$3,840.00
|
|
|
Service Code
|
HCPCS 44151
|
| Min. Negotiated Rate |
$1,536.00 |
| Max. Negotiated Rate |
$2,989.79 |
| Rate for Payer: Aetna Commercial |
$2,782.16
|
| Rate for Payer: Aetna Medicare |
$2,159.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,989.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,782.16
|
| Rate for Payer: BCBS Complete |
$1,536.00
|
| Rate for Payer: BCBS MAPPO |
$2,076.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,076.24
|
| Rate for Payer: Cash Price |
$3,072.00
|
| Rate for Payer: Cash Price |
$3,072.00
|
| Rate for Payer: Cofinity Commercial |
$2,989.79
|
| Rate for Payer: Cofinity Commercial |
$2,782.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,076.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,180.05
|
| Rate for Payer: Nomi Health Commercial |
$2,491.49
|
| Rate for Payer: PACE SWMI |
$2,076.24
|
| Rate for Payer: PHP Commercial |
$2,906.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,076.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,496.00
|
| Rate for Payer: Priority Health Medicare |
$2,076.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,076.24
|
| Rate for Payer: UHC Medicare Advantage |
$2,076.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,766.40
|
|
|
PR COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS
|
Professional
|
Both
|
$4,611.00
|
|
|
Service Code
|
HCPCS 44150
|
| Min. Negotiated Rate |
$1,780.09 |
| Max. Negotiated Rate |
$2,997.15 |
| Rate for Payer: Aetna Commercial |
$2,385.32
|
| Rate for Payer: Aetna Medicare |
$1,851.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,563.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,385.32
|
| Rate for Payer: BCBS Complete |
$1,844.40
|
| Rate for Payer: BCBS MAPPO |
$1,780.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,780.09
|
| Rate for Payer: Cash Price |
$3,688.80
|
| Rate for Payer: Cash Price |
$3,688.80
|
| Rate for Payer: Cofinity Commercial |
$2,563.33
|
| Rate for Payer: Cofinity Commercial |
$2,385.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,780.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,869.09
|
| Rate for Payer: Nomi Health Commercial |
$2,136.11
|
| Rate for Payer: PACE SWMI |
$1,780.09
|
| Rate for Payer: PHP Commercial |
$2,492.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,780.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,997.15
|
| Rate for Payer: Priority Health Medicare |
$1,780.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,780.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,780.09
|
| Rate for Payer: UMR Bronson Commercial |
$2,121.06
|
|
|
PR COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR
|
Professional
|
Both
|
$4,699.00
|
|
|
Service Code
|
HCPCS 44158
|
| Min. Negotiated Rate |
$1,879.60 |
| Max. Negotiated Rate |
$3,118.08 |
| Rate for Payer: Aetna Commercial |
$2,901.54
|
| Rate for Payer: Aetna Medicare |
$2,251.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,118.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,901.54
|
| Rate for Payer: BCBS Complete |
$1,879.60
|
| Rate for Payer: BCBS MAPPO |
$2,165.33
|
| Rate for Payer: BCN Medicare Advantage |
$2,165.33
|
| Rate for Payer: Cash Price |
$3,759.20
|
| Rate for Payer: Cash Price |
$3,759.20
|
| Rate for Payer: Cofinity Commercial |
$3,118.08
|
| Rate for Payer: Cofinity Commercial |
$2,901.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,165.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,273.60
|
| Rate for Payer: Nomi Health Commercial |
$2,598.40
|
| Rate for Payer: PACE SWMI |
$2,165.33
|
| Rate for Payer: PHP Commercial |
$3,031.46
|
| Rate for Payer: PHP Medicare Advantage |
$2,165.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,054.35
|
| Rate for Payer: Priority Health Medicare |
$2,165.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,165.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,165.33
|
| Rate for Payer: UMR Bronson Commercial |
$2,161.54
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,874.00
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
44140
|
| Min. Negotiated Rate |
$1,299.60 |
| Max. Negotiated Rate |
$2,518.10 |
| Rate for Payer: Aetna Commercial |
$1,741.46
|
| Rate for Payer: Aetna Medicare |
$1,351.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,741.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,871.42
|
| Rate for Payer: BCBS Complete |
$1,549.60
|
| Rate for Payer: BCBS MAPPO |
$1,299.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.60
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$1,871.42
|
| Rate for Payer: Cofinity Commercial |
$1,741.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.58
|
| Rate for Payer: Nomi Health Commercial |
$1,559.52
|
| Rate for Payer: PACE SWMI |
$1,299.60
|
| Rate for Payer: PHP Commercial |
$1,819.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health Medicare |
$1,299.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,782.04
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,874.00
|
|
|
Service Code
|
HCPCS 44140
|
| Min. Negotiated Rate |
$1,299.60 |
| Max. Negotiated Rate |
$2,518.10 |
| Rate for Payer: Aetna Commercial |
$1,741.46
|
| Rate for Payer: Aetna Medicare |
$1,351.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,871.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,741.46
|
| Rate for Payer: BCBS Complete |
$1,549.60
|
| Rate for Payer: BCBS MAPPO |
$1,299.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.60
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$1,871.42
|
| Rate for Payer: Cofinity Commercial |
$1,741.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.58
|
| Rate for Payer: Nomi Health Commercial |
$1,559.52
|
| Rate for Payer: PACE SWMI |
$1,299.60
|
| Rate for Payer: PHP Commercial |
$1,819.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health Medicare |
$1,299.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,782.04
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Facility
|
OP
|
$3,874.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
44140
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,433.38 |
| Max. Negotiated Rate |
$3,486.60 |
| Rate for Payer: Aetna American Axle |
$2,518.10
|
| Rate for Payer: Aetna Commercial |
$3,292.90
|
| Rate for Payer: Aetna Medicare |
$1,937.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,518.10
|
| Rate for Payer: BCBS Complete |
$1,549.60
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$2,711.80
|
| Rate for Payer: Cofinity Commercial |
$3,331.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,711.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,099.20
|
| Rate for Payer: Healthscope Commercial |
$3,486.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,711.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,905.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,292.90
|
| Rate for Payer: PHP Commercial |
$3,292.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health SBD |
$2,440.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,433.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,905.50
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Facility
|
IP
|
$3,874.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
44140
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,704.56 |
| Max. Negotiated Rate |
$3,486.60 |
| Rate for Payer: Aetna American Axle |
$2,518.10
|
| Rate for Payer: Aetna Commercial |
$3,292.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,518.10
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$2,711.80
|
| Rate for Payer: Cofinity Commercial |
$3,331.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,711.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,099.20
|
| Rate for Payer: Healthscope Commercial |
$3,486.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,711.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,905.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,292.90
|
| Rate for Payer: PHP Commercial |
$3,292.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health SBD |
$2,440.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,704.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,905.50
|
|
|
PR COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH
|
Professional
|
Both
|
$2,752.00
|
|
|
Service Code
|
HCPCS 44147
|
| Min. Negotiated Rate |
$1,100.80 |
| Max. Negotiated Rate |
$2,695.08 |
| Rate for Payer: Aetna Commercial |
$2,507.92
|
| Rate for Payer: Aetna Medicare |
$1,946.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,695.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,507.92
|
| Rate for Payer: BCBS Complete |
$1,100.80
|
| Rate for Payer: BCBS MAPPO |
$1,871.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,871.58
|
| Rate for Payer: Cash Price |
$2,201.60
|
| Rate for Payer: Cash Price |
$2,201.60
|
| Rate for Payer: Cofinity Commercial |
$2,695.08
|
| Rate for Payer: Cofinity Commercial |
$2,507.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,871.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,965.16
|
| Rate for Payer: Nomi Health Commercial |
$2,245.90
|
| Rate for Payer: PACE SWMI |
$1,871.58
|
| Rate for Payer: PHP Commercial |
$2,620.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,871.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,788.80
|
| Rate for Payer: Priority Health Medicare |
$1,871.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,871.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,871.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,265.92
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY
|
Professional
|
Both
|
$3,419.00
|
|
|
Service Code
|
HCPCS 44145
|
| Min. Negotiated Rate |
$1,367.60 |
| Max. Negotiated Rate |
$2,287.92 |
| Rate for Payer: Aetna Commercial |
$2,129.03
|
| Rate for Payer: Aetna Medicare |
$1,652.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,287.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,129.03
|
| Rate for Payer: BCBS Complete |
$1,367.60
|
| Rate for Payer: BCBS MAPPO |
$1,588.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,588.83
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cofinity Commercial |
$2,287.92
|
| Rate for Payer: Cofinity Commercial |
$2,129.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,588.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,668.27
|
| Rate for Payer: Nomi Health Commercial |
$1,906.60
|
| Rate for Payer: PACE SWMI |
$1,588.83
|
| Rate for Payer: PHP Commercial |
$2,224.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,588.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,222.35
|
| Rate for Payer: Priority Health Medicare |
$1,588.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,588.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,588.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,572.74
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY
|
Professional
|
Both
|
$5,145.00
|
|
|
Service Code
|
HCPCS 44146
|
| Min. Negotiated Rate |
$2,017.07 |
| Max. Negotiated Rate |
$3,344.25 |
| Rate for Payer: Aetna Commercial |
$2,702.87
|
| Rate for Payer: Aetna Medicare |
$2,097.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,904.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,702.87
|
| Rate for Payer: BCBS Complete |
$2,058.00
|
| Rate for Payer: BCBS MAPPO |
$2,017.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,017.07
|
| Rate for Payer: Cash Price |
$4,116.00
|
| Rate for Payer: Cash Price |
$4,116.00
|
| Rate for Payer: Cofinity Commercial |
$2,904.58
|
| Rate for Payer: Cofinity Commercial |
$2,702.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,017.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,117.92
|
| Rate for Payer: Nomi Health Commercial |
$2,420.48
|
| Rate for Payer: PACE SWMI |
$2,017.07
|
| Rate for Payer: PHP Commercial |
$2,823.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,017.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,344.25
|
| Rate for Payer: Priority Health Medicare |
$2,017.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,017.07
|
| Rate for Payer: UHC Medicare Advantage |
$2,017.07
|
| Rate for Payer: UMR Bronson Commercial |
$2,366.70
|
|
|
PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA
|
Professional
|
Both
|
$3,983.00
|
|
|
Service Code
|
HCPCS 44144
|
| Min. Negotiated Rate |
$1,593.20 |
| Max. Negotiated Rate |
$2,588.95 |
| Rate for Payer: Aetna Commercial |
$2,280.83
|
| Rate for Payer: Aetna Medicare |
$1,770.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,280.83
|
| Rate for Payer: BCBS Complete |
$1,593.20
|
| Rate for Payer: BCBS MAPPO |
$1,702.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,702.11
|
| Rate for Payer: Cash Price |
$3,186.40
|
| Rate for Payer: Cash Price |
$3,186.40
|
| Rate for Payer: Cofinity Commercial |
$2,451.04
|
| Rate for Payer: Cofinity Commercial |
$2,280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,702.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.22
|
| Rate for Payer: Nomi Health Commercial |
$2,042.53
|
| Rate for Payer: PACE SWMI |
$1,702.11
|
| Rate for Payer: PHP Commercial |
$2,382.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,702.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.95
|
| Rate for Payer: Priority Health Medicare |
$1,702.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,832.18
|
|
|
PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 44143
|
| Min. Negotiated Rate |
$1,593.57 |
| Max. Negotiated Rate |
$2,730.00 |
| Rate for Payer: Aetna Commercial |
$2,135.38
|
| Rate for Payer: Aetna Medicare |
$1,657.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,294.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,135.38
|
| Rate for Payer: BCBS Complete |
$1,680.00
|
| Rate for Payer: BCBS MAPPO |
$1,593.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,593.57
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Cofinity Commercial |
$2,294.74
|
| Rate for Payer: Cofinity Commercial |
$2,135.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,593.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,673.25
|
| Rate for Payer: Nomi Health Commercial |
$1,912.28
|
| Rate for Payer: PACE SWMI |
$1,593.57
|
| Rate for Payer: PHP Commercial |
$2,231.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,593.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: Priority Health Medicare |
$1,593.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,593.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,593.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,932.00
|
|
|
PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS
|
Professional
|
Both
|
$3,965.00
|
|
|
Service Code
|
HCPCS 44160
|
| Min. Negotiated Rate |
$1,201.94 |
| Max. Negotiated Rate |
$2,577.25 |
| Rate for Payer: Aetna Commercial |
$1,610.60
|
| Rate for Payer: Aetna Medicare |
$1,250.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,610.60
|
| Rate for Payer: BCBS Complete |
$1,586.00
|
| Rate for Payer: BCBS MAPPO |
$1,201.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.94
|
| Rate for Payer: Cash Price |
$3,172.00
|
| Rate for Payer: Cash Price |
$3,172.00
|
| Rate for Payer: Cofinity Commercial |
$1,730.79
|
| Rate for Payer: Cofinity Commercial |
$1,610.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,262.04
|
| Rate for Payer: Nomi Health Commercial |
$1,442.33
|
| Rate for Payer: PACE SWMI |
$1,201.94
|
| Rate for Payer: PHP Commercial |
$1,682.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,577.25
|
| Rate for Payer: Priority Health Medicare |
$1,201.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,201.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,201.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,823.90
|
|
|
PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY
|
Professional
|
Both
|
$3,835.00
|
|
|
Service Code
|
HCPCS 44141
|
| Min. Negotiated Rate |
$1,534.00 |
| Max. Negotiated Rate |
$2,511.43 |
| Rate for Payer: Aetna Commercial |
$2,337.03
|
| Rate for Payer: Aetna Medicare |
$1,813.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,511.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,337.03
|
| Rate for Payer: BCBS Complete |
$1,534.00
|
| Rate for Payer: BCBS MAPPO |
$1,744.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,744.05
|
| Rate for Payer: Cash Price |
$3,068.00
|
| Rate for Payer: Cash Price |
$3,068.00
|
| Rate for Payer: Cofinity Commercial |
$2,511.43
|
| Rate for Payer: Cofinity Commercial |
$2,337.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,744.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,831.25
|
| Rate for Payer: Nomi Health Commercial |
$2,092.86
|
| Rate for Payer: PACE SWMI |
$1,744.05
|
| Rate for Payer: PHP Commercial |
$2,441.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,744.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,492.75
|
| Rate for Payer: Priority Health Medicare |
$1,744.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,744.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,744.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,764.10
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST
|
Professional
|
Both
|
$6,820.00
|
|
|
Service Code
|
HCPCS 44156
|
| Min. Negotiated Rate |
$2,219.78 |
| Max. Negotiated Rate |
$4,433.00 |
| Rate for Payer: Aetna Commercial |
$2,974.51
|
| Rate for Payer: Aetna Medicare |
$2,308.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,196.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,974.51
|
| Rate for Payer: BCBS Complete |
$2,728.00
|
| Rate for Payer: BCBS MAPPO |
$2,219.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,219.78
|
| Rate for Payer: Cash Price |
$5,456.00
|
| Rate for Payer: Cash Price |
$5,456.00
|
| Rate for Payer: Cofinity Commercial |
$3,196.48
|
| Rate for Payer: Cofinity Commercial |
$2,974.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,219.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,330.77
|
| Rate for Payer: Nomi Health Commercial |
$2,663.74
|
| Rate for Payer: PACE SWMI |
$2,219.78
|
| Rate for Payer: PHP Commercial |
$3,107.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,219.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,433.00
|
| Rate for Payer: Priority Health Medicare |
$2,219.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,219.78
|
| Rate for Payer: UHC Medicare Advantage |
$2,219.78
|
| Rate for Payer: UMR Bronson Commercial |
$3,137.20
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$5,822.00
|
|
|
Service Code
|
HCPCS 44155
|
| Min. Negotiated Rate |
$1,979.09 |
| Max. Negotiated Rate |
$3,784.30 |
| Rate for Payer: Aetna Commercial |
$2,651.98
|
| Rate for Payer: Aetna Medicare |
$2,058.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,651.98
|
| Rate for Payer: BCBS Complete |
$2,328.80
|
| Rate for Payer: BCBS MAPPO |
$1,979.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,979.09
|
| Rate for Payer: Cash Price |
$4,657.60
|
| Rate for Payer: Cash Price |
$4,657.60
|
| Rate for Payer: Cofinity Commercial |
$2,849.89
|
| Rate for Payer: Cofinity Commercial |
$2,651.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,979.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,078.04
|
| Rate for Payer: Nomi Health Commercial |
$2,374.91
|
| Rate for Payer: PACE SWMI |
$1,979.09
|
| Rate for Payer: PHP Commercial |
$2,770.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,979.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,784.30
|
| Rate for Payer: Priority Health Medicare |
$1,979.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,979.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,979.09
|
| Rate for Payer: UMR Bronson Commercial |
$2,678.12
|
|
|
PR COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST
|
Professional
|
Both
|
$4,567.00
|
|
|
Service Code
|
HCPCS 44157
|
| Min. Negotiated Rate |
$1,826.80 |
| Max. Negotiated Rate |
$3,042.26 |
| Rate for Payer: Aetna Commercial |
$2,830.99
|
| Rate for Payer: Aetna Medicare |
$2,197.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,042.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,830.99
|
| Rate for Payer: BCBS Complete |
$1,826.80
|
| Rate for Payer: BCBS MAPPO |
$2,112.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,112.68
|
| Rate for Payer: Cash Price |
$3,653.60
|
| Rate for Payer: Cash Price |
$3,653.60
|
| Rate for Payer: Cofinity Commercial |
$3,042.26
|
| Rate for Payer: Cofinity Commercial |
$2,830.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,112.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,218.31
|
| Rate for Payer: Nomi Health Commercial |
$2,535.22
|
| Rate for Payer: PACE SWMI |
$2,112.68
|
| Rate for Payer: PHP Commercial |
$2,957.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,968.55
|
| Rate for Payer: Priority Health Medicare |
$2,112.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,112.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,112.68
|
| Rate for Payer: UMR Bronson Commercial |
$2,100.82
|
|
|
PR COLLAGENASE, CLOST HIST INJ
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS J0775
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$109.31 |
| Rate for Payer: Aetna Commercial |
$101.72
|
| Rate for Payer: Aetna Medicare |
$78.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.72
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$75.91
|
| Rate for Payer: BCN Medicare Advantage |
$75.91
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$109.31
|
| Rate for Payer: Cofinity Commercial |
$101.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.71
|
| Rate for Payer: Nomi Health Commercial |
$91.09
|
| Rate for Payer: PACE SWMI |
$75.91
|
| Rate for Payer: PHP Commercial |
$106.27
|
| Rate for Payer: PHP Medicare Advantage |
$75.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health Medicare |
$75.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.91
|
| Rate for Payer: UHC Medicare Advantage |
$75.91
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
|
|
PR COLLECT BLOOD FROM CATHETER VENOUS NOS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 36592
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$40.95 |
| Rate for Payer: Aetna Commercial |
$35.26
|
| Rate for Payer: Aetna Medicare |
$27.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.26
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$26.31
|
| Rate for Payer: BCN Medicare Advantage |
$26.31
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Cofinity Commercial |
$35.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.63
|
| Rate for Payer: Nomi Health Commercial |
$31.57
|
| Rate for Payer: PACE SWMI |
$26.31
|
| Rate for Payer: PHP Commercial |
$36.83
|
| Rate for Payer: PHP Medicare Advantage |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Medicare |
$26.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.31
|
| Rate for Payer: UHC Medicare Advantage |
$26.31
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR COLLECTION CAPILLARY BLOOD SPECIMEN
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 36416
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: UMR Bronson Commercial |
$5.06
|
|
|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$13.09 |
| Rate for Payer: Aetna Commercial |
$12.18
|
| Rate for Payer: Aetna Medicare |
$9.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.09
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Cofinity Commercial |
$13.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$10.91
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Commercial |
$12.73
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
|
|
PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 99091
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$76.05 |
| Rate for Payer: Aetna Commercial |
$68.22
|
| Rate for Payer: Aetna Medicare |
$52.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.22
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$50.91
|
| Rate for Payer: BCN Medicare Advantage |
$50.91
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$73.31
|
| Rate for Payer: Cofinity Commercial |
$68.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.46
|
| Rate for Payer: Nomi Health Commercial |
$61.09
|
| Rate for Payer: PACE SWMI |
$50.91
|
| Rate for Payer: PHP Commercial |
$71.27
|
| Rate for Payer: PHP Medicare Advantage |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Medicare |
$50.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.91
|
| Rate for Payer: UHC Medicare Advantage |
$50.91
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
