|
PR COLONOSCOPY STOMA W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 44390
|
| Min. Negotiated Rate |
$198.63 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Aetna Commercial |
$266.16
|
| Rate for Payer: Aetna Medicare |
$206.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$286.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.16
|
| Rate for Payer: BCBS Complete |
$468.00
|
| Rate for Payer: BCBS MAPPO |
$198.63
|
| Rate for Payer: BCN Medicare Advantage |
$198.63
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$286.03
|
| Rate for Payer: Cofinity Commercial |
$266.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.56
|
| Rate for Payer: Nomi Health Commercial |
$238.36
|
| Rate for Payer: PACE SWMI |
$198.63
|
| Rate for Payer: PHP Commercial |
$278.08
|
| Rate for Payer: PHP Medicare Advantage |
$198.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health Medicare |
$198.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.63
|
| Rate for Payer: UHC Medicare Advantage |
$198.63
|
| Rate for Payer: UMR Bronson Commercial |
$538.20
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Facility
|
IP
|
$1,371.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
44394
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$603.24 |
| Max. Negotiated Rate |
$1,233.90 |
| Rate for Payer: Aetna American Axle |
$891.15
|
| Rate for Payer: Aetna Commercial |
$1,165.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.15
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,179.06
|
| Rate for Payer: Cofinity Commercial |
$959.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Healthscope Commercial |
$1,233.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$959.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,028.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: PHP Commercial |
$1,165.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health SBD |
$863.73
|
| Rate for Payer: UMR Bronson Commercial |
$603.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,028.25
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Facility
|
OP
|
$1,371.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
44394
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$507.27 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna American Axle |
$891.15
|
| Rate for Payer: Aetna Commercial |
$1,165.35
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$959.70
|
| Rate for Payer: Cofinity Commercial |
$1,179.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$1,233.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$959.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,028.25
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$1,165.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$863.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,236.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$2,197.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: UMR Bronson Commercial |
$507.27
|
| Rate for Payer: VA VA |
$1,149.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,028.25
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 44394
|
| Min. Negotiated Rate |
$212.73 |
| Max. Negotiated Rate |
$891.15 |
| Rate for Payer: Aetna Commercial |
$285.06
|
| Rate for Payer: Aetna Medicare |
$221.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.06
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: BCBS MAPPO |
$212.73
|
| Rate for Payer: BCN Medicare Advantage |
$212.73
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$306.33
|
| Rate for Payer: Cofinity Commercial |
$285.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.37
|
| Rate for Payer: Nomi Health Commercial |
$255.28
|
| Rate for Payer: PACE SWMI |
$212.73
|
| Rate for Payer: PHP Commercial |
$297.82
|
| Rate for Payer: PHP Medicare Advantage |
$212.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health Medicare |
$212.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.73
|
| Rate for Payer: UHC Medicare Advantage |
$212.73
|
| Rate for Payer: UMR Bronson Commercial |
$630.66
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
44394
|
| Min. Negotiated Rate |
$212.73 |
| Max. Negotiated Rate |
$891.15 |
| Rate for Payer: Aetna Commercial |
$285.06
|
| Rate for Payer: Aetna Medicare |
$221.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.06
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: BCBS MAPPO |
$212.73
|
| Rate for Payer: BCN Medicare Advantage |
$212.73
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$306.33
|
| Rate for Payer: Cofinity Commercial |
$285.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.37
|
| Rate for Payer: Nomi Health Commercial |
$255.28
|
| Rate for Payer: PACE SWMI |
$212.73
|
| Rate for Payer: PHP Commercial |
$297.82
|
| Rate for Payer: PHP Medicare Advantage |
$212.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health Medicare |
$212.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.73
|
| Rate for Payer: UHC Medicare Advantage |
$212.73
|
| Rate for Payer: UMR Bronson Commercial |
$630.66
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 44393
|
| Min. Negotiated Rate |
$548.40 |
| Max. Negotiated Rate |
$891.15 |
| Rate for Payer: Aetna Medicare |
$685.50
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: UMR Bronson Commercial |
$630.66
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$548.40 |
| Max. Negotiated Rate |
$891.15 |
| Rate for Payer: Aetna Medicare |
$685.50
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: UMR Bronson Commercial |
$630.66
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Facility
|
OP
|
$1,371.00
|
|
|
Service Code
|
CPT 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$507.27 |
| Max. Negotiated Rate |
$1,233.90 |
| Rate for Payer: Aetna American Axle |
$891.15
|
| Rate for Payer: Aetna Commercial |
$1,165.35
|
| Rate for Payer: Aetna Medicare |
$685.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.15
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,179.06
|
| Rate for Payer: Cofinity Commercial |
$959.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Healthscope Commercial |
$1,233.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$959.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,028.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: PHP Commercial |
$1,165.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health SBD |
$863.73
|
| Rate for Payer: UMR Bronson Commercial |
$507.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,028.25
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Facility
|
IP
|
$1,371.00
|
|
|
Service Code
|
CPT 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$603.24 |
| Max. Negotiated Rate |
$1,233.90 |
| Rate for Payer: Aetna American Axle |
$891.15
|
| Rate for Payer: Aetna Commercial |
$1,165.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.15
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,179.06
|
| Rate for Payer: Cofinity Commercial |
$959.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$959.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Healthscope Commercial |
$1,233.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$959.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,028.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: PHP Commercial |
$1,165.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health SBD |
$863.73
|
| Rate for Payer: UMR Bronson Commercial |
$603.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,028.25
|
|
|
PR COLONOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$1,602.00
|
|
|
Service Code
|
HCPCS 45387
|
| Min. Negotiated Rate |
$640.80 |
| Max. Negotiated Rate |
$1,041.30 |
| Rate for Payer: Aetna Medicare |
$801.00
|
| Rate for Payer: BCBS Complete |
$640.80
|
| Rate for Payer: Cash Price |
$1,281.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,041.30
|
| Rate for Payer: UMR Bronson Commercial |
$736.92
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
45380
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$495.00 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna American Axle |
$731.25
|
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.25
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$787.50
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health SBD |
$708.75
|
| Rate for Payer: UMR Bronson Commercial |
$495.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.75
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
45380
|
| Min. Negotiated Rate |
$189.86 |
| Max. Negotiated Rate |
$731.25 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.41
|
| Rate for Payer: BCBS Complete |
$450.00
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$254.41
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.35
|
| Rate for Payer: Nomi Health Commercial |
$227.83
|
| Rate for Payer: PACE SWMI |
$189.86
|
| Rate for Payer: PHP Commercial |
$265.80
|
| Rate for Payer: PHP Medicare Advantage |
$189.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UMR Bronson Commercial |
$517.50
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
45380
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$416.25 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna American Axle |
$731.25
|
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$787.50
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.75
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$708.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,236.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$2,197.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: UMR Bronson Commercial |
$416.25
|
| Rate for Payer: VA VA |
$1,149.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.75
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45380
|
| Min. Negotiated Rate |
$189.86 |
| Max. Negotiated Rate |
$731.25 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.41
|
| Rate for Payer: BCBS Complete |
$450.00
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$254.41
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.35
|
| Rate for Payer: Nomi Health Commercial |
$227.83
|
| Rate for Payer: PACE SWMI |
$189.86
|
| Rate for Payer: PHP Commercial |
$265.80
|
| Rate for Payer: PHP Medicare Advantage |
$189.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UMR Bronson Commercial |
$517.50
|
|
|
PR COLONOSCOPY W/STENT
|
Professional
|
Both
|
$1,602.00
|
|
|
Service Code
|
HCPCS G6025
|
| Min. Negotiated Rate |
$640.80 |
| Max. Negotiated Rate |
$1,041.30 |
| Rate for Payer: Aetna Medicare |
$801.00
|
| Rate for Payer: BCBS Complete |
$640.80
|
| Rate for Payer: Cash Price |
$1,281.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,041.30
|
| Rate for Payer: UMR Bronson Commercial |
$736.92
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$438.45 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna American Axle |
$770.25
|
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Cofinity Commercial |
$829.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$829.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$829.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.75
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,699.29
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: UMR Bronson Commercial |
$438.45
|
| Rate for Payer: VA VA |
$889.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.75
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
| Min. Negotiated Rate |
$174.51 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$181.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.84
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCN Medicare Advantage |
$174.51
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| Rate for Payer: Cofinity Commercial |
$251.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.24
|
| Rate for Payer: Nomi Health Commercial |
$209.41
|
| Rate for Payer: PACE SWMI |
$174.51
|
| Rate for Payer: PHP Commercial |
$244.31
|
| Rate for Payer: PHP Medicare Advantage |
$174.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$521.40 |
| Max. Negotiated Rate |
$1,066.50 |
| Rate for Payer: Aetna American Axle |
$770.25
|
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Cofinity Commercial |
$829.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$829.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$829.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: UMR Bronson Commercial |
$521.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.75
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$174.51 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$181.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.29
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCN Medicare Advantage |
$174.51
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| Rate for Payer: Cofinity Commercial |
$251.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.24
|
| Rate for Payer: Nomi Health Commercial |
$209.41
|
| Rate for Payer: PACE SWMI |
$174.51
|
| Rate for Payer: PHP Commercial |
$244.31
|
| Rate for Payer: PHP Medicare Advantage |
$174.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 92283
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$70.11 |
| Rate for Payer: Aetna Commercial |
$65.24
|
| Rate for Payer: Aetna Medicare |
$50.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.24
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS MAPPO |
$48.69
|
| Rate for Payer: BCN Medicare Advantage |
$48.69
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Cofinity Commercial |
$65.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.12
|
| Rate for Payer: Nomi Health Commercial |
$58.43
|
| Rate for Payer: PACE SWMI |
$48.69
|
| Rate for Payer: PHP Commercial |
$68.17
|
| Rate for Payer: PHP Medicare Advantage |
$48.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health Medicare |
$48.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.69
|
| Rate for Payer: UHC Medicare Advantage |
$48.69
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
PR COLOSTOMY/SKIN LEVEL CECOSTOMY
|
Professional
|
Both
|
$2,695.00
|
|
|
Service Code
|
HCPCS 44320
|
| Min. Negotiated Rate |
$1,078.00 |
| Max. Negotiated Rate |
$1,751.75 |
| Rate for Payer: Aetna Commercial |
$1,553.42
|
| Rate for Payer: Aetna Medicare |
$1,205.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,669.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,553.42
|
| Rate for Payer: BCBS Complete |
$1,078.00
|
| Rate for Payer: BCBS MAPPO |
$1,159.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,159.27
|
| Rate for Payer: Cash Price |
$2,156.00
|
| Rate for Payer: Cash Price |
$2,156.00
|
| Rate for Payer: Cofinity Commercial |
$1,669.35
|
| Rate for Payer: Cofinity Commercial |
$1,553.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,159.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,217.23
|
| Rate for Payer: Nomi Health Commercial |
$1,391.12
|
| Rate for Payer: PACE SWMI |
$1,159.27
|
| Rate for Payer: PHP Commercial |
$1,622.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.75
|
| Rate for Payer: Priority Health Medicare |
$1,159.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,159.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,159.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,239.70
|
|
|
PR COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX
|
Professional
|
Both
|
$2,766.00
|
|
|
Service Code
|
HCPCS 44322
|
| Min. Negotiated Rate |
$959.53 |
| Max. Negotiated Rate |
$1,797.90 |
| Rate for Payer: Aetna Commercial |
$1,285.77
|
| Rate for Payer: Aetna Medicare |
$997.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.77
|
| Rate for Payer: BCBS Complete |
$1,106.40
|
| Rate for Payer: BCBS MAPPO |
$959.53
|
| Rate for Payer: BCN Medicare Advantage |
$959.53
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cofinity Commercial |
$1,381.72
|
| Rate for Payer: Cofinity Commercial |
$1,285.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.51
|
| Rate for Payer: Nomi Health Commercial |
$1,151.44
|
| Rate for Payer: PACE SWMI |
$959.53
|
| Rate for Payer: PHP Commercial |
$1,343.34
|
| Rate for Payer: PHP Medicare Advantage |
$959.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.90
|
| Rate for Payer: Priority Health Medicare |
$959.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.53
|
| Rate for Payer: UHC Medicare Advantage |
$959.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,272.36
|
|
|
PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,872.00
|
|
|
Service Code
|
HCPCS 44025
|
| Min. Negotiated Rate |
$953.96 |
| Max. Negotiated Rate |
$1,866.80 |
| Rate for Payer: Aetna Commercial |
$1,278.31
|
| Rate for Payer: Aetna Medicare |
$992.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,373.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.31
|
| Rate for Payer: BCBS Complete |
$1,148.80
|
| Rate for Payer: BCBS MAPPO |
$953.96
|
| Rate for Payer: BCN Medicare Advantage |
$953.96
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cofinity Commercial |
$1,373.70
|
| Rate for Payer: Cofinity Commercial |
$1,278.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.66
|
| Rate for Payer: Nomi Health Commercial |
$1,144.75
|
| Rate for Payer: PACE SWMI |
$953.96
|
| Rate for Payer: PHP Commercial |
$1,335.54
|
| Rate for Payer: PHP Medicare Advantage |
$953.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health Medicare |
$953.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.96
|
| Rate for Payer: UHC Medicare Advantage |
$953.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,321.12
|
|
|
PR COLPOCENTESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 57020
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Commercial |
$102.22
|
| Rate for Payer: Aetna Medicare |
$79.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.22
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: BCBS MAPPO |
$76.28
|
| Rate for Payer: BCN Medicare Advantage |
$76.28
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$109.84
|
| Rate for Payer: Cofinity Commercial |
$102.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.09
|
| Rate for Payer: Nomi Health Commercial |
$91.54
|
| Rate for Payer: PACE SWMI |
$76.28
|
| Rate for Payer: PHP Commercial |
$106.79
|
| Rate for Payer: PHP Medicare Advantage |
$76.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health Medicare |
$76.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.28
|
| Rate for Payer: UHC Medicare Advantage |
$76.28
|
| Rate for Payer: UMR Bronson Commercial |
$79.12
|
|
|
PR COLPOCLEISIS LE FORT TYPE
|
Professional
|
Both
|
$2,636.00
|
|
|
Service Code
|
HCPCS 57120
|
| Min. Negotiated Rate |
$506.72 |
| Max. Negotiated Rate |
$1,713.40 |
| Rate for Payer: Aetna Commercial |
$679.00
|
| Rate for Payer: Aetna Medicare |
$526.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.00
|
| Rate for Payer: BCBS Complete |
$1,054.40
|
| Rate for Payer: BCBS MAPPO |
$506.72
|
| Rate for Payer: BCN Medicare Advantage |
$506.72
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cofinity Commercial |
$729.68
|
| Rate for Payer: Cofinity Commercial |
$679.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.06
|
| Rate for Payer: Nomi Health Commercial |
$608.06
|
| Rate for Payer: PACE SWMI |
$506.72
|
| Rate for Payer: PHP Commercial |
$709.41
|
| Rate for Payer: PHP Medicare Advantage |
$506.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,713.40
|
| Rate for Payer: Priority Health Medicare |
$506.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.72
|
| Rate for Payer: UHC Medicare Advantage |
$506.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.56
|
|
