|
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 |
$175.68 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$770.25
|
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$785.12
|
| Rate for Payer: BCN Commercial |
$785.12
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$948.00
|
| 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 |
$893.28
|
| 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 |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.25
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$175.68
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$438.45
|
| Rate for Payer: VA VA |
$893.28
|
| 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 |
$58.36 |
| Max. Negotiated Rate |
$2,245.28 |
| 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 |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.28
|
| Rate for Payer: BCN Commercial |
$497.96
|
| 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 |
$251.29
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| 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: Meridian Medicaid |
$61.28
|
| 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 Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.15
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: Priority Health Narrow Network |
$325.15
|
| Rate for Payer: Priority Health SBD |
$325.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$2,245.28 |
| 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 |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.28
|
| Rate for Payer: BCN Commercial |
$497.96
|
| 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 |
$251.29
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| 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: Meridian Medicaid |
$61.28
|
| 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 Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.15
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: Priority Health Narrow Network |
$325.15
|
| Rate for Payer: Priority Health SBD |
$325.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
| 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 |
$5.54 |
| Max. Negotiated Rate |
$1,441.20 |
| Rate for Payer: Aetna Commercial |
$65.24
|
| Rate for Payer: Aetna Medicare |
$50.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.11
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$48.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.20
|
| Rate for Payer: BCN Commercial |
$78.68
|
| 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 |
$65.24
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| 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: Meridian Medicaid |
$5.82
|
| 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 Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.68
|
| Rate for Payer: Priority Health Medicare |
$48.69
|
| Rate for Payer: Priority Health Narrow Network |
$67.68
|
| Rate for Payer: Priority Health SBD |
$10.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.69
|
| Rate for Payer: UHC Medicare Advantage |
$48.69
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| 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 |
$262.57 |
| Max. Negotiated Rate |
$2,144.76 |
| Rate for Payer: Aetna Commercial |
$1,553.42
|
| Rate for Payer: Aetna Medicare |
$1,205.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,553.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,669.35
|
| Rate for Payer: BCBS Complete |
$808.05
|
| Rate for Payer: BCBS MAPPO |
$1,159.27
|
| Rate for Payer: BCBS Trust/PPO |
$262.57
|
| Rate for Payer: BCN Commercial |
$1,745.56
|
| 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 |
$1,553.42
|
| Rate for Payer: Cofinity Commercial |
$1,669.35
|
| 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: Meridian Medicaid |
$808.05
|
| 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 Choice Medicaid |
$769.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,144.76
|
| Rate for Payer: Priority Health Medicare |
$1,159.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,144.76
|
| Rate for Payer: Priority Health SBD |
$2,144.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,159.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,159.27
|
| Rate for Payer: UHCCP Medicaid |
$769.57
|
| 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 |
$644.96 |
| Max. Negotiated Rate |
$1,802.91 |
| Rate for Payer: Aetna Commercial |
$1,285.77
|
| Rate for Payer: Aetna Medicare |
$997.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,285.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.72
|
| Rate for Payer: BCBS Complete |
$677.21
|
| Rate for Payer: BCBS MAPPO |
$959.53
|
| Rate for Payer: BCBS Trust/PPO |
$955.17
|
| Rate for Payer: BCN Commercial |
$1,471.41
|
| 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 |
$1,285.77
|
| Rate for Payer: Cofinity Commercial |
$1,381.72
|
| 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: Meridian Medicaid |
$677.21
|
| 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 Choice Medicaid |
$644.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,802.91
|
| Rate for Payer: Priority Health Medicare |
$959.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,802.91
|
| Rate for Payer: Priority Health SBD |
$1,802.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.53
|
| Rate for Payer: UHC Medicare Advantage |
$959.53
|
| Rate for Payer: UHCCP Medicaid |
$644.96
|
| 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 |
$631.55 |
| Max. Negotiated Rate |
$2,143.84 |
| Rate for Payer: Aetna Commercial |
$1,278.31
|
| Rate for Payer: Aetna Medicare |
$992.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,373.70
|
| Rate for Payer: BCBS Complete |
$663.13
|
| Rate for Payer: BCBS MAPPO |
$953.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,143.84
|
| Rate for Payer: BCN Commercial |
$1,427.91
|
| 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 |
$1,278.31
|
| Rate for Payer: Cofinity Commercial |
$1,373.70
|
| 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: Meridian Medicaid |
$663.13
|
| 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 Choice Medicaid |
$631.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,756.37
|
| Rate for Payer: Priority Health Medicare |
$953.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,756.37
|
| Rate for Payer: Priority Health SBD |
$1,756.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.96
|
| Rate for Payer: UHC Medicare Advantage |
$953.96
|
| Rate for Payer: UHCCP Medicaid |
$631.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,321.12
|
|
|
PR COLPOCENTESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 57020
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$2,675.31 |
| Rate for Payer: Aetna Commercial |
$102.22
|
| Rate for Payer: Aetna Medicare |
$79.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.84
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$76.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,675.31
|
| Rate for Payer: BCN Commercial |
$185.69
|
| 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 |
$102.22
|
| Rate for Payer: Cofinity Commercial |
$109.84
|
| 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: Meridian Medicaid |
$53.00
|
| 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 Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.56
|
| Rate for Payer: Priority Health Medicare |
$76.28
|
| Rate for Payer: Priority Health Narrow Network |
$117.56
|
| Rate for Payer: Priority Health SBD |
$117.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.28
|
| Rate for Payer: UHC Medicare Advantage |
$76.28
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
| 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 |
$341.01 |
| Max. Negotiated Rate |
$1,901.88 |
| Rate for Payer: Aetna Commercial |
$679.00
|
| Rate for Payer: Aetna Medicare |
$526.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.68
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$506.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.88
|
| Rate for Payer: BCN Commercial |
$779.93
|
| 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 |
$679.00
|
| Rate for Payer: Cofinity Commercial |
$729.68
|
| 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: Meridian Medicaid |
$358.06
|
| 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 Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,713.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.15
|
| Rate for Payer: Priority Health Medicare |
$506.72
|
| Rate for Payer: Priority Health Narrow Network |
$796.15
|
| Rate for Payer: Priority Health SBD |
$796.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.72
|
| Rate for Payer: UHC Medicare Advantage |
$506.72
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.56
|
|
|
PR COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 57210
|
| Min. Negotiated Rate |
$252.62 |
| Max. Negotiated Rate |
$2,571.24 |
| Rate for Payer: Aetna Commercial |
$500.78
|
| Rate for Payer: Aetna Medicare |
$388.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.16
|
| Rate for Payer: BCBS Complete |
$265.25
|
| Rate for Payer: BCBS MAPPO |
$373.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.24
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$373.72
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cofinity Commercial |
$500.78
|
| Rate for Payer: Cofinity Commercial |
$538.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.41
|
| Rate for Payer: Meridian Medicaid |
$265.25
|
| Rate for Payer: Nomi Health Commercial |
$448.46
|
| Rate for Payer: PACE SWMI |
$373.72
|
| Rate for Payer: PHP Commercial |
$523.21
|
| Rate for Payer: PHP Medicare Advantage |
$373.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$591.29
|
| Rate for Payer: Priority Health Medicare |
$373.72
|
| Rate for Payer: Priority Health Narrow Network |
$591.29
|
| Rate for Payer: Priority Health SBD |
$591.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.72
|
| Rate for Payer: UHC Medicare Advantage |
$373.72
|
| Rate for Payer: UHCCP Medicaid |
$252.62
|
| Rate for Payer: UMR Bronson Commercial |
$496.34
|
|
|
PR COLPOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,103.00
|
|
|
Service Code
|
HCPCS 57280
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$2,847.01 |
| Rate for Payer: Aetna Commercial |
$1,240.60
|
| Rate for Payer: Aetna Medicare |
$962.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,240.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.18
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS MAPPO |
$925.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,847.01
|
| Rate for Payer: BCN Commercial |
$1,412.28
|
| Rate for Payer: BCN Medicare Advantage |
$925.82
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,240.60
|
| Rate for Payer: Cofinity Commercial |
$1,333.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.11
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Nomi Health Commercial |
$1,110.98
|
| Rate for Payer: PACE SWMI |
$925.82
|
| Rate for Payer: PHP Commercial |
$1,296.15
|
| Rate for Payer: PHP Medicare Advantage |
$925.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,440.52
|
| Rate for Payer: Priority Health Medicare |
$925.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,440.52
|
| Rate for Payer: Priority Health SBD |
$1,440.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.82
|
| Rate for Payer: UHC Medicare Advantage |
$925.82
|
| Rate for Payer: UHCCP Medicaid |
$618.55
|
| Rate for Payer: UMR Bronson Commercial |
$967.38
|
|
|
PR COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$2,128.00
|
|
|
Service Code
|
HCPCS 57282
|
| Min. Negotiated Rate |
$444.96 |
| Max. Negotiated Rate |
$2,780.44 |
| Rate for Payer: Aetna Commercial |
$890.18
|
| Rate for Payer: Aetna Medicare |
$690.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$956.61
|
| Rate for Payer: BCBS Complete |
$467.21
|
| Rate for Payer: BCBS MAPPO |
$664.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,780.44
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$664.31
|
| Rate for Payer: Cash Price |
$1,702.40
|
| Rate for Payer: Cash Price |
$1,702.40
|
| Rate for Payer: Cofinity Commercial |
$890.18
|
| Rate for Payer: Cofinity Commercial |
$956.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$697.53
|
| Rate for Payer: Meridian Medicaid |
$467.21
|
| Rate for Payer: Nomi Health Commercial |
$797.17
|
| Rate for Payer: PACE SWMI |
$664.31
|
| Rate for Payer: PHP Commercial |
$930.03
|
| Rate for Payer: PHP Medicare Advantage |
$664.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.72
|
| Rate for Payer: Priority Health Medicare |
$664.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.72
|
| Rate for Payer: Priority Health SBD |
$1,037.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$664.31
|
| Rate for Payer: UHC Medicare Advantage |
$664.31
|
| Rate for Payer: UHCCP Medicaid |
$444.96
|
| Rate for Payer: UMR Bronson Commercial |
$978.88
|
|
|
PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$1,164.00
|
|
|
Service Code
|
HCPCS 57283
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$3,053.05 |
| Rate for Payer: Aetna Commercial |
$898.15
|
| Rate for Payer: Aetna Medicare |
$697.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.17
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS MAPPO |
$670.26
|
| Rate for Payer: BCBS Trust/PPO |
$3,053.05
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: BCN Medicare Advantage |
$670.26
|
| Rate for Payer: Cash Price |
$931.20
|
| Rate for Payer: Cash Price |
$931.20
|
| Rate for Payer: Cofinity Commercial |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.77
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Nomi Health Commercial |
$804.31
|
| Rate for Payer: PACE SWMI |
$670.26
|
| Rate for Payer: PHP Commercial |
$938.36
|
| Rate for Payer: PHP Medicare Advantage |
$670.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,045.17
|
| Rate for Payer: Priority Health Medicare |
$670.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,045.17
|
| Rate for Payer: Priority Health SBD |
$1,045.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.26
|
| Rate for Payer: UHC Medicare Advantage |
$670.26
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
| Rate for Payer: UMR Bronson Commercial |
$535.44
|
|
|
PR COLPORRHAPHY SUTURE INJURY VAGINA
|
Professional
|
Both
|
$875.00
|
|
|
Service Code
|
HCPCS 57200
|
| Min. Negotiated Rate |
$213.85 |
| Max. Negotiated Rate |
$2,224.14 |
| Rate for Payer: Aetna Commercial |
$421.79
|
| Rate for Payer: Aetna Medicare |
$327.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.27
|
| Rate for Payer: BCBS Complete |
$224.54
|
| Rate for Payer: BCBS MAPPO |
$314.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.14
|
| Rate for Payer: BCN Commercial |
$487.70
|
| Rate for Payer: BCN Medicare Advantage |
$314.77
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cofinity Commercial |
$421.79
|
| Rate for Payer: Cofinity Commercial |
$453.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.51
|
| Rate for Payer: Meridian Medicaid |
$224.54
|
| Rate for Payer: Nomi Health Commercial |
$377.72
|
| Rate for Payer: PACE SWMI |
$314.77
|
| Rate for Payer: PHP Commercial |
$440.68
|
| Rate for Payer: PHP Medicare Advantage |
$314.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$500.51
|
| Rate for Payer: Priority Health Medicare |
$314.77
|
| Rate for Payer: Priority Health Narrow Network |
$500.51
|
| Rate for Payer: Priority Health SBD |
$500.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.77
|
| Rate for Payer: UHC Medicare Advantage |
$314.77
|
| Rate for Payer: UHCCP Medicaid |
$213.85
|
| Rate for Payer: UMR Bronson Commercial |
$402.50
|
|
|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$246.72 |
| Rate for Payer: Aetna Commercial |
$172.15
|
| Rate for Payer: Aetna Medicare |
$133.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.00
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$128.47
|
| Rate for Payer: BCBS Trust/PPO |
$246.72
|
| Rate for Payer: BCN Commercial |
$199.48
|
| Rate for Payer: BCN Medicare Advantage |
$128.47
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$172.15
|
| Rate for Payer: Cofinity Commercial |
$185.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.89
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: PACE SWMI |
$128.47
|
| Rate for Payer: PHP Commercial |
$179.86
|
| Rate for Payer: PHP Medicare Advantage |
$128.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.91
|
| Rate for Payer: Priority Health Medicare |
$128.47
|
| Rate for Payer: Priority Health Narrow Network |
$198.91
|
| Rate for Payer: Priority Health SBD |
$198.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.47
|
| Rate for Payer: UHC Medicare Advantage |
$128.47
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
| Rate for Payer: UMR Bronson Commercial |
$166.06
|
|
|
PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 57456
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$1,290.64 |
| Rate for Payer: Aetna Commercial |
$129.28
|
| Rate for Payer: Aetna Medicare |
$100.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.93
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS MAPPO |
$96.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.64
|
| Rate for Payer: BCN Commercial |
$179.84
|
| Rate for Payer: BCN Medicare Advantage |
$96.48
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$129.28
|
| Rate for Payer: Cofinity Commercial |
$138.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.30
|
| Rate for Payer: Meridian Medicaid |
$67.32
|
| Rate for Payer: Nomi Health Commercial |
$115.78
|
| Rate for Payer: PACE SWMI |
$96.48
|
| Rate for Payer: PHP Commercial |
$135.07
|
| Rate for Payer: PHP Medicare Advantage |
$96.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.30
|
| Rate for Payer: Priority Health Medicare |
$96.48
|
| Rate for Payer: Priority Health Narrow Network |
$150.30
|
| Rate for Payer: Priority Health SBD |
$150.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.48
|
| Rate for Payer: UHC Medicare Advantage |
$96.48
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
| Rate for Payer: UMR Bronson Commercial |
$167.44
|
|
|
PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 57452
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$304.30 |
| Rate for Payer: Aetna Commercial |
$116.70
|
| Rate for Payer: Aetna Medicare |
$90.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.41
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$87.09
|
| Rate for Payer: BCBS Trust/PPO |
$304.30
|
| Rate for Payer: BCN Commercial |
$150.00
|
| Rate for Payer: BCN Medicare Advantage |
$87.09
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$116.70
|
| Rate for Payer: Cofinity Commercial |
$125.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.44
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$104.51
|
| Rate for Payer: PACE SWMI |
$87.09
|
| Rate for Payer: PHP Commercial |
$121.93
|
| Rate for Payer: PHP Medicare Advantage |
$87.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.41
|
| Rate for Payer: Priority Health Medicare |
$87.09
|
| Rate for Payer: Priority Health Narrow Network |
$135.41
|
| Rate for Payer: Priority Health SBD |
$135.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.09
|
| Rate for Payer: UHC Medicare Advantage |
$87.09
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
| Rate for Payer: UMR Bronson Commercial |
$128.34
|
|
|
PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 57455
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$1,460.22 |
| Rate for Payer: Aetna Commercial |
$140.66
|
| Rate for Payer: Aetna Medicare |
$109.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.16
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$104.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.22
|
| Rate for Payer: BCN Commercial |
$190.44
|
| Rate for Payer: BCN Medicare Advantage |
$104.97
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$140.66
|
| Rate for Payer: Cofinity Commercial |
$151.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.22
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Nomi Health Commercial |
$125.96
|
| Rate for Payer: PACE SWMI |
$104.97
|
| Rate for Payer: PHP Commercial |
$146.96
|
| Rate for Payer: PHP Medicare Advantage |
$104.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.21
|
| Rate for Payer: Priority Health Medicare |
$104.97
|
| Rate for Payer: Priority Health Narrow Network |
$161.21
|
| Rate for Payer: Priority Health SBD |
$161.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.97
|
| Rate for Payer: UHC Medicare Advantage |
$104.97
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
| Rate for Payer: UMR Bronson Commercial |
$167.44
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$960.00
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$178.06 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$624.00
|
| Rate for Payer: Aetna Commercial |
$816.00
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,171.26
|
| Rate for Payer: BCCCP Commercial |
$331.06
|
| Rate for Payer: BCN Commercial |
$3,171.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$825.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$672.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$864.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$672.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$720.00
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.00
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$816.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$604.80
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.87
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$178.06
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$355.20
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$720.00
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 57461
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$1,582.26 |
| Rate for Payer: Aetna Commercial |
$236.99
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.68
|
| Rate for Payer: BCBS Complete |
$123.01
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.26
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: BCN Medicare Advantage |
$176.86
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$236.99
|
| Rate for Payer: Cofinity Commercial |
$254.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.70
|
| Rate for Payer: Meridian Medicaid |
$123.01
|
| Rate for Payer: Nomi Health Commercial |
$212.23
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$247.60
|
| Rate for Payer: PHP Medicare Advantage |
$176.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.33
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow Network |
$271.33
|
| Rate for Payer: Priority Health SBD |
$271.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.86
|
| Rate for Payer: UHC Medicare Advantage |
$176.86
|
| Rate for Payer: UHCCP Medicaid |
$117.15
|
| Rate for Payer: UMR Bronson Commercial |
$441.60
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$1,582.26 |
| Rate for Payer: Aetna Commercial |
$236.99
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.68
|
| Rate for Payer: BCBS Complete |
$123.01
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.26
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: BCN Medicare Advantage |
$176.86
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$254.68
|
| Rate for Payer: Cofinity Commercial |
$236.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.70
|
| Rate for Payer: Meridian Medicaid |
$123.01
|
| Rate for Payer: Nomi Health Commercial |
$212.23
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$247.60
|
| Rate for Payer: PHP Medicare Advantage |
$176.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.33
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow Network |
$271.33
|
| Rate for Payer: Priority Health SBD |
$271.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.86
|
| Rate for Payer: UHC Medicare Advantage |
$176.86
|
| Rate for Payer: UHCCP Medicaid |
$117.15
|
| Rate for Payer: UMR Bronson Commercial |
$441.60
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$960.00
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$422.40 |
| Max. Negotiated Rate |
$864.00 |
| Rate for Payer: Aetna American Axle |
$624.00
|
| Rate for Payer: Aetna Commercial |
$816.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$672.00
|
| Rate for Payer: Cofinity Commercial |
$825.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$672.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.00
|
| Rate for Payer: Healthscope Commercial |
$864.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$672.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$720.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.00
|
| Rate for Payer: PHP Commercial |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health SBD |
$604.80
|
| Rate for Payer: UMR Bronson Commercial |
$422.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$720.00
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$647.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$154.87 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$420.55
|
| Rate for Payer: Aetna Commercial |
$549.95
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$420.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,171.26
|
| Rate for Payer: BCCCP Commercial |
$295.08
|
| Rate for Payer: BCN Commercial |
$3,171.26
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$452.90
|
| Rate for Payer: Cofinity Commercial |
$556.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$452.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$582.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$452.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$485.25
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.95
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$549.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$407.61
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.36
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$154.87
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$239.39
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$485.25
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 57460
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$1,524.15 |
| Rate for Payer: Aetna Commercial |
$206.41
|
| Rate for Payer: Aetna Medicare |
$160.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.82
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$154.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.15
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: BCN Medicare Advantage |
$154.04
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$206.41
|
| Rate for Payer: Cofinity Commercial |
$221.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.74
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Nomi Health Commercial |
$184.85
|
| Rate for Payer: PACE SWMI |
$154.04
|
| Rate for Payer: PHP Commercial |
$215.66
|
| Rate for Payer: PHP Medicare Advantage |
$154.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.10
|
| Rate for Payer: Priority Health Medicare |
$154.04
|
| Rate for Payer: Priority Health Narrow Network |
$237.10
|
| Rate for Payer: Priority Health SBD |
$237.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.04
|
| Rate for Payer: UHC Medicare Advantage |
$154.04
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
| Rate for Payer: UMR Bronson Commercial |
$297.62
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$1,524.15 |
| Rate for Payer: Aetna Commercial |
$206.41
|
| Rate for Payer: Aetna Medicare |
$160.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.82
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$154.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.15
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: BCN Medicare Advantage |
$154.04
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$221.82
|
| Rate for Payer: Cofinity Commercial |
$206.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.74
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Nomi Health Commercial |
$184.85
|
| Rate for Payer: PACE SWMI |
$154.04
|
| Rate for Payer: PHP Commercial |
$215.66
|
| Rate for Payer: PHP Medicare Advantage |
$154.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.10
|
| Rate for Payer: Priority Health Medicare |
$154.04
|
| Rate for Payer: Priority Health Narrow Network |
$237.10
|
| Rate for Payer: Priority Health SBD |
$237.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.04
|
| Rate for Payer: UHC Medicare Advantage |
$154.04
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
| Rate for Payer: UMR Bronson Commercial |
$297.62
|
|
