|
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 ENTIRE VAGINA W/CERVIX IF PRESENT
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 57420
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$1,752.90 |
| Rate for Payer: Aetna Commercial |
$116.24
|
| Rate for Payer: Aetna Medicare |
$90.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.92
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$86.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.90
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$86.75
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$116.24
|
| Rate for Payer: Cofinity Commercial |
$124.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.09
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Nomi Health Commercial |
$104.10
|
| Rate for Payer: PACE SWMI |
$86.75
|
| Rate for Payer: PHP Commercial |
$121.45
|
| Rate for Payer: PHP Medicare Advantage |
$86.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.43
|
| Rate for Payer: Priority Health Medicare |
$86.75
|
| Rate for Payer: Priority Health Narrow Network |
$133.43
|
| Rate for Payer: Priority Health SBD |
$133.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.75
|
| Rate for Payer: UHC Medicare Advantage |
$86.75
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
| Rate for Payer: UMR Bronson Commercial |
$108.10
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 57421
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$260.95 |
| Rate for Payer: Aetna Commercial |
$157.83
|
| Rate for Payer: Aetna Medicare |
$122.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.60
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$117.78
|
| Rate for Payer: BCBS Trust/PPO |
$122.57
|
| Rate for Payer: BCN Commercial |
$260.95
|
| Rate for Payer: BCN Medicare Advantage |
$117.78
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$157.83
|
| Rate for Payer: Cofinity Commercial |
$169.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.67
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$141.34
|
| Rate for Payer: PACE SWMI |
$117.78
|
| Rate for Payer: PHP Commercial |
$164.89
|
| Rate for Payer: PHP Medicare Advantage |
$117.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.06
|
| Rate for Payer: Priority Health Medicare |
$117.78
|
| Rate for Payer: Priority Health Narrow Network |
$181.06
|
| Rate for Payer: Priority Health SBD |
$181.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.78
|
| Rate for Payer: UHC Medicare Advantage |
$117.78
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
| Rate for Payer: UMR Bronson Commercial |
$140.30
|
|
|
PR COLPOSCOPY VULVA
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 56820
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$1,801.50 |
| Rate for Payer: Aetna Commercial |
$108.42
|
| Rate for Payer: Aetna Medicare |
$84.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.51
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$80.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.50
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: BCN Medicare Advantage |
$80.91
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$108.42
|
| Rate for Payer: Cofinity Commercial |
$116.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.96
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$97.09
|
| Rate for Payer: PACE SWMI |
$80.91
|
| Rate for Payer: PHP Commercial |
$113.27
|
| Rate for Payer: PHP Medicare Advantage |
$80.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.00
|
| Rate for Payer: Priority Health Medicare |
$80.91
|
| Rate for Payer: Priority Health Narrow Network |
$125.00
|
| Rate for Payer: Priority Health SBD |
$125.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.91
|
| Rate for Payer: UHC Medicare Advantage |
$80.91
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$351.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$88.31 |
| Max. Negotiated Rate |
$936.74 |
| Rate for Payer: Aetna American Axle |
$228.15
|
| Rate for Payer: Aetna Commercial |
$298.35
|
| Rate for Payer: Aetna Medicare |
$309.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$88.31
|
| Rate for Payer: BCN Commercial |
$88.31
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$245.70
|
| Rate for Payer: Cofinity Commercial |
$301.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$315.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.25
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.35
|
| Rate for Payer: Nomi Health Commercial |
$625.88
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$298.35
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.74
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$749.39
|
| Rate for Payer: Priority Health SBD |
$221.13
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.44
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$110.40
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$129.87
|
| Rate for Payer: VA VA |
$298.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.25
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 56821
|
| Min. Negotiated Rate |
$72.63 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$146.53
|
| Rate for Payer: Aetna Medicare |
$113.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.46
|
| Rate for Payer: BCBS Complete |
$76.26
|
| Rate for Payer: BCBS MAPPO |
$109.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$109.35
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$146.53
|
| Rate for Payer: Cofinity Commercial |
$157.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.82
|
| Rate for Payer: Meridian Medicaid |
$76.26
|
| Rate for Payer: Nomi Health Commercial |
$131.22
|
| Rate for Payer: PACE SWMI |
$109.35
|
| Rate for Payer: PHP Commercial |
$153.09
|
| Rate for Payer: PHP Medicare Advantage |
$109.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.66
|
| Rate for Payer: Priority Health Medicare |
$109.35
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Priority Health SBD |
$168.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.35
|
| Rate for Payer: UHC Medicare Advantage |
$109.35
|
| Rate for Payer: UHCCP Medicaid |
$72.63
|
| Rate for Payer: UMR Bronson Commercial |
$161.46
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$351.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$154.44 |
| Max. Negotiated Rate |
$315.90 |
| Rate for Payer: Aetna American Axle |
$228.15
|
| Rate for Payer: Aetna Commercial |
$298.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.15
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$245.70
|
| Rate for Payer: Cofinity Commercial |
$301.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.80
|
| Rate for Payer: Healthscope Commercial |
$315.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.35
|
| Rate for Payer: PHP Commercial |
$298.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health SBD |
$221.13
|
| Rate for Payer: UMR Bronson Commercial |
$154.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.25
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 56821
|
| Hospital Charge Code |
56821
|
| Min. Negotiated Rate |
$72.63 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$146.53
|
| Rate for Payer: Aetna Medicare |
$113.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.46
|
| Rate for Payer: BCBS Complete |
$76.26
|
| Rate for Payer: BCBS MAPPO |
$109.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$109.35
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$157.46
|
| Rate for Payer: Cofinity Commercial |
$146.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.82
|
| Rate for Payer: Meridian Medicaid |
$76.26
|
| Rate for Payer: Nomi Health Commercial |
$131.22
|
| Rate for Payer: PACE SWMI |
$109.35
|
| Rate for Payer: PHP Commercial |
$153.09
|
| Rate for Payer: PHP Medicare Advantage |
$109.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.66
|
| Rate for Payer: Priority Health Medicare |
$109.35
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: Priority Health SBD |
$168.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.35
|
| Rate for Payer: UHC Medicare Advantage |
$109.35
|
| Rate for Payer: UHCCP Medicaid |
$72.63
|
| Rate for Payer: UMR Bronson Commercial |
$161.46
|
|
|
PR COLPOTOMY W/DRAINAGE PELVIC ABSCESS
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 57010
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$1,747.09 |
| Rate for Payer: Aetna Commercial |
$584.76
|
| Rate for Payer: Aetna Medicare |
$453.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.40
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$436.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,747.09
|
| Rate for Payer: BCN Commercial |
$673.89
|
| Rate for Payer: BCN Medicare Advantage |
$436.39
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$584.76
|
| Rate for Payer: Cofinity Commercial |
$628.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.21
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Nomi Health Commercial |
$523.67
|
| Rate for Payer: PACE SWMI |
$436.39
|
| Rate for Payer: PHP Commercial |
$610.95
|
| Rate for Payer: PHP Medicare Advantage |
$436.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$651.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.02
|
| Rate for Payer: Priority Health Medicare |
$436.39
|
| Rate for Payer: Priority Health Narrow Network |
$688.02
|
| Rate for Payer: Priority Health SBD |
$688.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.39
|
| Rate for Payer: UHC Medicare Advantage |
$436.39
|
| Rate for Payer: UHCCP Medicaid |
$294.15
|
| Rate for Payer: UMR Bronson Commercial |
$461.38
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$979.31 |
| Rate for Payer: Aetna Commercial |
$326.41
|
| Rate for Payer: Aetna Medicare |
$253.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.77
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$243.59
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: BCN Medicare Advantage |
$243.59
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$326.41
|
| Rate for Payer: Cofinity Commercial |
$350.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.77
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Nomi Health Commercial |
$292.31
|
| Rate for Payer: PACE SWMI |
$243.59
|
| Rate for Payer: PHP Commercial |
$341.03
|
| Rate for Payer: PHP Medicare Advantage |
$243.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.60
|
| Rate for Payer: Priority Health Medicare |
$243.59
|
| Rate for Payer: Priority Health Narrow Network |
$454.60
|
| Rate for Payer: Priority Health SBD |
$454.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.59
|
| Rate for Payer: UHC Medicare Advantage |
$243.59
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
| Rate for Payer: UMR Bronson Commercial |
$655.04
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
IP
|
$1,424.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$626.56 |
| Max. Negotiated Rate |
$1,281.60 |
| Rate for Payer: Aetna American Axle |
$925.60
|
| Rate for Payer: Aetna Commercial |
$1,210.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$925.60
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,224.64
|
| Rate for Payer: Cofinity Commercial |
$996.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$996.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.20
|
| Rate for Payer: Healthscope Commercial |
$1,281.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$996.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,068.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,210.40
|
| Rate for Payer: PHP Commercial |
$1,210.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health SBD |
$897.12
|
| Rate for Payer: UMR Bronson Commercial |
$626.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,068.00
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
OP
|
$1,424.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$245.60 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna American Axle |
$925.60
|
| Rate for Payer: Aetna Commercial |
$1,210.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$925.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$861.39
|
| Rate for Payer: BCN Commercial |
$861.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$996.80
|
| Rate for Payer: Cofinity Commercial |
$1,224.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$996.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,281.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$996.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,068.00
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,210.40
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,210.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$897.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.16
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$245.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$526.88
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,068.00
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 45382
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$979.31 |
| Rate for Payer: Aetna Commercial |
$326.41
|
| Rate for Payer: Aetna Medicare |
$253.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.77
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS MAPPO |
$243.59
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: BCN Medicare Advantage |
$243.59
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$326.41
|
| Rate for Payer: Cofinity Commercial |
$350.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.77
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Nomi Health Commercial |
$292.31
|
| Rate for Payer: PACE SWMI |
$243.59
|
| Rate for Payer: PHP Commercial |
$341.03
|
| Rate for Payer: PHP Medicare Advantage |
$243.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.60
|
| Rate for Payer: Priority Health Medicare |
$243.59
|
| Rate for Payer: Priority Health Narrow Network |
$454.60
|
| Rate for Payer: Priority Health SBD |
$454.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.59
|
| Rate for Payer: UHC Medicare Advantage |
$243.59
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
| Rate for Payer: UMR Bronson Commercial |
$655.04
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$898.67 |
| Rate for Payer: Aetna Commercial |
$268.59
|
| Rate for Payer: Aetna Medicare |
$208.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.63
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$200.44
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$200.44
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$268.59
|
| Rate for Payer: Cofinity Commercial |
$288.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.46
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Nomi Health Commercial |
$240.53
|
| Rate for Payer: PACE SWMI |
$200.44
|
| Rate for Payer: PHP Commercial |
$280.62
|
| Rate for Payer: PHP Medicare Advantage |
$200.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.88
|
| Rate for Payer: Priority Health Medicare |
$200.44
|
| Rate for Payer: Priority Health Narrow Network |
$372.88
|
| Rate for Payer: Priority Health SBD |
$372.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.44
|
| Rate for Payer: UHC Medicare Advantage |
$200.44
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
| Rate for Payer: UMR Bronson Commercial |
$607.20
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Facility
|
OP
|
$1,320.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$201.54 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: BCN Commercial |
$861.39
|
| Rate for Payer: Aetna American Axle |
$858.00
|
| Rate for Payer: Aetna Commercial |
$1,122.00
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$861.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$1,135.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$924.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,188.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$924.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.00
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.00
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,122.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$831.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.69
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$201.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$488.40
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.00
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$898.67 |
| Rate for Payer: Aetna Commercial |
$268.59
|
| Rate for Payer: Aetna Medicare |
$208.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.63
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS MAPPO |
$200.44
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$200.44
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$288.63
|
| Rate for Payer: Cofinity Commercial |
$268.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.46
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Nomi Health Commercial |
$240.53
|
| Rate for Payer: PACE SWMI |
$200.44
|
| Rate for Payer: PHP Commercial |
$280.62
|
| Rate for Payer: PHP Medicare Advantage |
$200.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.88
|
| Rate for Payer: Priority Health Medicare |
$200.44
|
| Rate for Payer: Priority Health Narrow Network |
$372.88
|
| Rate for Payer: Priority Health SBD |
$372.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.44
|
| Rate for Payer: UHC Medicare Advantage |
$200.44
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
| Rate for Payer: UMR Bronson Commercial |
$607.20
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Facility
|
IP
|
$1,320.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$580.80 |
| Max. Negotiated Rate |
$1,188.00 |
| Rate for Payer: Aetna American Axle |
$858.00
|
| Rate for Payer: Aetna Commercial |
$1,122.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,135.20
|
| Rate for Payer: Cofinity Commercial |
$924.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$924.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.00
|
| Rate for Payer: Healthscope Commercial |
$1,188.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$924.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.00
|
| Rate for Payer: PHP Commercial |
$1,122.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health SBD |
$831.60
|
| Rate for Payer: UMR Bronson Commercial |
$580.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.00
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 45381
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$913.90 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| 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: Meridian Medicaid |
$133.30
|
| 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 Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.59
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: Priority Health Narrow Network |
$352.59
|
| Rate for Payer: Priority Health SBD |
$352.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
| Rate for Payer: UMR Bronson Commercial |
$646.76
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
OP
|
$1,406.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$190.44 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna American Axle |
$913.90
|
| Rate for Payer: Aetna Commercial |
$1,195.10
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$861.39
|
| Rate for Payer: BCN Commercial |
$861.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,209.16
|
| Rate for Payer: Cofinity Commercial |
$984.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$984.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,265.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$984.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,054.50
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.10
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,195.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$885.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.48
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$190.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$520.22
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,054.50
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
45381
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$913.90 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$197.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Cofinity Commercial |
$254.41
|
| 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: Meridian Medicaid |
$133.30
|
| 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 Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.59
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: Priority Health Narrow Network |
$352.59
|
| Rate for Payer: Priority Health SBD |
$352.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
| Rate for Payer: UMR Bronson Commercial |
$646.76
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
IP
|
$1,406.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$618.64 |
| Max. Negotiated Rate |
$1,265.40 |
| Rate for Payer: Aetna American Axle |
$913.90
|
| Rate for Payer: Aetna Commercial |
$1,195.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.90
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,209.16
|
| Rate for Payer: Cofinity Commercial |
$984.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$984.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Healthscope Commercial |
$1,265.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$984.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,054.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.10
|
| Rate for Payer: PHP Commercial |
$1,195.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health SBD |
$885.78
|
| Rate for Payer: UMR Bronson Commercial |
$618.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,054.50
|
|
|
PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 45391
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$452.81 |
| Rate for Payer: Aetna Commercial |
$324.52
|
| Rate for Payer: Aetna Medicare |
$251.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.74
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCBS MAPPO |
$242.18
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$242.18
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cofinity Commercial |
$324.52
|
| Rate for Payer: Cofinity Commercial |
$348.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.29
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Nomi Health Commercial |
$290.62
|
| Rate for Payer: PACE SWMI |
$242.18
|
| Rate for Payer: PHP Commercial |
$339.05
|
| Rate for Payer: PHP Medicare Advantage |
$242.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.81
|
| Rate for Payer: Priority Health Medicare |
$242.18
|
| Rate for Payer: Priority Health Narrow Network |
$452.81
|
| Rate for Payer: Priority Health SBD |
$452.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.18
|
| Rate for Payer: UHC Medicare Advantage |
$242.18
|
| Rate for Payer: UHCCP Medicaid |
$162.09
|
| Rate for Payer: UMR Bronson Commercial |
$250.24
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45384
|
| Hospital Charge Code |
45384
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$941.20 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare |
$225.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.83
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$216.55
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$717.86
|
| Rate for Payer: BCN Medicare Advantage |
$216.55
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$311.83
|
| Rate for Payer: Cofinity Commercial |
$290.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.38
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Nomi Health Commercial |
$259.86
|
| Rate for Payer: PACE SWMI |
$216.55
|
| Rate for Payer: PHP Commercial |
$303.17
|
| Rate for Payer: PHP Medicare Advantage |
$216.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.11
|
| Rate for Payer: Priority Health Medicare |
$216.55
|
| Rate for Payer: Priority Health Narrow Network |
$402.11
|
| Rate for Payer: Priority Health SBD |
$402.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.55
|
| Rate for Payer: UHC Medicare Advantage |
$216.55
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
| Rate for Payer: UMR Bronson Commercial |
$666.08
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Facility
|
OP
|
$1,448.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
45384
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$218.23 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna American Axle |
$941.20
|
| Rate for Payer: Aetna Commercial |
$1,230.80
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$861.39
|
| Rate for Payer: BCN Commercial |
$861.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$1,013.60
|
| Rate for Payer: Cofinity Commercial |
$1,245.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,013.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,303.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,013.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.00
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,230.80
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,230.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$912.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.05
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$218.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$535.76
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.00
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45384
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$941.20 |
| Rate for Payer: Aetna Commercial |
$290.18
|
| Rate for Payer: Aetna Medicare |
$225.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.83
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$216.55
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$717.86
|
| Rate for Payer: BCN Medicare Advantage |
$216.55
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cofinity Commercial |
$290.18
|
| Rate for Payer: Cofinity Commercial |
$311.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.38
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Nomi Health Commercial |
$259.86
|
| Rate for Payer: PACE SWMI |
$216.55
|
| Rate for Payer: PHP Commercial |
$303.17
|
| Rate for Payer: PHP Medicare Advantage |
$216.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.11
|
| Rate for Payer: Priority Health Medicare |
$216.55
|
| Rate for Payer: Priority Health Narrow Network |
$402.11
|
| Rate for Payer: Priority Health SBD |
$402.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.55
|
| Rate for Payer: UHC Medicare Advantage |
$216.55
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
| Rate for Payer: UMR Bronson Commercial |
$666.08
|
|
