|
PR ENTERORRHAPHY SINGLE PERFORATION
|
Professional
|
Both
|
$2,498.00
|
|
|
Service Code
|
HCPCS 44602
|
| Min. Negotiated Rate |
$822.82 |
| Max. Negotiated Rate |
$2,558.09 |
| Rate for Payer: Aetna Commercial |
$1,730.40
|
| Rate for Payer: Aetna Medicare |
$1,342.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.53
|
| Rate for Payer: BCBS Complete |
$863.96
|
| Rate for Payer: BCBS MAPPO |
$1,291.34
|
| Rate for Payer: BCN Commercial |
$2,099.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,291.34
|
| Rate for Payer: Cash Price |
$1,998.40
|
| Rate for Payer: Cash Price |
$1,998.40
|
| Rate for Payer: Cofinity Commercial |
$1,730.40
|
| Rate for Payer: Cofinity Commercial |
$1,859.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,355.91
|
| Rate for Payer: Meridian Medicaid |
$863.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,420.47
|
| Rate for Payer: Nomi Health Commercial |
$1,549.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,873.50
|
| Rate for Payer: PACE SWMI |
$1,291.34
|
| Rate for Payer: PHP Commercial |
$1,807.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,291.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$822.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,558.09
|
| Rate for Payer: Priority Health Medicare |
$1,291.34
|
| Rate for Payer: Priority Health SBD |
$2,558.09
|
| Rate for Payer: Priority Health Tiered Network |
$2,558.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,291.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,522.39
|
| Rate for Payer: UHC Core |
$2,522.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,291.34
|
| Rate for Payer: UHC Exchange |
$2,522.39
|
| Rate for Payer: UHC Medicaid |
$822.82
|
| Rate for Payer: UHCCP Medicaid |
$822.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,149.08
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 44377
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$877.50 |
| Rate for Payer: Aetna Commercial |
$345.41
|
| Rate for Payer: Aetna Medicare |
$268.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.19
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS MAPPO |
$257.77
|
| Rate for Payer: BCN Commercial |
$438.23
|
| Rate for Payer: BCN Medicare Advantage |
$257.77
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$345.41
|
| Rate for Payer: Cofinity Commercial |
$371.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.66
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.55
|
| Rate for Payer: Nomi Health Commercial |
$309.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$877.50
|
| Rate for Payer: PACE SWMI |
$257.77
|
| Rate for Payer: PHP Commercial |
$360.88
|
| Rate for Payer: PHP Medicare Advantage |
$257.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$533.95
|
| Rate for Payer: Priority Health Medicare |
$257.77
|
| Rate for Payer: Priority Health SBD |
$533.95
|
| Rate for Payer: Priority Health Tiered Network |
$533.95
|
| Rate for Payer: Railroad Medicare Medicare |
$257.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.85
|
| Rate for Payer: UHC Core |
$527.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.77
|
| Rate for Payer: UHC Exchange |
$527.85
|
| Rate for Payer: UHC Medicaid |
$166.35
|
| Rate for Payer: UHCCP Medicaid |
$166.35
|
| Rate for Payer: UMR Bronson Commercial |
$538.20
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 44376
|
| Min. Negotiated Rate |
$158.47 |
| Max. Negotiated Rate |
$800.25 |
| Rate for Payer: Aetna Commercial |
$328.80
|
| Rate for Payer: Aetna Medicare |
$255.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.33
|
| Rate for Payer: BCBS Complete |
$166.39
|
| Rate for Payer: BCBS MAPPO |
$245.37
|
| Rate for Payer: BCN Commercial |
$417.80
|
| Rate for Payer: BCN Medicare Advantage |
$245.37
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cofinity Commercial |
$328.80
|
| Rate for Payer: Cofinity Commercial |
$353.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.64
|
| Rate for Payer: Meridian Medicaid |
$166.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$269.91
|
| Rate for Payer: Nomi Health Commercial |
$294.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$800.25
|
| Rate for Payer: PACE SWMI |
$245.37
|
| Rate for Payer: PHP Commercial |
$343.52
|
| Rate for Payer: PHP Medicare Advantage |
$245.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$509.07
|
| Rate for Payer: Priority Health Medicare |
$245.37
|
| Rate for Payer: Priority Health SBD |
$509.07
|
| Rate for Payer: Priority Health Tiered Network |
$509.07
|
| Rate for Payer: Railroad Medicare Medicare |
$245.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$501.50
|
| Rate for Payer: UHC Core |
$501.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$245.37
|
| Rate for Payer: UHC Exchange |
$501.50
|
| Rate for Payer: UHC Medicaid |
$158.47
|
| Rate for Payer: UHCCP Medicaid |
$158.47
|
| Rate for Payer: UMR Bronson Commercial |
$490.82
|
|
|
PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 44369
|
| Min. Negotiated Rate |
$137.60 |
| Max. Negotiated Rate |
$865.50 |
| Rate for Payer: Aetna Commercial |
$285.26
|
| Rate for Payer: Aetna Medicare |
$221.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.55
|
| Rate for Payer: BCBS Complete |
$144.48
|
| Rate for Payer: BCBS MAPPO |
$212.88
|
| Rate for Payer: BCN Commercial |
$361.04
|
| Rate for Payer: BCN Medicare Advantage |
$212.88
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$285.26
|
| Rate for Payer: Cofinity Commercial |
$306.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.52
|
| Rate for Payer: Meridian Medicaid |
$144.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$234.17
|
| Rate for Payer: Nomi Health Commercial |
$255.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.50
|
| Rate for Payer: PACE SWMI |
$212.88
|
| Rate for Payer: PHP Commercial |
$298.03
|
| Rate for Payer: PHP Medicare Advantage |
$212.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$439.90
|
| Rate for Payer: Priority Health Medicare |
$212.88
|
| Rate for Payer: Priority Health SBD |
$439.90
|
| Rate for Payer: Priority Health Tiered Network |
$439.90
|
| Rate for Payer: Railroad Medicare Medicare |
$212.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.97
|
| Rate for Payer: UHC Core |
$433.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$212.88
|
| Rate for Payer: UHC Exchange |
$433.97
|
| Rate for Payer: UHC Medicaid |
$137.60
|
| Rate for Payer: UHCCP Medicaid |
$137.60
|
| Rate for Payer: UMR Bronson Commercial |
$530.84
|
|
|
PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE
|
Professional
|
Both
|
$950.00
|
|
|
Service Code
|
HCPCS 44373
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Aetna Commercial |
$225.46
|
| Rate for Payer: Aetna Medicare |
$174.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.28
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$168.25
|
| Rate for Payer: BCN Commercial |
$283.85
|
| Rate for Payer: BCN Medicare Advantage |
$168.25
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$225.46
|
| Rate for Payer: Cofinity Commercial |
$242.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.66
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.07
|
| Rate for Payer: Nomi Health Commercial |
$201.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.50
|
| Rate for Payer: PACE SWMI |
$168.25
|
| Rate for Payer: PHP Commercial |
$235.55
|
| Rate for Payer: PHP Medicare Advantage |
$168.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$345.86
|
| Rate for Payer: Priority Health Medicare |
$168.25
|
| Rate for Payer: Priority Health SBD |
$345.86
|
| Rate for Payer: Priority Health Tiered Network |
$345.86
|
| Rate for Payer: Railroad Medicare Medicare |
$168.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.25
|
| Rate for Payer: UHC Core |
$339.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.25
|
| Rate for Payer: UHC Exchange |
$339.25
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
| Rate for Payer: UMR Bronson Commercial |
$437.00
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,594.00
|
|
|
Service Code
|
HCPCS 44378
|
| Min. Negotiated Rate |
$213.64 |
| Max. Negotiated Rate |
$1,195.50 |
| Rate for Payer: Aetna Commercial |
$443.83
|
| Rate for Payer: Aetna Medicare |
$344.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.96
|
| Rate for Payer: BCBS Complete |
$224.32
|
| Rate for Payer: BCBS MAPPO |
$331.22
|
| Rate for Payer: BCN Commercial |
$564.22
|
| Rate for Payer: BCN Medicare Advantage |
$331.22
|
| Rate for Payer: Cash Price |
$1,275.20
|
| Rate for Payer: Cash Price |
$1,275.20
|
| Rate for Payer: Cofinity Commercial |
$443.83
|
| Rate for Payer: Cofinity Commercial |
$476.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.78
|
| Rate for Payer: Meridian Medicaid |
$224.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$364.34
|
| Rate for Payer: Nomi Health Commercial |
$397.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,195.50
|
| Rate for Payer: PACE SWMI |
$331.22
|
| Rate for Payer: PHP Commercial |
$463.71
|
| Rate for Payer: PHP Medicare Advantage |
$331.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$687.46
|
| Rate for Payer: Priority Health Medicare |
$331.22
|
| Rate for Payer: Priority Health SBD |
$687.46
|
| Rate for Payer: Priority Health Tiered Network |
$687.46
|
| Rate for Payer: Railroad Medicare Medicare |
$331.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.10
|
| Rate for Payer: UHC Core |
$679.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.22
|
| Rate for Payer: UHC Exchange |
$679.10
|
| Rate for Payer: UHC Medicaid |
$213.64
|
| Rate for Payer: UHCCP Medicaid |
$213.64
|
| Rate for Payer: UMR Bronson Commercial |
$733.24
|
|
|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,426.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$150.17 |
| Max. Negotiated Rate |
$1,069.50 |
| Rate for Payer: Aetna Commercial |
$310.61
|
| Rate for Payer: Aetna Medicare |
$241.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.79
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS MAPPO |
$231.80
|
| Rate for Payer: BCN Commercial |
$392.41
|
| Rate for Payer: BCN Medicare Advantage |
$231.80
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Cash Price |
$1,140.80
|
| Rate for Payer: Cofinity Commercial |
$310.61
|
| Rate for Payer: Cofinity Commercial |
$333.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.39
|
| Rate for Payer: Meridian Medicaid |
$157.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$254.98
|
| Rate for Payer: Nomi Health Commercial |
$278.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,069.50
|
| Rate for Payer: PACE SWMI |
$231.80
|
| Rate for Payer: PHP Commercial |
$324.52
|
| Rate for Payer: PHP Medicare Advantage |
$231.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$478.12
|
| Rate for Payer: Priority Health Medicare |
$231.80
|
| Rate for Payer: Priority Health SBD |
$478.12
|
| Rate for Payer: Priority Health Tiered Network |
$478.12
|
| Rate for Payer: Railroad Medicare Medicare |
$231.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.57
|
| Rate for Payer: UHC Core |
$469.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$231.80
|
| Rate for Payer: UHC Exchange |
$469.57
|
| Rate for Payer: UHC Medicaid |
$150.17
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
| Rate for Payer: UMR Bronson Commercial |
$655.96
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,358.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$1,018.50 |
| Rate for Payer: Aetna Commercial |
$278.10
|
| Rate for Payer: Aetna Medicare |
$215.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.86
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS MAPPO |
$207.54
|
| Rate for Payer: BCN Commercial |
$352.57
|
| Rate for Payer: BCN Medicare Advantage |
$207.54
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cash Price |
$1,086.40
|
| Rate for Payer: Cofinity Commercial |
$278.10
|
| Rate for Payer: Cofinity Commercial |
$298.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.92
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$228.29
|
| Rate for Payer: Nomi Health Commercial |
$249.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,018.50
|
| Rate for Payer: PACE SWMI |
$207.54
|
| Rate for Payer: PHP Commercial |
$290.56
|
| Rate for Payer: PHP Medicare Advantage |
$207.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$429.58
|
| Rate for Payer: Priority Health Medicare |
$207.54
|
| Rate for Payer: Priority Health SBD |
$429.58
|
| Rate for Payer: Priority Health Tiered Network |
$429.58
|
| Rate for Payer: Railroad Medicare Medicare |
$207.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.57
|
| Rate for Payer: UHC Core |
$423.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$207.54
|
| Rate for Payer: UHC Exchange |
$423.57
|
| Rate for Payer: UHC Medicaid |
$134.19
|
| Rate for Payer: UHCCP Medicaid |
$134.19
|
| Rate for Payer: UMR Bronson Commercial |
$624.68
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,578.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$228.76 |
| Max. Negotiated Rate |
$1,183.50 |
| Rate for Payer: Aetna Commercial |
$474.65
|
| Rate for Payer: Aetna Medicare |
$368.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$474.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.08
|
| Rate for Payer: BCBS Complete |
$240.20
|
| Rate for Payer: BCBS MAPPO |
$354.22
|
| Rate for Payer: BCN Commercial |
$600.57
|
| Rate for Payer: BCN Medicare Advantage |
$354.22
|
| Rate for Payer: Cash Price |
$1,262.40
|
| Rate for Payer: Cash Price |
$1,262.40
|
| Rate for Payer: Cofinity Commercial |
$474.65
|
| Rate for Payer: Cofinity Commercial |
$510.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$371.93
|
| Rate for Payer: Meridian Medicaid |
$240.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$389.64
|
| Rate for Payer: Nomi Health Commercial |
$425.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,183.50
|
| Rate for Payer: PACE SWMI |
$354.22
|
| Rate for Payer: PHP Commercial |
$495.91
|
| Rate for Payer: PHP Medicare Advantage |
$354.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$731.75
|
| Rate for Payer: Priority Health Medicare |
$354.22
|
| Rate for Payer: Priority Health SBD |
$731.75
|
| Rate for Payer: Priority Health Tiered Network |
$731.75
|
| Rate for Payer: Railroad Medicare Medicare |
$354.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.46
|
| Rate for Payer: UHC Core |
$721.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$354.22
|
| Rate for Payer: UHC Exchange |
$721.46
|
| Rate for Payer: UHC Medicaid |
$228.76
|
| Rate for Payer: UHCCP Medicaid |
$228.76
|
| Rate for Payer: UMR Bronson Commercial |
$725.88
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE
|
Professional
|
Both
|
$968.00
|
|
|
Service Code
|
HCPCS 44372
|
| Min. Negotiated Rate |
$135.26 |
| Max. Negotiated Rate |
$726.00 |
| Rate for Payer: Aetna Commercial |
$281.12
|
| Rate for Payer: Aetna Medicare |
$218.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.10
|
| Rate for Payer: BCBS Complete |
$142.02
|
| Rate for Payer: BCBS MAPPO |
$209.79
|
| Rate for Payer: BCN Commercial |
$353.57
|
| Rate for Payer: BCN Medicare Advantage |
$209.79
|
| Rate for Payer: Cash Price |
$774.40
|
| Rate for Payer: Cash Price |
$774.40
|
| Rate for Payer: Cofinity Commercial |
$281.12
|
| Rate for Payer: Cofinity Commercial |
$302.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.28
|
| Rate for Payer: Meridian Medicaid |
$142.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$230.77
|
| Rate for Payer: Nomi Health Commercial |
$251.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$726.00
|
| Rate for Payer: PACE SWMI |
$209.79
|
| Rate for Payer: PHP Commercial |
$293.71
|
| Rate for Payer: PHP Medicare Advantage |
$209.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$430.80
|
| Rate for Payer: Priority Health Medicare |
$209.79
|
| Rate for Payer: Priority Health SBD |
$430.80
|
| Rate for Payer: Priority Health Tiered Network |
$430.80
|
| Rate for Payer: Railroad Medicare Medicare |
$209.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.93
|
| Rate for Payer: UHC Core |
$423.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$209.79
|
| Rate for Payer: UHC Exchange |
$423.93
|
| Rate for Payer: UHC Medicaid |
$135.26
|
| Rate for Payer: UHCCP Medicaid |
$135.26
|
| Rate for Payer: UMR Bronson Commercial |
$445.28
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$752.25 |
| Rate for Payer: Aetna Commercial |
$224.14
|
| Rate for Payer: Aetna Medicare |
$173.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.87
|
| Rate for Payer: BCBS Complete |
$113.61
|
| Rate for Payer: BCBS MAPPO |
$167.27
|
| Rate for Payer: BCN Commercial |
$281.86
|
| Rate for Payer: BCN Medicare Advantage |
$167.27
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cofinity Commercial |
$224.14
|
| Rate for Payer: Cofinity Commercial |
$240.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.63
|
| Rate for Payer: Meridian Medicaid |
$113.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.00
|
| Rate for Payer: Nomi Health Commercial |
$200.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.25
|
| Rate for Payer: PACE SWMI |
$167.27
|
| Rate for Payer: PHP Commercial |
$234.18
|
| Rate for Payer: PHP Medicare Advantage |
$167.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$343.42
|
| Rate for Payer: Priority Health Medicare |
$167.27
|
| Rate for Payer: Priority Health SBD |
$343.42
|
| Rate for Payer: Priority Health Tiered Network |
$343.42
|
| Rate for Payer: Railroad Medicare Medicare |
$167.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.46
|
| Rate for Payer: UHC Core |
$338.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.27
|
| Rate for Payer: UHC Exchange |
$338.46
|
| Rate for Payer: UHC Medicaid |
$108.20
|
| Rate for Payer: UHCCP Medicaid |
$108.20
|
| Rate for Payer: UMR Bronson Commercial |
$461.38
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$102.67 |
| Max. Negotiated Rate |
$865.50 |
| Rate for Payer: Aetna Commercial |
$212.54
|
| Rate for Payer: Aetna Medicare |
$164.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.40
|
| Rate for Payer: BCBS Complete |
$107.80
|
| Rate for Payer: BCBS MAPPO |
$158.61
|
| Rate for Payer: BCN Commercial |
$268.41
|
| Rate for Payer: BCN Medicare Advantage |
$158.61
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$212.54
|
| Rate for Payer: Cofinity Commercial |
$228.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.54
|
| Rate for Payer: Meridian Medicaid |
$107.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.47
|
| Rate for Payer: Nomi Health Commercial |
$190.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.50
|
| Rate for Payer: PACE SWMI |
$158.61
|
| Rate for Payer: PHP Commercial |
$222.05
|
| Rate for Payer: PHP Medicare Advantage |
$158.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.05
|
| Rate for Payer: Priority Health Medicare |
$158.61
|
| Rate for Payer: Priority Health SBD |
$327.05
|
| Rate for Payer: Priority Health Tiered Network |
$327.05
|
| Rate for Payer: Railroad Medicare Medicare |
$158.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.00
|
| Rate for Payer: UHC Core |
$320.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.61
|
| Rate for Payer: UHC Exchange |
$320.00
|
| Rate for Payer: UHC Medicaid |
$102.67
|
| Rate for Payer: UHCCP Medicaid |
$102.67
|
| Rate for Payer: UMR Bronson Commercial |
$530.84
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,154.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$115.02 |
| Max. Negotiated Rate |
$865.50 |
| Rate for Payer: Aetna Commercial |
$238.21
|
| Rate for Payer: Aetna Medicare |
$184.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.99
|
| Rate for Payer: BCBS Complete |
$120.77
|
| Rate for Payer: BCBS MAPPO |
$177.77
|
| Rate for Payer: BCN Commercial |
$300.78
|
| Rate for Payer: BCN Medicare Advantage |
$177.77
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cash Price |
$923.20
|
| Rate for Payer: Cofinity Commercial |
$238.21
|
| Rate for Payer: Cofinity Commercial |
$255.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.66
|
| Rate for Payer: Meridian Medicaid |
$120.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.55
|
| Rate for Payer: Nomi Health Commercial |
$213.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$865.50
|
| Rate for Payer: PACE SWMI |
$177.77
|
| Rate for Payer: PHP Commercial |
$248.88
|
| Rate for Payer: PHP Medicare Advantage |
$177.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$366.48
|
| Rate for Payer: Priority Health Medicare |
$177.77
|
| Rate for Payer: Priority Health SBD |
$366.48
|
| Rate for Payer: Priority Health Tiered Network |
$366.48
|
| Rate for Payer: Railroad Medicare Medicare |
$177.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.44
|
| Rate for Payer: UHC Core |
$360.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.77
|
| Rate for Payer: UHC Exchange |
$360.44
|
| Rate for Payer: UHC Medicaid |
$115.02
|
| Rate for Payer: UHCCP Medicaid |
$115.02
|
| Rate for Payer: UMR Bronson Commercial |
$530.84
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,847.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$579.57 |
| Max. Negotiated Rate |
$2,135.25 |
| Rate for Payer: Aetna Commercial |
$1,212.08
|
| Rate for Payer: Aetna Medicare |
$940.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,212.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.54
|
| Rate for Payer: BCBS Complete |
$608.55
|
| Rate for Payer: BCBS MAPPO |
$904.54
|
| Rate for Payer: BCN Commercial |
$1,464.57
|
| Rate for Payer: BCN Medicare Advantage |
$904.54
|
| Rate for Payer: Cash Price |
$2,277.60
|
| Rate for Payer: Cash Price |
$2,277.60
|
| Rate for Payer: Cofinity Commercial |
$1,212.08
|
| Rate for Payer: Cofinity Commercial |
$1,302.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$904.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$949.77
|
| Rate for Payer: Meridian Medicaid |
$608.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.99
|
| Rate for Payer: Nomi Health Commercial |
$1,085.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,135.25
|
| Rate for Payer: PACE SWMI |
$904.54
|
| Rate for Payer: PHP Commercial |
$1,266.36
|
| Rate for Payer: PHP Medicare Advantage |
$904.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,784.47
|
| Rate for Payer: Priority Health Medicare |
$904.54
|
| Rate for Payer: Priority Health SBD |
$1,784.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,784.47
|
| Rate for Payer: Railroad Medicare Medicare |
$904.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,737.23
|
| Rate for Payer: UHC Core |
$1,737.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$904.54
|
| Rate for Payer: UHC Exchange |
$1,737.23
|
| Rate for Payer: UHC Medicaid |
$579.57
|
| Rate for Payer: UHCCP Medicaid |
$579.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,309.62
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$3,034.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$583.62 |
| Max. Negotiated Rate |
$2,275.50 |
| Rate for Payer: Aetna Commercial |
$1,220.18
|
| Rate for Payer: Aetna Medicare |
$947.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,220.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,311.24
|
| Rate for Payer: BCBS Complete |
$612.80
|
| Rate for Payer: BCBS MAPPO |
$910.58
|
| Rate for Payer: BCN Commercial |
$1,466.05
|
| Rate for Payer: BCN Medicare Advantage |
$910.58
|
| Rate for Payer: Cash Price |
$2,427.20
|
| Rate for Payer: Cash Price |
$2,427.20
|
| Rate for Payer: Cofinity Commercial |
$1,220.18
|
| Rate for Payer: Cofinity Commercial |
$1,311.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$956.11
|
| Rate for Payer: Meridian Medicaid |
$612.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.64
|
| Rate for Payer: Nomi Health Commercial |
$1,092.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,275.50
|
| Rate for Payer: PACE SWMI |
$910.58
|
| Rate for Payer: PHP Commercial |
$1,274.81
|
| Rate for Payer: PHP Medicare Advantage |
$910.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$583.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,786.29
|
| Rate for Payer: Priority Health Medicare |
$910.58
|
| Rate for Payer: Priority Health SBD |
$1,786.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,786.29
|
| Rate for Payer: Railroad Medicare Medicare |
$910.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,737.29
|
| Rate for Payer: UHC Core |
$1,737.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$910.58
|
| Rate for Payer: UHC Exchange |
$1,737.29
|
| Rate for Payer: UHC Medicaid |
$583.62
|
| Rate for Payer: UHCCP Medicaid |
$583.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,395.64
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$2,052.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$139.30 |
| Max. Negotiated Rate |
$1,539.00 |
| Rate for Payer: Aetna Commercial |
$295.32
|
| Rate for Payer: Aetna Medicare |
$229.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.36
|
| Rate for Payer: BCBS Complete |
$146.26
|
| Rate for Payer: BCBS MAPPO |
$220.39
|
| Rate for Payer: BCN Commercial |
$361.04
|
| Rate for Payer: BCN Medicare Advantage |
$220.39
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cofinity Commercial |
$295.32
|
| Rate for Payer: Cofinity Commercial |
$317.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.41
|
| Rate for Payer: Meridian Medicaid |
$146.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.43
|
| Rate for Payer: Nomi Health Commercial |
$264.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,539.00
|
| Rate for Payer: PACE SWMI |
$220.39
|
| Rate for Payer: PHP Commercial |
$308.55
|
| Rate for Payer: PHP Medicare Advantage |
$220.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$439.90
|
| Rate for Payer: Priority Health Medicare |
$220.39
|
| Rate for Payer: Priority Health SBD |
$439.90
|
| Rate for Payer: Priority Health Tiered Network |
$439.90
|
| Rate for Payer: Railroad Medicare Medicare |
$220.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.87
|
| Rate for Payer: UHC Core |
$437.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.39
|
| Rate for Payer: UHC Exchange |
$437.87
|
| Rate for Payer: UHC Medicaid |
$139.30
|
| Rate for Payer: UHCCP Medicaid |
$139.30
|
| Rate for Payer: UMR Bronson Commercial |
$943.92
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING
|
Professional
|
Both
|
$5,178.00
|
|
|
Service Code
|
HCPCS 44127
|
| Min. Negotiated Rate |
$1,675.67 |
| Max. Negotiated Rate |
$5,196.26 |
| Rate for Payer: Aetna Commercial |
$3,526.32
|
| Rate for Payer: Aetna Medicare |
$2,736.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,526.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,789.48
|
| Rate for Payer: BCBS Complete |
$1,759.45
|
| Rate for Payer: BCBS MAPPO |
$2,631.58
|
| Rate for Payer: BCN Commercial |
$4,264.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,631.58
|
| Rate for Payer: Cash Price |
$4,142.40
|
| Rate for Payer: Cash Price |
$4,142.40
|
| Rate for Payer: Cofinity Commercial |
$3,526.32
|
| Rate for Payer: Cofinity Commercial |
$3,789.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,631.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,763.16
|
| Rate for Payer: Meridian Medicaid |
$1,759.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,894.74
|
| Rate for Payer: Nomi Health Commercial |
$3,157.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,883.50
|
| Rate for Payer: PACE SWMI |
$2,631.58
|
| Rate for Payer: PHP Commercial |
$3,684.21
|
| Rate for Payer: PHP Medicare Advantage |
$2,631.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,675.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,196.26
|
| Rate for Payer: Priority Health Medicare |
$2,631.58
|
| Rate for Payer: Priority Health SBD |
$5,196.26
|
| Rate for Payer: Priority Health Tiered Network |
$5,196.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,631.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,115.86
|
| Rate for Payer: UHC Core |
$5,115.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,631.58
|
| Rate for Payer: UHC Exchange |
$5,115.86
|
| Rate for Payer: UHC Medicaid |
$1,675.67
|
| Rate for Payer: UHCCP Medicaid |
$1,675.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,381.88
|
|
|
PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING
|
Professional
|
Both
|
$4,462.00
|
|
|
Service Code
|
HCPCS 44126
|
| Min. Negotiated Rate |
$1,457.35 |
| Max. Negotiated Rate |
$4,505.18 |
| Rate for Payer: Aetna Commercial |
$3,063.01
|
| Rate for Payer: Aetna Medicare |
$2,377.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,063.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,291.60
|
| Rate for Payer: BCBS Complete |
$1,530.22
|
| Rate for Payer: BCBS MAPPO |
$2,285.83
|
| Rate for Payer: BCN Commercial |
$3,697.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,285.83
|
| Rate for Payer: Cash Price |
$3,569.60
|
| Rate for Payer: Cash Price |
$3,569.60
|
| Rate for Payer: Cofinity Commercial |
$3,063.01
|
| Rate for Payer: Cofinity Commercial |
$3,291.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,285.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,400.12
|
| Rate for Payer: Meridian Medicaid |
$1,530.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,514.41
|
| Rate for Payer: Nomi Health Commercial |
$2,743.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,346.50
|
| Rate for Payer: PACE SWMI |
$2,285.83
|
| Rate for Payer: PHP Commercial |
$3,200.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,285.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,457.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,505.18
|
| Rate for Payer: Priority Health Medicare |
$2,285.83
|
| Rate for Payer: Priority Health SBD |
$4,505.18
|
| Rate for Payer: Priority Health Tiered Network |
$4,505.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,285.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,421.32
|
| Rate for Payer: UHC Core |
$4,421.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,285.83
|
| Rate for Payer: UHC Exchange |
$4,421.32
|
| Rate for Payer: UHC Medicaid |
$1,457.35
|
| Rate for Payer: UHCCP Medicaid |
$1,457.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,052.52
|
|
|
PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST
|
Professional
|
Both
|
$3,415.00
|
|
|
Service Code
|
HCPCS 44120
|
| Min. Negotiated Rate |
$724.63 |
| Max. Negotiated Rate |
$2,561.25 |
| Rate for Payer: Aetna Commercial |
$1,518.51
|
| Rate for Payer: Aetna Medicare |
$1,178.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,518.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,631.84
|
| Rate for Payer: BCBS Complete |
$760.86
|
| Rate for Payer: BCBS MAPPO |
$1,133.22
|
| Rate for Payer: BCN Commercial |
$1,832.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,133.22
|
| Rate for Payer: Cash Price |
$2,732.00
|
| Rate for Payer: Cash Price |
$2,732.00
|
| Rate for Payer: Cofinity Commercial |
$1,518.51
|
| Rate for Payer: Cofinity Commercial |
$1,631.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,133.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,189.88
|
| Rate for Payer: Meridian Medicaid |
$760.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,246.54
|
| Rate for Payer: Nomi Health Commercial |
$1,359.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.25
|
| Rate for Payer: PACE SWMI |
$1,133.22
|
| Rate for Payer: PHP Commercial |
$1,586.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,133.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$724.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,232.87
|
| Rate for Payer: Priority Health Medicare |
$1,133.22
|
| Rate for Payer: Priority Health SBD |
$2,232.87
|
| Rate for Payer: Priority Health Tiered Network |
$2,232.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,133.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,183.58
|
| Rate for Payer: UHC Core |
$2,183.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,133.22
|
| Rate for Payer: UHC Exchange |
$2,183.58
|
| Rate for Payer: UHC Medicaid |
$724.63
|
| Rate for Payer: UHCCP Medicaid |
$724.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.90
|
|
|
PR EO W/O JOINTS CF
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS L3702
|
| Min. Negotiated Rate |
$105.31 |
| Max. Negotiated Rate |
$465.08 |
| Rate for Payer: Aetna Commercial |
$432.78
|
| Rate for Payer: Aetna Medicare |
$335.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.08
|
| Rate for Payer: BCBS Complete |
$111.20
|
| Rate for Payer: BCBS MAPPO |
$322.97
|
| Rate for Payer: BCN Commercial |
$309.22
|
| Rate for Payer: BCN Medicare Advantage |
$322.97
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$432.78
|
| Rate for Payer: Cofinity Commercial |
$465.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.27
|
| Rate for Payer: Nomi Health Commercial |
$387.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: PACE SWMI |
$322.97
|
| Rate for Payer: PHP Commercial |
$452.16
|
| Rate for Payer: PHP Medicare Advantage |
$322.97
|
| Rate for Payer: Priority Health Medicare |
$322.97
|
| Rate for Payer: Railroad Medicare Medicare |
$322.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.31
|
| Rate for Payer: UHC Core |
$105.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$322.97
|
| Rate for Payer: UHC Exchange |
$105.31
|
| Rate for Payer: UMR Bronson Commercial |
$127.88
|
|
|
PR EPDRM AGRFT T/A/L EA ADD 100 SQCM/EA 1%INFT/CHLD
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 15111
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$196.50 |
| Rate for Payer: Aetna Commercial |
$121.81
|
| Rate for Payer: Aetna Medicare |
$94.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.81
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$90.90
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: BCN Medicare Advantage |
$90.90
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cofinity Commercial |
$130.90
|
| Rate for Payer: Cofinity Commercial |
$121.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.44
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.99
|
| Rate for Payer: Nomi Health Commercial |
$109.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.50
|
| Rate for Payer: PACE SWMI |
$90.90
|
| Rate for Payer: PHP Commercial |
$127.26
|
| Rate for Payer: PHP Medicare Advantage |
$90.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.02
|
| Rate for Payer: Priority Health Medicare |
$90.90
|
| Rate for Payer: Priority Health SBD |
$139.02
|
| Rate for Payer: Priority Health Tiered Network |
$139.02
|
| Rate for Payer: Railroad Medicare Medicare |
$90.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.68
|
| Rate for Payer: UHC Core |
$185.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.90
|
| Rate for Payer: UHC Exchange |
$185.68
|
| Rate for Payer: UHC Medicaid |
$57.72
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
| Rate for Payer: UMR Bronson Commercial |
$120.52
|
|
|
PR EP EVAL 1/2CHMB PACG CVDFB LDS TSTG OF PULSE GEN
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 93641
|
| Min. Negotiated Rate |
$254.38 |
| Max. Negotiated Rate |
$1,037.93 |
| Rate for Payer: Aetna Commercial |
$765.30
|
| Rate for Payer: Aetna Medicare |
$276.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.30
|
| Rate for Payer: BCN Commercial |
$445.71
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$799.41
|
| Rate for Payer: Priority Health SBD |
$799.41
|
| Rate for Payer: Priority Health Tiered Network |
$799.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.93
|
| Rate for Payer: UHC Core |
$1,037.93
|
| Rate for Payer: UHC Exchange |
$1,037.93
|
| Rate for Payer: UMR Bronson Commercial |
$254.38
|
|
|
PR EP EVAL 1/2 CHMB TRANSVNS PAC CVDFB
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 93642
|
| Min. Negotiated Rate |
$321.18 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$430.38
|
| Rate for Payer: Aetna Medicare |
$334.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.50
|
| Rate for Payer: BCBS MAPPO |
$321.18
|
| Rate for Payer: BCN Commercial |
$487.53
|
| Rate for Payer: BCN Medicare Advantage |
$321.18
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$462.50
|
| Rate for Payer: Cofinity Commercial |
$430.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.30
|
| Rate for Payer: Nomi Health Commercial |
$385.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$321.18
|
| Rate for Payer: PHP Commercial |
$449.65
|
| Rate for Payer: PHP Medicare Advantage |
$321.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$463.36
|
| Rate for Payer: Priority Health Medicare |
$321.18
|
| Rate for Payer: Priority Health SBD |
$463.36
|
| Rate for Payer: Priority Health Tiered Network |
$463.36
|
| Rate for Payer: Railroad Medicare Medicare |
$321.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.39
|
| Rate for Payer: UHC Core |
$543.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$321.18
|
| Rate for Payer: UHC Exchange |
$543.39
|
| Rate for Payer: UMR Bronson Commercial |
$821.56
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT 1ST 100 SQCM/<
|
Professional
|
Both
|
$1,512.00
|
|
|
Service Code
|
HCPCS 15115
|
| Min. Negotiated Rate |
$415.14 |
| Max. Negotiated Rate |
$1,199.52 |
| Rate for Payer: Aetna Commercial |
$857.72
|
| Rate for Payer: Aetna Medicare |
$665.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.73
|
| Rate for Payer: BCBS Complete |
$435.90
|
| Rate for Payer: BCBS MAPPO |
$640.09
|
| Rate for Payer: BCN Commercial |
$1,054.22
|
| Rate for Payer: BCN Medicare Advantage |
$640.09
|
| Rate for Payer: Cash Price |
$1,209.60
|
| Rate for Payer: Cash Price |
$1,209.60
|
| Rate for Payer: Cofinity Commercial |
$857.72
|
| Rate for Payer: Cofinity Commercial |
$921.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.09
|
| Rate for Payer: Meridian Medicaid |
$435.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$704.10
|
| Rate for Payer: Nomi Health Commercial |
$768.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,134.00
|
| Rate for Payer: PACE SWMI |
$640.09
|
| Rate for Payer: PHP Commercial |
$896.13
|
| Rate for Payer: PHP Medicare Advantage |
$640.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$964.90
|
| Rate for Payer: Priority Health Medicare |
$640.09
|
| Rate for Payer: Priority Health SBD |
$964.90
|
| Rate for Payer: Priority Health Tiered Network |
$964.90
|
| Rate for Payer: Railroad Medicare Medicare |
$640.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,199.52
|
| Rate for Payer: UHC Core |
$1,199.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$640.09
|
| Rate for Payer: UHC Exchange |
$1,199.52
|
| Rate for Payer: UHC Medicaid |
$415.14
|
| Rate for Payer: UHCCP Medicaid |
$415.14
|
| Rate for Payer: UMR Bronson Commercial |
$695.52
|
|
|
PR EPIDERMAL AGRFT F/S/N/H/F/G/M/DGT EA 100 SQCM
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 15116
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$164.89
|
| Rate for Payer: Aetna Medicare |
$127.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.19
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$123.05
|
| Rate for Payer: BCN Commercial |
$205.66
|
| Rate for Payer: BCN Medicare Advantage |
$123.05
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$164.89
|
| Rate for Payer: Cofinity Commercial |
$177.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.20
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.35
|
| Rate for Payer: Nomi Health Commercial |
$147.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PACE SWMI |
$123.05
|
| Rate for Payer: PHP Commercial |
$172.27
|
| Rate for Payer: PHP Medicare Advantage |
$123.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.24
|
| Rate for Payer: Priority Health Medicare |
$123.05
|
| Rate for Payer: Priority Health SBD |
$188.24
|
| Rate for Payer: Priority Health Tiered Network |
$188.24
|
| Rate for Payer: Railroad Medicare Medicare |
$123.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.91
|
| Rate for Payer: UHC Core |
$267.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.05
|
| Rate for Payer: UHC Exchange |
$267.91
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
| Rate for Payer: UMR Bronson Commercial |
$158.24
|
|
