|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,172.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$1,268.80 |
| Max. Negotiated Rate |
$2,061.80 |
| Rate for Payer: Aetna Commercial |
$1,711.41
|
| Rate for Payer: Aetna Medicare |
$1,328.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,839.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,711.41
|
| Rate for Payer: BCBS Complete |
$1,268.80
|
| Rate for Payer: BCBS MAPPO |
$1,277.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,277.17
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cofinity Commercial |
$1,839.12
|
| Rate for Payer: Cofinity Commercial |
$1,711.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,277.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,341.03
|
| Rate for Payer: Nomi Health Commercial |
$1,532.60
|
| Rate for Payer: PACE SWMI |
$1,277.17
|
| Rate for Payer: PHP Commercial |
$1,788.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,277.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.80
|
| Rate for Payer: Priority Health Medicare |
$1,277.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,277.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,277.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,459.12
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$1,059.79 |
| Max. Negotiated Rate |
$1,830.40 |
| Rate for Payer: Aetna Commercial |
$1,420.12
|
| Rate for Payer: Aetna Medicare |
$1,102.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,526.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.12
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCBS MAPPO |
$1,059.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,059.79
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,420.12
|
| Rate for Payer: Cofinity Commercial |
$1,526.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,059.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,112.78
|
| Rate for Payer: Nomi Health Commercial |
$1,271.75
|
| Rate for Payer: PACE SWMI |
$1,059.79
|
| Rate for Payer: PHP Commercial |
$1,483.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,059.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health Medicare |
$1,059.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,059.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,295.36
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$1,059.79 |
| Max. Negotiated Rate |
$1,830.40 |
| Rate for Payer: Aetna Commercial |
$1,420.12
|
| Rate for Payer: Aetna Medicare |
$1,102.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,526.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.12
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCBS MAPPO |
$1,059.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,059.79
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,526.10
|
| Rate for Payer: Cofinity Commercial |
$1,420.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,059.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,112.78
|
| Rate for Payer: Nomi Health Commercial |
$1,271.75
|
| Rate for Payer: PACE SWMI |
$1,059.79
|
| Rate for Payer: PHP Commercial |
$1,483.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,059.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health Medicare |
$1,059.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,059.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,295.36
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,816.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,041.92 |
| Max. Negotiated Rate |
$2,534.40 |
| Rate for Payer: Aetna American Axle |
$1,830.40
|
| Rate for Payer: Aetna Commercial |
$2,393.60
|
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,830.40
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,971.20
|
| Rate for Payer: Cofinity Commercial |
$2,421.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,971.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,252.80
|
| Rate for Payer: Healthscope Commercial |
$2,534.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,971.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,112.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,393.60
|
| Rate for Payer: PHP Commercial |
$2,393.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health SBD |
$1,774.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,041.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,112.00
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,816.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,239.04 |
| Max. Negotiated Rate |
$2,534.40 |
| Rate for Payer: Aetna American Axle |
$1,830.40
|
| Rate for Payer: Aetna Commercial |
$2,393.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,830.40
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,971.20
|
| Rate for Payer: Cofinity Commercial |
$2,421.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,971.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,252.80
|
| Rate for Payer: Healthscope Commercial |
$2,534.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,971.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,112.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,393.60
|
| Rate for Payer: PHP Commercial |
$2,393.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health SBD |
$1,774.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,239.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,112.00
|
|
|
PR ENTERORRHAPHY MULTIPLE PERFORATIONS
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 44603
|
| Min. Negotiated Rate |
$1,232.40 |
| Max. Negotiated Rate |
$2,254.81 |
| Rate for Payer: Aetna Commercial |
$2,098.23
|
| Rate for Payer: Aetna Medicare |
$1,628.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,254.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,098.23
|
| Rate for Payer: BCBS Complete |
$1,232.40
|
| Rate for Payer: BCBS MAPPO |
$1,565.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,565.84
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cofinity Commercial |
$2,254.81
|
| Rate for Payer: Cofinity Commercial |
$2,098.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,565.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,644.13
|
| Rate for Payer: Nomi Health Commercial |
$1,879.01
|
| Rate for Payer: PACE SWMI |
$1,565.84
|
| Rate for Payer: PHP Commercial |
$2,192.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,565.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health Medicare |
$1,565.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,565.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,565.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,417.26
|
|
|
PR ENTERORRHAPHY SINGLE PERFORATION
|
Professional
|
Both
|
$2,425.00
|
|
|
Service Code
|
HCPCS 44602
|
| Min. Negotiated Rate |
$970.00 |
| Max. Negotiated Rate |
$1,962.73 |
| Rate for Payer: Aetna Commercial |
$1,826.43
|
| Rate for Payer: Aetna Medicare |
$1,417.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,962.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,826.43
|
| Rate for Payer: BCBS Complete |
$970.00
|
| Rate for Payer: BCBS MAPPO |
$1,363.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,363.01
|
| Rate for Payer: Cash Price |
$1,940.00
|
| Rate for Payer: Cash Price |
$1,940.00
|
| Rate for Payer: Cofinity Commercial |
$1,962.73
|
| Rate for Payer: Cofinity Commercial |
$1,826.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,363.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,431.16
|
| Rate for Payer: Nomi Health Commercial |
$1,635.61
|
| Rate for Payer: PACE SWMI |
$1,363.01
|
| Rate for Payer: PHP Commercial |
$1,908.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,363.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.25
|
| Rate for Payer: Priority Health Medicare |
$1,363.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,363.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,363.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,115.50
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,136.00
|
|
|
Service Code
|
HCPCS 44377
|
| Min. Negotiated Rate |
$280.26 |
| Max. Negotiated Rate |
$738.40 |
| Rate for Payer: Aetna Commercial |
$375.55
|
| Rate for Payer: Aetna Medicare |
$291.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.55
|
| Rate for Payer: BCBS Complete |
$454.40
|
| Rate for Payer: BCBS MAPPO |
$280.26
|
| Rate for Payer: BCN Medicare Advantage |
$280.26
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cofinity Commercial |
$403.57
|
| Rate for Payer: Cofinity Commercial |
$375.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.27
|
| Rate for Payer: Nomi Health Commercial |
$336.31
|
| Rate for Payer: PACE SWMI |
$280.26
|
| Rate for Payer: PHP Commercial |
$392.36
|
| Rate for Payer: PHP Medicare Advantage |
$280.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$738.40
|
| Rate for Payer: Priority Health Medicare |
$280.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.26
|
| Rate for Payer: UHC Medicare Advantage |
$280.26
|
| Rate for Payer: UMR Bronson Commercial |
$522.56
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 44376
|
| Min. Negotiated Rate |
$267.14 |
| Max. Negotiated Rate |
$673.40 |
| Rate for Payer: Aetna Commercial |
$357.97
|
| Rate for Payer: Aetna Medicare |
$277.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.97
|
| Rate for Payer: BCBS Complete |
$414.40
|
| Rate for Payer: BCBS MAPPO |
$267.14
|
| Rate for Payer: BCN Medicare Advantage |
$267.14
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$384.68
|
| Rate for Payer: Cofinity Commercial |
$357.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.50
|
| Rate for Payer: Nomi Health Commercial |
$320.57
|
| Rate for Payer: PACE SWMI |
$267.14
|
| Rate for Payer: PHP Commercial |
$374.00
|
| Rate for Payer: PHP Medicare Advantage |
$267.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health Medicare |
$267.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.14
|
| Rate for Payer: UHC Medicare Advantage |
$267.14
|
| Rate for Payer: UMR Bronson Commercial |
$476.56
|
|
|
PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44369
|
| Min. Negotiated Rate |
$230.66 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$309.08
|
| Rate for Payer: Aetna Medicare |
$239.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.08
|
| Rate for Payer: BCBS Complete |
$448.00
|
| Rate for Payer: BCBS MAPPO |
$230.66
|
| Rate for Payer: BCN Medicare Advantage |
$230.66
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$332.15
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.19
|
| Rate for Payer: Nomi Health Commercial |
$276.79
|
| Rate for Payer: PACE SWMI |
$230.66
|
| Rate for Payer: PHP Commercial |
$322.92
|
| Rate for Payer: PHP Medicare Advantage |
$230.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health Medicare |
$230.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.66
|
| Rate for Payer: UHC Medicare Advantage |
$230.66
|
| Rate for Payer: UMR Bronson Commercial |
$515.20
|
|
|
PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 44373
|
| Min. Negotiated Rate |
$181.71 |
| Max. Negotiated Rate |
$599.30 |
| Rate for Payer: Aetna Commercial |
$243.49
|
| Rate for Payer: Aetna Medicare |
$188.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.49
|
| Rate for Payer: BCBS Complete |
$368.80
|
| Rate for Payer: BCBS MAPPO |
$181.71
|
| Rate for Payer: BCN Medicare Advantage |
$181.71
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cofinity Commercial |
$261.66
|
| Rate for Payer: Cofinity Commercial |
$243.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.80
|
| Rate for Payer: Nomi Health Commercial |
$218.05
|
| Rate for Payer: PACE SWMI |
$181.71
|
| Rate for Payer: PHP Commercial |
$254.39
|
| Rate for Payer: PHP Medicare Advantage |
$181.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health Medicare |
$181.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.71
|
| Rate for Payer: UHC Medicare Advantage |
$181.71
|
| Rate for Payer: UMR Bronson Commercial |
$424.12
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
OP
|
$1,548.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$572.76 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna American Axle |
$1,006.20
|
| Rate for Payer: Aetna Commercial |
$1,315.80
|
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,331.28
|
| Rate for Payer: Cofinity Commercial |
$1,083.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,083.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$1,393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.00
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,315.80
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$1,315.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health SBD |
$975.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: UMR Bronson Commercial |
$572.76
|
| Rate for Payer: VA VA |
$1,850.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.00
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 44378
|
| Min. Negotiated Rate |
$361.03 |
| Max. Negotiated Rate |
$1,006.20 |
| Rate for Payer: Aetna Commercial |
$483.78
|
| Rate for Payer: Aetna Medicare |
$375.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.78
|
| Rate for Payer: BCBS Complete |
$619.20
|
| Rate for Payer: BCBS MAPPO |
$361.03
|
| Rate for Payer: BCN Medicare Advantage |
$361.03
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$519.88
|
| Rate for Payer: Cofinity Commercial |
$483.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.08
|
| Rate for Payer: Nomi Health Commercial |
$433.24
|
| Rate for Payer: PACE SWMI |
$361.03
|
| Rate for Payer: PHP Commercial |
$505.44
|
| Rate for Payer: PHP Medicare Advantage |
$361.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health Medicare |
$361.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.03
|
| Rate for Payer: UHC Medicare Advantage |
$361.03
|
| Rate for Payer: UMR Bronson Commercial |
$712.08
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
IP
|
$1,548.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$681.12 |
| Max. Negotiated Rate |
$1,393.20 |
| Rate for Payer: Aetna American Axle |
$1,006.20
|
| Rate for Payer: Aetna Commercial |
$1,315.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.20
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,083.60
|
| Rate for Payer: Cofinity Commercial |
$1,331.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,083.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Healthscope Commercial |
$1,393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,083.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,315.80
|
| Rate for Payer: PHP Commercial |
$1,315.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health SBD |
$975.24
|
| Rate for Payer: UMR Bronson Commercial |
$681.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.00
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$361.03 |
| Max. Negotiated Rate |
$1,006.20 |
| Rate for Payer: Aetna Commercial |
$483.78
|
| Rate for Payer: Aetna Medicare |
$375.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.78
|
| Rate for Payer: BCBS Complete |
$619.20
|
| Rate for Payer: BCBS MAPPO |
$361.03
|
| Rate for Payer: BCN Medicare Advantage |
$361.03
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$483.78
|
| Rate for Payer: Cofinity Commercial |
$519.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.08
|
| Rate for Payer: Nomi Health Commercial |
$433.24
|
| Rate for Payer: PACE SWMI |
$361.03
|
| Rate for Payer: PHP Commercial |
$505.44
|
| Rate for Payer: PHP Medicare Advantage |
$361.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health Medicare |
$361.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.03
|
| Rate for Payer: UHC Medicare Advantage |
$361.03
|
| Rate for Payer: UMR Bronson Commercial |
$712.08
|
|
|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$250.37 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$335.50
|
| Rate for Payer: Aetna Medicare |
$260.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.50
|
| Rate for Payer: BCBS Complete |
$553.60
|
| Rate for Payer: BCBS MAPPO |
$250.37
|
| Rate for Payer: BCN Medicare Advantage |
$250.37
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$360.53
|
| Rate for Payer: Cofinity Commercial |
$335.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.89
|
| Rate for Payer: Nomi Health Commercial |
$300.44
|
| Rate for Payer: PACE SWMI |
$250.37
|
| Rate for Payer: PHP Commercial |
$350.52
|
| Rate for Payer: PHP Medicare Advantage |
$250.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health Medicare |
$250.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.37
|
| Rate for Payer: UHC Medicare Advantage |
$250.37
|
| Rate for Payer: UMR Bronson Commercial |
$636.64
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,318.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$225.25 |
| Max. Negotiated Rate |
$856.70 |
| Rate for Payer: Aetna Commercial |
$301.83
|
| Rate for Payer: Aetna Medicare |
$234.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.83
|
| Rate for Payer: BCBS Complete |
$527.20
|
| Rate for Payer: BCBS MAPPO |
$225.25
|
| Rate for Payer: BCN Medicare Advantage |
$225.25
|
| Rate for Payer: Cash Price |
$1,054.40
|
| Rate for Payer: Cash Price |
$1,054.40
|
| Rate for Payer: Cofinity Commercial |
$324.36
|
| Rate for Payer: Cofinity Commercial |
$301.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.51
|
| Rate for Payer: Nomi Health Commercial |
$270.30
|
| Rate for Payer: PACE SWMI |
$225.25
|
| Rate for Payer: PHP Commercial |
$315.35
|
| Rate for Payer: PHP Medicare Advantage |
$225.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.70
|
| Rate for Payer: Priority Health Medicare |
$225.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.25
|
| Rate for Payer: UHC Medicare Advantage |
$225.25
|
| Rate for Payer: UMR Bronson Commercial |
$606.28
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,532.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$383.86 |
| Max. Negotiated Rate |
$995.80 |
| Rate for Payer: Aetna Commercial |
$514.37
|
| Rate for Payer: Aetna Medicare |
$399.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.37
|
| Rate for Payer: BCBS Complete |
$612.80
|
| Rate for Payer: BCBS MAPPO |
$383.86
|
| Rate for Payer: BCN Medicare Advantage |
$383.86
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cofinity Commercial |
$552.76
|
| Rate for Payer: Cofinity Commercial |
$514.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.05
|
| Rate for Payer: Nomi Health Commercial |
$460.63
|
| Rate for Payer: PACE SWMI |
$383.86
|
| Rate for Payer: PHP Commercial |
$537.40
|
| Rate for Payer: PHP Medicare Advantage |
$383.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.80
|
| Rate for Payer: Priority Health Medicare |
$383.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.86
|
| Rate for Payer: UHC Medicare Advantage |
$383.86
|
| Rate for Payer: UMR Bronson Commercial |
$704.72
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE
|
Professional
|
Both
|
$940.00
|
|
|
Service Code
|
HCPCS 44372
|
| Min. Negotiated Rate |
$226.51 |
| Max. Negotiated Rate |
$611.00 |
| Rate for Payer: Aetna Commercial |
$303.52
|
| Rate for Payer: Aetna Medicare |
$235.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.52
|
| Rate for Payer: BCBS Complete |
$376.00
|
| Rate for Payer: BCBS MAPPO |
$226.51
|
| Rate for Payer: BCN Medicare Advantage |
$226.51
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cofinity Commercial |
$326.17
|
| Rate for Payer: Cofinity Commercial |
$303.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.84
|
| Rate for Payer: Nomi Health Commercial |
$271.81
|
| Rate for Payer: PACE SWMI |
$226.51
|
| Rate for Payer: PHP Commercial |
$317.11
|
| Rate for Payer: PHP Medicare Advantage |
$226.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.00
|
| Rate for Payer: Priority Health Medicare |
$226.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.51
|
| Rate for Payer: UHC Medicare Advantage |
$226.51
|
| Rate for Payer: UMR Bronson Commercial |
$432.40
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$179.94 |
| Max. Negotiated Rate |
$633.10 |
| Rate for Payer: Aetna Commercial |
$241.12
|
| Rate for Payer: Aetna Medicare |
$187.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.12
|
| Rate for Payer: BCBS Complete |
$389.60
|
| Rate for Payer: BCBS MAPPO |
$179.94
|
| Rate for Payer: BCN Medicare Advantage |
$179.94
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cofinity Commercial |
$259.11
|
| Rate for Payer: Cofinity Commercial |
$241.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.94
|
| Rate for Payer: Nomi Health Commercial |
$215.93
|
| Rate for Payer: PACE SWMI |
$179.94
|
| Rate for Payer: PHP Commercial |
$251.92
|
| Rate for Payer: PHP Medicare Advantage |
$179.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.10
|
| Rate for Payer: Priority Health Medicare |
$179.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.94
|
| Rate for Payer: UHC Medicare Advantage |
$179.94
|
| Rate for Payer: UMR Bronson Commercial |
$448.04
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44365
|
| Min. Negotiated Rate |
$171.38 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$229.65
|
| Rate for Payer: Aetna Medicare |
$178.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.65
|
| Rate for Payer: BCBS Complete |
$448.00
|
| Rate for Payer: BCBS MAPPO |
$171.38
|
| Rate for Payer: BCN Medicare Advantage |
$171.38
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$246.79
|
| Rate for Payer: Cofinity Commercial |
$229.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.95
|
| Rate for Payer: Nomi Health Commercial |
$205.66
|
| Rate for Payer: PACE SWMI |
$171.38
|
| Rate for Payer: PHP Commercial |
$239.93
|
| Rate for Payer: PHP Medicare Advantage |
$171.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health Medicare |
$171.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.38
|
| Rate for Payer: UHC Medicare Advantage |
$171.38
|
| Rate for Payer: UMR Bronson Commercial |
$515.20
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44364
|
| Min. Negotiated Rate |
$192.08 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$257.39
|
| Rate for Payer: Aetna Medicare |
$199.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.39
|
| Rate for Payer: BCBS Complete |
$448.00
|
| Rate for Payer: BCBS MAPPO |
$192.08
|
| Rate for Payer: BCN Medicare Advantage |
$192.08
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$276.60
|
| Rate for Payer: Cofinity Commercial |
$257.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.68
|
| Rate for Payer: Nomi Health Commercial |
$230.50
|
| Rate for Payer: PACE SWMI |
$192.08
|
| Rate for Payer: PHP Commercial |
$268.91
|
| Rate for Payer: PHP Medicare Advantage |
$192.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health Medicare |
$192.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.08
|
| Rate for Payer: UHC Medicare Advantage |
$192.08
|
| Rate for Payer: UMR Bronson Commercial |
$515.20
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN
|
Professional
|
Both
|
$2,764.00
|
|
|
Service Code
|
HCPCS 44021
|
| Min. Negotiated Rate |
$947.33 |
| Max. Negotiated Rate |
$1,796.60 |
| Rate for Payer: Aetna Commercial |
$1,269.42
|
| Rate for Payer: Aetna Medicare |
$985.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,364.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,269.42
|
| Rate for Payer: BCBS Complete |
$1,105.60
|
| Rate for Payer: BCBS MAPPO |
$947.33
|
| Rate for Payer: BCN Medicare Advantage |
$947.33
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cash Price |
$2,211.20
|
| Rate for Payer: Cofinity Commercial |
$1,364.16
|
| Rate for Payer: Cofinity Commercial |
$1,269.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$947.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$994.70
|
| Rate for Payer: Nomi Health Commercial |
$1,136.80
|
| Rate for Payer: PACE SWMI |
$947.33
|
| Rate for Payer: PHP Commercial |
$1,326.26
|
| Rate for Payer: PHP Medicare Advantage |
$947.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.60
|
| Rate for Payer: Priority Health Medicare |
$947.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$947.33
|
| Rate for Payer: UHC Medicare Advantage |
$947.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,271.44
|
|
|
PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL
|
Professional
|
Both
|
$2,946.00
|
|
|
Service Code
|
HCPCS 44020
|
| Min. Negotiated Rate |
$947.95 |
| Max. Negotiated Rate |
$1,914.90 |
| Rate for Payer: Aetna Commercial |
$1,270.25
|
| Rate for Payer: Aetna Medicare |
$985.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,270.25
|
| Rate for Payer: BCBS Complete |
$1,178.40
|
| Rate for Payer: BCBS MAPPO |
$947.95
|
| Rate for Payer: BCN Medicare Advantage |
$947.95
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cash Price |
$2,356.80
|
| Rate for Payer: Cofinity Commercial |
$1,365.05
|
| Rate for Payer: Cofinity Commercial |
$1,270.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$947.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$995.35
|
| Rate for Payer: Nomi Health Commercial |
$1,137.54
|
| Rate for Payer: PACE SWMI |
$947.95
|
| Rate for Payer: PHP Commercial |
$1,327.13
|
| Rate for Payer: PHP Medicare Advantage |
$947.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,914.90
|
| Rate for Payer: Priority Health Medicare |
$947.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$947.95
|
| Rate for Payer: UHC Medicare Advantage |
$947.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,355.16
|
|
|
PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS
|
Professional
|
Both
|
$1,992.00
|
|
|
Service Code
|
HCPCS 44128
|
| Min. Negotiated Rate |
$236.17 |
| Max. Negotiated Rate |
$1,294.80 |
| Rate for Payer: Aetna Commercial |
$316.47
|
| Rate for Payer: Aetna Medicare |
$245.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.47
|
| Rate for Payer: BCBS Complete |
$796.80
|
| Rate for Payer: BCBS MAPPO |
$236.17
|
| Rate for Payer: BCN Medicare Advantage |
$236.17
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cofinity Commercial |
$340.08
|
| Rate for Payer: Cofinity Commercial |
$316.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.98
|
| Rate for Payer: Nomi Health Commercial |
$283.40
|
| Rate for Payer: PACE SWMI |
$236.17
|
| Rate for Payer: PHP Commercial |
$330.64
|
| Rate for Payer: PHP Medicare Advantage |
$236.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,294.80
|
| Rate for Payer: Priority Health Medicare |
$236.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.17
|
| Rate for Payer: UHC Medicare Advantage |
$236.17
|
| Rate for Payer: UMR Bronson Commercial |
$916.32
|
|
