|
PR PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 99427
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$971.54 |
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.41
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$33.62
|
| Rate for Payer: BCBS Trust/PPO |
$971.54
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Medicare Advantage |
$33.62
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$45.05
|
| Rate for Payer: Cofinity Commercial |
$48.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.30
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Nomi Health Commercial |
$40.34
|
| Rate for Payer: PACE SWMI |
$33.62
|
| Rate for Payer: PHP Commercial |
$47.07
|
| Rate for Payer: PHP Medicare Advantage |
$33.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.52
|
| Rate for Payer: Priority Health Medicare |
$33.62
|
| Rate for Payer: Priority Health Narrow Network |
$38.52
|
| Rate for Payer: Priority Health SBD |
$38.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.62
|
| Rate for Payer: UHC Medicare Advantage |
$33.62
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
| Rate for Payer: UMR Bronson Commercial |
$44.62
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 99425
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$1,104.48 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$50.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.38
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.48
|
| Rate for Payer: BCN Commercial |
$84.05
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PHP Commercial |
$67.45
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.85
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: Priority Health Narrow Network |
$56.85
|
| Rate for Payer: Priority Health SBD |
$56.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.18
|
| Rate for Payer: UHC Medicare Advantage |
$48.18
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
| Rate for Payer: UMR Bronson Commercial |
$55.20
|
|
|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$4,968.66 |
| Rate for Payer: Aetna Commercial |
$158.66
|
| Rate for Payer: Aetna Medicare |
$123.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.50
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$118.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,968.66
|
| Rate for Payer: BCN Commercial |
$188.09
|
| Rate for Payer: BCN Medicare Advantage |
$118.40
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$158.66
|
| Rate for Payer: Cofinity Commercial |
$170.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.32
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Nomi Health Commercial |
$142.08
|
| Rate for Payer: PACE SWMI |
$118.40
|
| Rate for Payer: PHP Commercial |
$165.76
|
| Rate for Payer: PHP Medicare Advantage |
$118.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.86
|
| Rate for Payer: Priority Health Medicare |
$118.40
|
| Rate for Payer: Priority Health Narrow Network |
$222.86
|
| Rate for Payer: Priority Health SBD |
$222.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.40
|
| Rate for Payer: UHC Medicare Advantage |
$118.40
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
| Rate for Payer: UMR Bronson Commercial |
$130.64
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Commercial |
$3.38
|
| Rate for Payer: Aetna Medicare |
$2.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.63
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$2.52
|
| Rate for Payer: BCBS Trust/PPO |
$1.73
|
| Rate for Payer: BCN Commercial |
$1.74
|
| Rate for Payer: BCN Medicare Advantage |
$2.52
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$3.38
|
| Rate for Payer: Cofinity Commercial |
$3.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.65
|
| Rate for Payer: Nomi Health Commercial |
$3.03
|
| Rate for Payer: PACE SWMI |
$2.52
|
| Rate for Payer: PHP Commercial |
$3.53
|
| Rate for Payer: PHP Medicare Advantage |
$2.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Medicare |
$2.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.52
|
| Rate for Payer: UHC Medicare Advantage |
$2.52
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,082.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$670.74 |
| Max. Negotiated Rate |
$2,003.30 |
| Rate for Payer: Aetna Commercial |
$1,347.29
|
| Rate for Payer: Aetna Medicare |
$1,045.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,347.29
|
| Rate for Payer: BCBS Complete |
$704.28
|
| Rate for Payer: BCBS MAPPO |
$1,005.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,895.01
|
| Rate for Payer: BCN Commercial |
$1,528.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.44
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cash Price |
$2,465.60
|
| Rate for Payer: Cofinity Commercial |
$1,347.29
|
| Rate for Payer: Cofinity Commercial |
$1,447.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.71
|
| Rate for Payer: Meridian Medicaid |
$704.28
|
| Rate for Payer: Nomi Health Commercial |
$1,206.53
|
| Rate for Payer: PACE SWMI |
$1,005.44
|
| Rate for Payer: PHP Commercial |
$1,407.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,869.13
|
| Rate for Payer: Priority Health Medicare |
$1,005.44
|
| Rate for Payer: Priority Health Narrow Network |
$1,869.13
|
| Rate for Payer: Priority Health SBD |
$1,869.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,005.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.44
|
| Rate for Payer: UHCCP Medicaid |
$670.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,417.72
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,658.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$603.43 |
| Max. Negotiated Rate |
$2,270.63 |
| Rate for Payer: Aetna Commercial |
$1,208.30
|
| Rate for Payer: Aetna Medicare |
$937.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,208.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,298.48
|
| Rate for Payer: BCBS Complete |
$633.60
|
| Rate for Payer: BCBS MAPPO |
$901.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.63
|
| Rate for Payer: BCN Commercial |
$1,368.30
|
| Rate for Payer: BCN Medicare Advantage |
$901.72
|
| Rate for Payer: Cash Price |
$1,326.40
|
| Rate for Payer: Cash Price |
$1,326.40
|
| Rate for Payer: Cofinity Commercial |
$1,208.30
|
| Rate for Payer: Cofinity Commercial |
$1,298.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$901.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$946.81
|
| Rate for Payer: Meridian Medicaid |
$633.60
|
| Rate for Payer: Nomi Health Commercial |
$1,082.06
|
| Rate for Payer: PACE SWMI |
$901.72
|
| Rate for Payer: PHP Commercial |
$1,262.41
|
| Rate for Payer: PHP Medicare Advantage |
$901.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,677.02
|
| Rate for Payer: Priority Health Medicare |
$901.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,677.02
|
| Rate for Payer: Priority Health SBD |
$1,677.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$901.72
|
| Rate for Payer: UHC Medicare Advantage |
$901.72
|
| Rate for Payer: UHCCP Medicaid |
$603.43
|
| Rate for Payer: UMR Bronson Commercial |
$762.68
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,690.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$927.62 |
| Max. Negotiated Rate |
$2,582.05 |
| Rate for Payer: Aetna Commercial |
$1,864.60
|
| Rate for Payer: Aetna Medicare |
$1,447.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,864.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,003.75
|
| Rate for Payer: BCBS Complete |
$974.00
|
| Rate for Payer: BCBS MAPPO |
$1,391.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.43
|
| Rate for Payer: BCN Commercial |
$2,116.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.49
|
| Rate for Payer: Cash Price |
$2,952.00
|
| Rate for Payer: Cash Price |
$2,952.00
|
| Rate for Payer: Cofinity Commercial |
$1,864.60
|
| Rate for Payer: Cofinity Commercial |
$2,003.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,461.06
|
| Rate for Payer: Meridian Medicaid |
$974.00
|
| Rate for Payer: Nomi Health Commercial |
$1,669.79
|
| Rate for Payer: PACE SWMI |
$1,391.49
|
| Rate for Payer: PHP Commercial |
$1,948.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$927.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,398.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,582.05
|
| Rate for Payer: Priority Health Medicare |
$1,391.49
|
| Rate for Payer: Priority Health Narrow Network |
$2,582.05
|
| Rate for Payer: Priority Health SBD |
$2,582.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,391.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,391.49
|
| Rate for Payer: UHCCP Medicaid |
$927.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,697.40
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,687.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$389.15 |
| Max. Negotiated Rate |
$2,064.60 |
| Rate for Payer: Aetna Commercial |
$769.80
|
| Rate for Payer: Aetna Medicare |
$597.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$827.25
|
| Rate for Payer: BCBS Complete |
$408.61
|
| Rate for Payer: BCBS MAPPO |
$574.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.60
|
| Rate for Payer: BCN Commercial |
$882.55
|
| Rate for Payer: BCN Medicare Advantage |
$574.48
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cash Price |
$1,349.60
|
| Rate for Payer: Cofinity Commercial |
$769.80
|
| Rate for Payer: Cofinity Commercial |
$827.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$603.20
|
| Rate for Payer: Meridian Medicaid |
$408.61
|
| Rate for Payer: Nomi Health Commercial |
$689.38
|
| Rate for Payer: PACE SWMI |
$574.48
|
| Rate for Payer: PHP Commercial |
$804.27
|
| Rate for Payer: PHP Medicare Advantage |
$574.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,082.82
|
| Rate for Payer: Priority Health Medicare |
$574.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,082.82
|
| Rate for Payer: Priority Health SBD |
$1,082.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$574.48
|
| Rate for Payer: UHC Medicare Advantage |
$574.48
|
| Rate for Payer: UHCCP Medicaid |
$389.15
|
| Rate for Payer: UMR Bronson Commercial |
$776.02
|
|
|
PR PROCTOPLASTY STENOSIS
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 45500
|
| Min. Negotiated Rate |
$370.19 |
| Max. Negotiated Rate |
$2,757.73 |
| Rate for Payer: Aetna Commercial |
$738.47
|
| Rate for Payer: Aetna Medicare |
$573.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.58
|
| Rate for Payer: BCBS Complete |
$388.70
|
| Rate for Payer: BCBS MAPPO |
$551.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,757.73
|
| Rate for Payer: BCN Commercial |
$836.62
|
| Rate for Payer: BCN Medicare Advantage |
$551.10
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$738.47
|
| Rate for Payer: Cofinity Commercial |
$793.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.66
|
| Rate for Payer: Meridian Medicaid |
$388.70
|
| Rate for Payer: Nomi Health Commercial |
$661.32
|
| Rate for Payer: PACE SWMI |
$551.10
|
| Rate for Payer: PHP Commercial |
$771.54
|
| Rate for Payer: PHP Medicare Advantage |
$551.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,027.33
|
| Rate for Payer: Priority Health Medicare |
$551.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,027.33
|
| Rate for Payer: Priority Health SBD |
$1,027.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.10
|
| Rate for Payer: UHC Medicare Advantage |
$551.10
|
| Rate for Payer: UHCCP Medicaid |
$370.19
|
| Rate for Payer: UMR Bronson Commercial |
$524.40
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$128.05
|
| Rate for Payer: Aetna Commercial |
$167.45
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$122.50
|
| Rate for Payer: BCN Commercial |
$122.50
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$169.42
|
| Rate for Payer: Cofinity Commercial |
$137.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$177.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.75
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.45
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$167.45
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Priority Health SBD |
$124.11
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.04
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$46.40
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$72.89
|
| Rate for Payer: VA VA |
$893.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.75
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 45300
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$502.41 |
| Rate for Payer: Aetna Commercial |
$62.22
|
| Rate for Payer: Aetna Medicare |
$48.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.86
|
| Rate for Payer: BCBS Complete |
$32.66
|
| Rate for Payer: BCBS MAPPO |
$46.43
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$151.96
|
| Rate for Payer: BCN Medicare Advantage |
$46.43
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$62.22
|
| Rate for Payer: Cofinity Commercial |
$66.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.75
|
| Rate for Payer: Meridian Medicaid |
$32.66
|
| Rate for Payer: Nomi Health Commercial |
$55.72
|
| Rate for Payer: PACE SWMI |
$46.43
|
| Rate for Payer: PHP Commercial |
$65.00
|
| Rate for Payer: PHP Medicare Advantage |
$46.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.90
|
| Rate for Payer: Priority Health Medicare |
$46.43
|
| Rate for Payer: Priority Health Narrow Network |
$85.90
|
| Rate for Payer: Priority Health SBD |
$85.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.43
|
| Rate for Payer: UHC Medicare Advantage |
$46.43
|
| Rate for Payer: UHCCP Medicaid |
$31.10
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
45300
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$86.68 |
| Max. Negotiated Rate |
$177.30 |
| Rate for Payer: Aetna American Axle |
$128.05
|
| Rate for Payer: Aetna Commercial |
$167.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.05
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$137.90
|
| Rate for Payer: Cofinity Commercial |
$169.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.60
|
| Rate for Payer: Healthscope Commercial |
$177.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.45
|
| Rate for Payer: PHP Commercial |
$167.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health SBD |
$124.11
|
| Rate for Payer: UMR Bronson Commercial |
$86.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.75
|
|
|
PR PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 45300
|
| Hospital Charge Code |
45300
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$502.41 |
| Rate for Payer: Aetna Commercial |
$62.22
|
| Rate for Payer: Aetna Medicare |
$48.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.86
|
| Rate for Payer: BCBS Complete |
$32.66
|
| Rate for Payer: BCBS MAPPO |
$46.43
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$151.96
|
| Rate for Payer: BCN Medicare Advantage |
$46.43
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$66.86
|
| Rate for Payer: Cofinity Commercial |
$62.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.75
|
| Rate for Payer: Meridian Medicaid |
$32.66
|
| Rate for Payer: Nomi Health Commercial |
$55.72
|
| Rate for Payer: PACE SWMI |
$46.43
|
| Rate for Payer: PHP Commercial |
$65.00
|
| Rate for Payer: PHP Medicare Advantage |
$46.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.90
|
| Rate for Payer: Priority Health Medicare |
$46.43
|
| Rate for Payer: Priority Health Narrow Network |
$85.90
|
| Rate for Payer: Priority Health SBD |
$85.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.43
|
| Rate for Payer: UHC Medicare Advantage |
$46.43
|
| Rate for Payer: UHCCP Medicaid |
$31.10
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
|
|
PR PROCTOSGMDSC RIGID ABLATION LESION
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 45320
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$330.35 |
| Rate for Payer: Aetna Commercial |
$137.44
|
| Rate for Payer: Aetna Medicare |
$106.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.70
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$102.57
|
| Rate for Payer: BCBS Trust/PPO |
$223.95
|
| Rate for Payer: BCN Commercial |
$330.35
|
| Rate for Payer: BCN Medicare Advantage |
$102.57
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$137.44
|
| Rate for Payer: Cofinity Commercial |
$147.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.70
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Nomi Health Commercial |
$123.08
|
| Rate for Payer: PACE SWMI |
$102.57
|
| Rate for Payer: PHP Commercial |
$143.60
|
| Rate for Payer: PHP Medicare Advantage |
$102.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.33
|
| Rate for Payer: Priority Health Medicare |
$102.57
|
| Rate for Payer: Priority Health Narrow Network |
$187.33
|
| Rate for Payer: Priority Health SBD |
$187.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.57
|
| Rate for Payer: UHC Medicare Advantage |
$102.57
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: UMR Bronson Commercial |
$221.72
|
|
|
PR PROCTOSGMDSC RIGID CONTROL BLEEDING
|
Professional
|
Both
|
$452.00
|
|
|
Service Code
|
HCPCS 45317
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$325.46 |
| Rate for Payer: Aetna Commercial |
$141.72
|
| Rate for Payer: Aetna Medicare |
$109.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.29
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$105.76
|
| Rate for Payer: BCBS Trust/PPO |
$180.68
|
| Rate for Payer: BCN Commercial |
$325.46
|
| Rate for Payer: BCN Medicare Advantage |
$105.76
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cash Price |
$361.60
|
| Rate for Payer: Cofinity Commercial |
$141.72
|
| Rate for Payer: Cofinity Commercial |
$152.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.05
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Nomi Health Commercial |
$126.91
|
| Rate for Payer: PACE SWMI |
$105.76
|
| Rate for Payer: PHP Commercial |
$148.06
|
| Rate for Payer: PHP Medicare Advantage |
$105.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.47
|
| Rate for Payer: Priority Health Medicare |
$105.76
|
| Rate for Payer: Priority Health Narrow Network |
$197.47
|
| Rate for Payer: Priority Health SBD |
$197.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.76
|
| Rate for Payer: UHC Medicare Advantage |
$105.76
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
| Rate for Payer: UMR Bronson Commercial |
$207.92
|
|
|
PR PROCTOSGMDSC RIGID DCMPRN VOLVULUS
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 45321
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$254.80 |
| Rate for Payer: Aetna Commercial |
$135.23
|
| Rate for Payer: Aetna Medicare |
$104.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.32
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: BCBS MAPPO |
$100.92
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: BCN Medicare Advantage |
$100.92
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$135.23
|
| Rate for Payer: Cofinity Commercial |
$145.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.97
|
| Rate for Payer: Meridian Medicaid |
$70.22
|
| Rate for Payer: Nomi Health Commercial |
$121.10
|
| Rate for Payer: PACE SWMI |
$100.92
|
| Rate for Payer: PHP Commercial |
$141.29
|
| Rate for Payer: PHP Medicare Advantage |
$100.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.94
|
| Rate for Payer: Priority Health Medicare |
$100.92
|
| Rate for Payer: Priority Health Narrow Network |
$184.94
|
| Rate for Payer: Priority Health SBD |
$184.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.92
|
| Rate for Payer: UHC Medicare Advantage |
$100.92
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
| Rate for Payer: UMR Bronson Commercial |
$180.32
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 45308
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$302.98 |
| Rate for Payer: Aetna Commercial |
$109.96
|
| Rate for Payer: Aetna Medicare |
$85.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.17
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS MAPPO |
$82.06
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: BCN Medicare Advantage |
$82.06
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$109.96
|
| Rate for Payer: Cofinity Commercial |
$118.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.16
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Nomi Health Commercial |
$98.47
|
| Rate for Payer: PACE SWMI |
$82.06
|
| Rate for Payer: PHP Commercial |
$114.88
|
| Rate for Payer: PHP Medicare Advantage |
$82.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.53
|
| Rate for Payer: Priority Health Medicare |
$82.06
|
| Rate for Payer: Priority Health Narrow Network |
$151.53
|
| Rate for Payer: Priority Health SBD |
$151.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.06
|
| Rate for Payer: UHC Medicare Advantage |
$82.06
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
| Rate for Payer: UMR Bronson Commercial |
$143.06
|
|
|
PR PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 45309
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$676.75 |
| Rate for Payer: Aetna Commercial |
$116.89
|
| Rate for Payer: Aetna Medicare |
$90.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.61
|
| Rate for Payer: BCBS Complete |
$60.84
|
| Rate for Payer: BCBS MAPPO |
$87.23
|
| Rate for Payer: BCBS Trust/PPO |
$676.75
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$87.23
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$116.89
|
| Rate for Payer: Cofinity Commercial |
$125.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.59
|
| Rate for Payer: Meridian Medicaid |
$60.84
|
| Rate for Payer: Nomi Health Commercial |
$104.68
|
| Rate for Payer: PACE SWMI |
$87.23
|
| Rate for Payer: PHP Commercial |
$122.12
|
| Rate for Payer: PHP Medicare Advantage |
$87.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.48
|
| Rate for Payer: Priority Health Medicare |
$87.23
|
| Rate for Payer: Priority Health Narrow Network |
$160.48
|
| Rate for Payer: Priority Health SBD |
$160.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.23
|
| Rate for Payer: UHC Medicare Advantage |
$87.23
|
| Rate for Payer: UHCCP Medicaid |
$57.94
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 45315
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$1,137.43 |
| Rate for Payer: Aetna Commercial |
$138.30
|
| Rate for Payer: Aetna Medicare |
$107.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.62
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$103.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.43
|
| Rate for Payer: BCN Commercial |
$336.70
|
| Rate for Payer: BCN Medicare Advantage |
$103.21
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$138.30
|
| Rate for Payer: Cofinity Commercial |
$148.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.37
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$123.85
|
| Rate for Payer: PACE SWMI |
$103.21
|
| Rate for Payer: PHP Commercial |
$144.49
|
| Rate for Payer: PHP Medicare Advantage |
$103.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.12
|
| Rate for Payer: Priority Health Medicare |
$103.21
|
| Rate for Payer: Priority Health Narrow Network |
$189.12
|
| Rate for Payer: Priority Health SBD |
$189.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.21
|
| Rate for Payer: UHC Medicare Advantage |
$103.21
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UMR Bronson Commercial |
$221.72
|
|
|
PR PROCTOSGMDSC RIGID TNDSC STENT PLMT
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 45327
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$208.81 |
| Rate for Payer: Aetna Commercial |
$153.19
|
| Rate for Payer: Aetna Medicare |
$118.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.62
|
| Rate for Payer: BCBS Complete |
$79.40
|
| Rate for Payer: BCBS MAPPO |
$114.32
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$114.32
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$153.19
|
| Rate for Payer: Cofinity Commercial |
$164.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.04
|
| Rate for Payer: Meridian Medicaid |
$79.40
|
| Rate for Payer: Nomi Health Commercial |
$137.18
|
| Rate for Payer: PACE SWMI |
$114.32
|
| Rate for Payer: PHP Commercial |
$160.05
|
| Rate for Payer: PHP Medicare Advantage |
$114.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$114.32
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: Priority Health SBD |
$208.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.32
|
| Rate for Payer: UHC Medicare Advantage |
$114.32
|
| Rate for Payer: UHCCP Medicaid |
$75.62
|
| Rate for Payer: UMR Bronson Commercial |
$103.04
|
|
|
PR PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 45305
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$1,525.20 |
| Rate for Payer: Aetna Commercial |
$93.57
|
| Rate for Payer: Aetna Medicare |
$72.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.57
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$69.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,525.20
|
| Rate for Payer: BCN Commercial |
$267.80
|
| Rate for Payer: BCN Medicare Advantage |
$69.83
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$100.56
|
| Rate for Payer: Cofinity Commercial |
$93.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.32
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Nomi Health Commercial |
$83.80
|
| Rate for Payer: PACE SWMI |
$69.83
|
| Rate for Payer: PHP Commercial |
$97.76
|
| Rate for Payer: PHP Medicare Advantage |
$69.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.06
|
| Rate for Payer: Priority Health Medicare |
$69.83
|
| Rate for Payer: Priority Health Narrow Network |
$130.06
|
| Rate for Payer: Priority Health SBD |
$130.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.83
|
| Rate for Payer: UHC Medicare Advantage |
$69.83
|
| Rate for Payer: UHCCP Medicaid |
$46.86
|
| Rate for Payer: UMR Bronson Commercial |
$136.62
|
|
|
PR PROCTOSGMDSC RIGID W/DILATION
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 45303
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$1,415.70 |
| Rate for Payer: Aetna Commercial |
$108.98
|
| Rate for Payer: Aetna Medicare |
$84.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.12
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS MAPPO |
$81.33
|
| Rate for Payer: BCBS Trust/PPO |
$520.38
|
| Rate for Payer: BCN Commercial |
$1,415.70
|
| Rate for Payer: BCN Medicare Advantage |
$81.33
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cofinity Commercial |
$108.98
|
| Rate for Payer: Cofinity Commercial |
$117.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.40
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: PACE SWMI |
$81.33
|
| Rate for Payer: PHP Commercial |
$113.86
|
| Rate for Payer: PHP Medicare Advantage |
$81.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.74
|
| Rate for Payer: Priority Health Medicare |
$81.33
|
| Rate for Payer: Priority Health Narrow Network |
$152.74
|
| Rate for Payer: Priority Health SBD |
$152.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.33
|
| Rate for Payer: UHC Medicare Advantage |
$81.33
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
| Rate for Payer: UMR Bronson Commercial |
$95.68
|
|
|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$854.26 |
| Rate for Payer: Aetna Commercial |
$130.76
|
| Rate for Payer: Aetna Medicare |
$101.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.52
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$97.58
|
| Rate for Payer: BCBS Trust/PPO |
$854.26
|
| Rate for Payer: BCN Commercial |
$316.66
|
| Rate for Payer: BCN Medicare Advantage |
$97.58
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cofinity Commercial |
$140.52
|
| Rate for Payer: Cofinity Commercial |
$130.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.46
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Nomi Health Commercial |
$117.10
|
| Rate for Payer: PACE SWMI |
$97.58
|
| Rate for Payer: PHP Commercial |
$136.61
|
| Rate for Payer: PHP Medicare Advantage |
$97.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.58
|
| Rate for Payer: Priority Health Medicare |
$97.58
|
| Rate for Payer: Priority Health Narrow Network |
$179.58
|
| Rate for Payer: Priority Health SBD |
$179.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.58
|
| Rate for Payer: UHC Medicare Advantage |
$97.58
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
| Rate for Payer: UMR Bronson Commercial |
$155.94
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 95115
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$432.68 |
| Rate for Payer: Aetna Commercial |
$12.74
|
| Rate for Payer: Aetna Medicare |
$9.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.69
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$9.51
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.51
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Cofinity Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.99
|
| Rate for Payer: Nomi Health Commercial |
$11.41
|
| Rate for Payer: PACE SWMI |
$9.51
|
| Rate for Payer: PHP Commercial |
$13.31
|
| Rate for Payer: PHP Medicare Advantage |
$9.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.72
|
| Rate for Payer: Priority Health Medicare |
$9.51
|
| Rate for Payer: Priority Health Narrow Network |
$13.72
|
| Rate for Payer: Priority Health SBD |
$13.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.51
|
| Rate for Payer: UHC Medicare Advantage |
$9.51
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 95117
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$446.94 |
| Rate for Payer: Aetna Commercial |
$14.73
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.83
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$10.99
|
| Rate for Payer: BCBS Trust/PPO |
$446.94
|
| Rate for Payer: BCN Commercial |
$17.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.99
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$15.83
|
| Rate for Payer: Cofinity Commercial |
$14.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.54
|
| Rate for Payer: Nomi Health Commercial |
$13.19
|
| Rate for Payer: PACE SWMI |
$10.99
|
| Rate for Payer: PHP Commercial |
$15.39
|
| Rate for Payer: PHP Medicare Advantage |
$10.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.65
|
| Rate for Payer: Priority Health Medicare |
$10.99
|
| Rate for Payer: Priority Health Narrow Network |
$16.65
|
| Rate for Payer: Priority Health SBD |
$16.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.99
|
| Rate for Payer: UHC Medicare Advantage |
$10.99
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
