|
PR SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 95926
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$873.81 |
| Rate for Payer: Aetna Commercial |
$168.89
|
| Rate for Payer: Aetna Medicare |
$131.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.50
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$126.04
|
| Rate for Payer: BCBS Trust/PPO |
$873.81
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$126.04
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$168.89
|
| Rate for Payer: Cofinity Commercial |
$181.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.34
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Nomi Health Commercial |
$151.25
|
| Rate for Payer: PACE SWMI |
$126.04
|
| Rate for Payer: PHP Commercial |
$176.46
|
| Rate for Payer: PHP Medicare Advantage |
$126.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.94
|
| Rate for Payer: Priority Health Medicare |
$126.04
|
| Rate for Payer: Priority Health Narrow Network |
$213.94
|
| Rate for Payer: Priority Health SBD |
$36.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.04
|
| Rate for Payer: UHC Medicare Advantage |
$126.04
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
| Rate for Payer: UMR Bronson Commercial |
$145.82
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 95927
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$247.41 |
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$164.27
|
| Rate for Payer: Aetna Medicare |
$164.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.45
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCBS MAPPO |
$157.95
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCBS Trust/PPO |
$99.85
|
| Rate for Payer: BCN Commercial |
$242.39
|
| Rate for Payer: BCN Commercial |
$242.39
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: BCN Medicare Advantage |
$157.95
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Cofinity Commercial |
$227.45
|
| Rate for Payer: Cofinity Commercial |
$211.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.85
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: Nomi Health Commercial |
$189.54
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PACE SWMI |
$157.95
|
| Rate for Payer: PHP Commercial |
$221.13
|
| Rate for Payer: PHP Commercial |
$221.13
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$157.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.41
|
| Rate for Payer: Priority Health Medicare |
$157.95
|
| Rate for Payer: Priority Health Medicare |
$157.95
|
| Rate for Payer: Priority Health Narrow Network |
$247.41
|
| Rate for Payer: Priority Health Narrow Network |
$247.41
|
| Rate for Payer: Priority Health SBD |
$36.19
|
| Rate for Payer: Priority Health SBD |
$36.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
| Rate for Payer: UHC Medicare Advantage |
$157.95
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: UMR Bronson Commercial |
$132.48
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 95925
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$1,239.39 |
| Rate for Payer: Aetna Commercial |
$184.40
|
| Rate for Payer: Aetna Medicare |
$143.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.16
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$137.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,239.39
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: BCN Medicare Advantage |
$137.61
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$184.40
|
| Rate for Payer: Cofinity Commercial |
$198.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.49
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Nomi Health Commercial |
$165.13
|
| Rate for Payer: PACE SWMI |
$137.61
|
| Rate for Payer: PHP Commercial |
$192.65
|
| Rate for Payer: PHP Medicare Advantage |
$137.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.82
|
| Rate for Payer: Priority Health Medicare |
$137.61
|
| Rate for Payer: Priority Health Narrow Network |
$238.82
|
| Rate for Payer: Priority Health SBD |
$37.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.61
|
| Rate for Payer: UHC Medicare Advantage |
$137.61
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
| Rate for Payer: UMR Bronson Commercial |
$150.42
|
|
|
PR SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 95938
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$556.30 |
| Rate for Payer: Aetna Commercial |
$445.30
|
| Rate for Payer: Aetna Medicare |
$345.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.53
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$332.31
|
| Rate for Payer: BCBS Trust/PPO |
$556.30
|
| Rate for Payer: BCN Commercial |
$531.68
|
| Rate for Payer: BCN Medicare Advantage |
$332.31
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$445.30
|
| Rate for Payer: Cofinity Commercial |
$478.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.93
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Nomi Health Commercial |
$398.77
|
| Rate for Payer: PACE SWMI |
$332.31
|
| Rate for Payer: PHP Commercial |
$465.23
|
| Rate for Payer: PHP Medicare Advantage |
$332.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.85
|
| Rate for Payer: Priority Health Medicare |
$332.31
|
| Rate for Payer: Priority Health Narrow Network |
$508.85
|
| Rate for Payer: Priority Health SBD |
$60.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.31
|
| Rate for Payer: UHC Medicare Advantage |
$332.31
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 11311
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$338.18 |
| Rate for Payer: Aetna Commercial |
$79.96
|
| Rate for Payer: Aetna Medicare |
$62.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.92
|
| Rate for Payer: BCBS Complete |
$42.04
|
| Rate for Payer: BCBS MAPPO |
$59.67
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$161.77
|
| Rate for Payer: BCN Medicare Advantage |
$59.67
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$85.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.65
|
| Rate for Payer: Meridian Medicaid |
$42.04
|
| Rate for Payer: Nomi Health Commercial |
$71.60
|
| Rate for Payer: PACE SWMI |
$59.67
|
| Rate for Payer: PHP Commercial |
$83.54
|
| Rate for Payer: PHP Medicare Advantage |
$59.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.98
|
| Rate for Payer: Priority Health Medicare |
$59.67
|
| Rate for Payer: Priority Health Narrow Network |
$83.98
|
| Rate for Payer: Priority Health SBD |
$83.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.67
|
| Rate for Payer: UHC Medicare Advantage |
$59.67
|
| Rate for Payer: UHCCP Medicaid |
$40.04
|
| Rate for Payer: UMR Bronson Commercial |
$85.10
|
|
|
PR SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 11312
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$184.94 |
| Rate for Payer: Aetna Commercial |
$94.78
|
| Rate for Payer: Aetna Medicare |
$73.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.78
|
| Rate for Payer: BCBS Complete |
$49.88
|
| Rate for Payer: BCBS MAPPO |
$70.73
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$184.94
|
| Rate for Payer: BCN Medicare Advantage |
$70.73
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$101.85
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.27
|
| Rate for Payer: Meridian Medicaid |
$49.88
|
| Rate for Payer: Nomi Health Commercial |
$84.88
|
| Rate for Payer: PACE SWMI |
$70.73
|
| Rate for Payer: PHP Commercial |
$99.02
|
| Rate for Payer: PHP Medicare Advantage |
$70.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.33
|
| Rate for Payer: Priority Health Medicare |
$70.73
|
| Rate for Payer: Priority Health Narrow Network |
$99.33
|
| Rate for Payer: Priority Health SBD |
$99.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.73
|
| Rate for Payer: UHC Medicare Advantage |
$70.73
|
| Rate for Payer: UHCCP Medicaid |
$47.50
|
| Rate for Payer: UMR Bronson Commercial |
$122.36
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$128.70
|
| Rate for Payer: Aetna Commercial |
$168.30
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$137.88
|
| Rate for Payer: BCN Commercial |
$137.88
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Commercial |
$170.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$178.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.50
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$168.30
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$124.74
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.70
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: UMR Bronson Commercial |
$73.26
|
| Rate for Payer: VA VA |
$194.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.50
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
11301
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$507.28 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.30
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCBS Trust/PPO |
$507.28
|
| Rate for Payer: BCN Commercial |
$144.11
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.63
|
| Rate for Payer: Priority Health Medicare |
$48.82
|
| Rate for Payer: Priority Health Narrow Network |
$68.63
|
| Rate for Payer: Priority Health SBD |
$68.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
| Rate for Payer: UHCCP Medicaid |
$32.80
|
| Rate for Payer: UMR Bronson Commercial |
$91.08
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$507.28 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.30
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCBS Trust/PPO |
$507.28
|
| Rate for Payer: BCN Commercial |
$144.11
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Commercial |
$68.35
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.63
|
| Rate for Payer: Priority Health Medicare |
$48.82
|
| Rate for Payer: Priority Health Narrow Network |
$68.63
|
| Rate for Payer: Priority Health SBD |
$68.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
| Rate for Payer: UHCCP Medicaid |
$32.80
|
| Rate for Payer: UMR Bronson Commercial |
$91.08
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Aetna American Axle |
$128.70
|
| Rate for Payer: Aetna Commercial |
$168.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.70
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Commercial |
$170.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$178.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: PHP Commercial |
$168.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health SBD |
$124.74
|
| Rate for Payer: UMR Bronson Commercial |
$87.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.50
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$257.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$2,827.44 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$70.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.82
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS MAPPO |
$67.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
| Rate for Payer: BCN Commercial |
$179.84
|
| Rate for Payer: BCN Medicare Advantage |
$67.93
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cofinity Commercial |
$91.03
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.33
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Nomi Health Commercial |
$81.52
|
| Rate for Payer: PACE SWMI |
$67.93
|
| Rate for Payer: PHP Commercial |
$95.10
|
| Rate for Payer: PHP Medicare Advantage |
$67.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.27
|
| Rate for Payer: Priority Health Medicare |
$67.93
|
| Rate for Payer: Priority Health Narrow Network |
$95.27
|
| Rate for Payer: Priority Health SBD |
$95.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.93
|
| Rate for Payer: UHC Medicare Advantage |
$67.93
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
| Rate for Payer: UMR Bronson Commercial |
$118.22
|
|
|
PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 11302
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$162.17 |
| Rate for Payer: Aetna Commercial |
$76.10
|
| Rate for Payer: Aetna Medicare |
$59.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.78
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$56.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$162.17
|
| Rate for Payer: BCN Medicare Advantage |
$56.79
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$76.10
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.63
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Nomi Health Commercial |
$68.15
|
| Rate for Payer: PACE SWMI |
$56.79
|
| Rate for Payer: PHP Commercial |
$79.51
|
| Rate for Payer: PHP Medicare Advantage |
$56.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.92
|
| Rate for Payer: Priority Health Medicare |
$56.79
|
| Rate for Payer: Priority Health Narrow Network |
$79.92
|
| Rate for Payer: Priority Health SBD |
$79.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.79
|
| Rate for Payer: UHC Medicare Advantage |
$56.79
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
| Rate for Payer: UMR Bronson Commercial |
$107.64
|
|
|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$782.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$223.44 |
| Max. Negotiated Rate |
$788.73 |
| Rate for Payer: Aetna Commercial |
$440.03
|
| Rate for Payer: Aetna Medicare |
$341.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.87
|
| Rate for Payer: BCBS Complete |
$234.61
|
| Rate for Payer: BCBS MAPPO |
$328.38
|
| Rate for Payer: BCBS Trust/PPO |
$782.41
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$328.38
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cofinity Commercial |
$440.03
|
| Rate for Payer: Cofinity Commercial |
$472.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.80
|
| Rate for Payer: Meridian Medicaid |
$234.61
|
| Rate for Payer: Nomi Health Commercial |
$394.06
|
| Rate for Payer: PACE SWMI |
$328.38
|
| Rate for Payer: PHP Commercial |
$459.73
|
| Rate for Payer: PHP Medicare Advantage |
$328.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.63
|
| Rate for Payer: Priority Health Medicare |
$328.38
|
| Rate for Payer: Priority Health Narrow Network |
$624.63
|
| Rate for Payer: Priority Health SBD |
$624.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.38
|
| Rate for Payer: UHC Medicare Advantage |
$328.38
|
| Rate for Payer: UHCCP Medicaid |
$223.44
|
| Rate for Payer: UMR Bronson Commercial |
$359.72
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,021.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$171.47 |
| Max. Negotiated Rate |
$663.65 |
| Rate for Payer: Aetna Commercial |
$336.70
|
| Rate for Payer: Aetna Medicare |
$261.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.83
|
| Rate for Payer: BCBS Complete |
$180.04
|
| Rate for Payer: BCBS MAPPO |
$251.27
|
| Rate for Payer: BCBS Trust/PPO |
$395.70
|
| Rate for Payer: BCN Commercial |
$639.67
|
| Rate for Payer: BCN Medicare Advantage |
$251.27
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cofinity Commercial |
$336.70
|
| Rate for Payer: Cofinity Commercial |
$361.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.83
|
| Rate for Payer: Meridian Medicaid |
$180.04
|
| Rate for Payer: Nomi Health Commercial |
$301.52
|
| Rate for Payer: PACE SWMI |
$251.27
|
| Rate for Payer: PHP Commercial |
$351.78
|
| Rate for Payer: PHP Medicare Advantage |
$251.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$476.68
|
| Rate for Payer: Priority Health Medicare |
$251.27
|
| Rate for Payer: Priority Health Narrow Network |
$476.68
|
| Rate for Payer: Priority Health SBD |
$476.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.27
|
| Rate for Payer: UHC Medicare Advantage |
$251.27
|
| Rate for Payer: UHCCP Medicaid |
$171.47
|
| Rate for Payer: UMR Bronson Commercial |
$469.66
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$345.01 |
| Rate for Payer: Aetna Commercial |
$210.35
|
| Rate for Payer: Aetna Medicare |
$163.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.05
|
| Rate for Payer: BCBS Complete |
$112.28
|
| Rate for Payer: BCBS MAPPO |
$156.98
|
| Rate for Payer: BCBS Trust/PPO |
$237.74
|
| Rate for Payer: BCN Commercial |
$345.01
|
| Rate for Payer: BCN Medicare Advantage |
$156.98
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$210.35
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.83
|
| Rate for Payer: Meridian Medicaid |
$112.28
|
| Rate for Payer: Nomi Health Commercial |
$188.38
|
| Rate for Payer: PACE SWMI |
$156.98
|
| Rate for Payer: PHP Commercial |
$219.77
|
| Rate for Payer: PHP Medicare Advantage |
$156.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$298.89
|
| Rate for Payer: Priority Health Medicare |
$156.98
|
| Rate for Payer: Priority Health Narrow Network |
$298.89
|
| Rate for Payer: Priority Health SBD |
$298.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.98
|
| Rate for Payer: UHC Medicare Advantage |
$156.98
|
| Rate for Payer: UHCCP Medicaid |
$106.93
|
| Rate for Payer: UMR Bronson Commercial |
$192.74
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$300.40 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Medicare |
$375.50
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: UMR Bronson Commercial |
$345.46
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$3,394.35 |
| Rate for Payer: Aetna Commercial |
$202.38
|
| Rate for Payer: Aetna Medicare |
$157.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.48
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$151.03
|
| Rate for Payer: BCBS Trust/PPO |
$333.36
|
| Rate for Payer: BCN Commercial |
$3,394.35
|
| Rate for Payer: BCN Medicare Advantage |
$151.03
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$217.48
|
| Rate for Payer: Cofinity Commercial |
$202.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.58
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Nomi Health Commercial |
$181.24
|
| Rate for Payer: PACE SWMI |
$151.03
|
| Rate for Payer: PHP Commercial |
$211.44
|
| Rate for Payer: PHP Medicare Advantage |
$151.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.78
|
| Rate for Payer: Priority Health Medicare |
$151.03
|
| Rate for Payer: Priority Health Narrow Network |
$282.78
|
| Rate for Payer: Priority Health SBD |
$282.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.03
|
| Rate for Payer: UHC Medicare Advantage |
$151.03
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
| Rate for Payer: UMR Bronson Commercial |
$347.76
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$727.15 |
| Rate for Payer: Aetna Commercial |
$148.24
|
| Rate for Payer: Aetna Medicare |
$115.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.31
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$110.63
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: BCN Medicare Advantage |
$110.63
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.16
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Nomi Health Commercial |
$132.76
|
| Rate for Payer: PACE SWMI |
$110.63
|
| Rate for Payer: PHP Commercial |
$154.88
|
| Rate for Payer: PHP Medicare Advantage |
$110.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.61
|
| Rate for Payer: Priority Health Medicare |
$110.63
|
| Rate for Payer: Priority Health Narrow Network |
$207.61
|
| Rate for Payer: Priority Health SBD |
$207.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.63
|
| Rate for Payer: UHC Medicare Advantage |
$110.63
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
| Rate for Payer: UMR Bronson Commercial |
$306.82
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$239.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.63
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCBS Trust/PPO |
$239.85
|
| Rate for Payer: BCN Commercial |
$219.89
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Commercial |
$75.47
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.83
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: Priority Health Narrow Network |
$100.83
|
| Rate for Payer: Priority Health SBD |
$100.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$114.54
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$161.85
|
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.85
|
| 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 |
$932.09
|
| Rate for Payer: BCN Commercial |
$932.09
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$174.30
|
| Rate for Payer: Cofinity Commercial |
$214.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$224.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.75
|
| 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 |
$211.65
|
| 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 |
$211.65
|
| 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 |
$161.85
|
| 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 |
$156.87
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.28
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$53.89
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$92.13
|
| Rate for Payer: VA VA |
$893.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.75
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$239.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.63
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCBS Trust/PPO |
$239.85
|
| Rate for Payer: BCN Commercial |
$219.89
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Commercial |
$75.47
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.83
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: Priority Health Narrow Network |
$100.83
|
| Rate for Payer: Priority Health SBD |
$100.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$114.54
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$109.56 |
| Max. Negotiated Rate |
$224.10 |
| Rate for Payer: Aetna American Axle |
$161.85
|
| Rate for Payer: Aetna Commercial |
$211.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.85
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$174.30
|
| Rate for Payer: Cofinity Commercial |
$214.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Healthscope Commercial |
$224.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: PHP Commercial |
$211.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health SBD |
$156.87
|
| Rate for Payer: UMR Bronson Commercial |
$109.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.75
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$291.09 |
| Rate for Payer: Aetna Commercial |
$156.32
|
| Rate for Payer: Aetna Medicare |
$121.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.99
|
| Rate for Payer: BCBS Complete |
$82.30
|
| Rate for Payer: BCBS MAPPO |
$116.66
|
| Rate for Payer: BCBS Trust/PPO |
$291.09
|
| Rate for Payer: BCN Commercial |
$177.39
|
| Rate for Payer: BCN Medicare Advantage |
$116.66
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$156.32
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.49
|
| Rate for Payer: Meridian Medicaid |
$82.30
|
| Rate for Payer: Nomi Health Commercial |
$139.99
|
| Rate for Payer: PACE SWMI |
$116.66
|
| Rate for Payer: PHP Commercial |
$163.32
|
| Rate for Payer: PHP Medicare Advantage |
$116.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.96
|
| Rate for Payer: Priority Health Medicare |
$116.66
|
| Rate for Payer: Priority Health Narrow Network |
$218.96
|
| Rate for Payer: Priority Health SBD |
$218.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.66
|
| Rate for Payer: UHC Medicare Advantage |
$116.66
|
| Rate for Payer: UHCCP Medicaid |
$78.38
|
| Rate for Payer: UMR Bronson Commercial |
$136.62
|
|
|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$271.45 |
| Rate for Payer: Aetna Commercial |
$194.30
|
| Rate for Payer: Aetna Medicare |
$150.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.80
|
| Rate for Payer: BCBS Complete |
$101.99
|
| Rate for Payer: BCBS MAPPO |
$145.00
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$220.39
|
| Rate for Payer: BCN Medicare Advantage |
$145.00
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$194.30
|
| Rate for Payer: Cofinity Commercial |
$208.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.25
|
| Rate for Payer: Meridian Medicaid |
$101.99
|
| Rate for Payer: Nomi Health Commercial |
$174.00
|
| Rate for Payer: PACE SWMI |
$145.00
|
| Rate for Payer: PHP Commercial |
$203.00
|
| Rate for Payer: PHP Medicare Advantage |
$145.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.45
|
| Rate for Payer: Priority Health Medicare |
$145.00
|
| Rate for Payer: Priority Health Narrow Network |
$271.45
|
| Rate for Payer: Priority Health SBD |
$271.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.00
|
| Rate for Payer: UHC Medicare Advantage |
$145.00
|
| Rate for Payer: UHCCP Medicaid |
$97.13
|
| Rate for Payer: UMR Bronson Commercial |
$170.66
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45340
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: Aetna Medicare |
$76.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.25
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS MAPPO |
$73.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.68
|
| Rate for Payer: BCN Commercial |
$675.35
|
| Rate for Payer: BCN Medicare Advantage |
$73.32
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.99
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Nomi Health Commercial |
$87.98
|
| Rate for Payer: PACE SWMI |
$73.32
|
| Rate for Payer: PHP Commercial |
$102.65
|
| Rate for Payer: PHP Medicare Advantage |
$73.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.01
|
| Rate for Payer: Priority Health Medicare |
$73.32
|
| Rate for Payer: Priority Health Narrow Network |
$139.01
|
| Rate for Payer: Priority Health SBD |
$139.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.32
|
| Rate for Payer: UHC Medicare Advantage |
$73.32
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
|
