|
PR SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX
|
Professional
|
Both
|
$807.00
|
|
|
Service Code
|
HCPCS 45342
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$524.55 |
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna Medicare |
$166.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.98
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$160.40
|
| Rate for Payer: BCBS Trust/PPO |
$269.43
|
| Rate for Payer: BCN Commercial |
$245.32
|
| Rate for Payer: BCN Medicare Advantage |
$160.40
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cofinity Commercial |
$214.94
|
| Rate for Payer: Cofinity Commercial |
$230.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.42
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Nomi Health Commercial |
$192.48
|
| Rate for Payer: PACE SWMI |
$160.40
|
| Rate for Payer: PHP Commercial |
$224.56
|
| Rate for Payer: PHP Medicare Advantage |
$160.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.69
|
| Rate for Payer: Priority Health Medicare |
$160.40
|
| Rate for Payer: Priority Health Narrow Network |
$300.69
|
| Rate for Payer: Priority Health SBD |
$300.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.40
|
| Rate for Payer: UHC Medicare Advantage |
$160.40
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
| Rate for Payer: UMR Bronson Commercial |
$371.22
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$421.73 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$71.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.76
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$421.73
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Commercial |
$96.01
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.27
|
| Rate for Payer: Priority Health Medicare |
$68.58
|
| Rate for Payer: Priority Health Narrow Network |
$128.27
|
| Rate for Payer: Priority Health SBD |
$128.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$68.74 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$222.95
|
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.95
|
| 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 |
$1,164.06
|
| Rate for Payer: BCN Commercial |
$1,164.06
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$240.10
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| 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 |
$291.55
|
| 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 |
$291.55
|
| 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 |
$222.95
|
| 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 |
$216.09
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.61
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$68.74
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$126.91
|
| Rate for Payer: VA VA |
$893.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$150.92 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna American Axle |
$222.95
|
| Rate for Payer: Aetna Commercial |
$291.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.95
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$240.10
|
| Rate for Payer: Cofinity Commercial |
$294.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Healthscope Commercial |
$308.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: PHP Commercial |
$291.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health SBD |
$216.09
|
| Rate for Payer: UMR Bronson Commercial |
$150.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.25
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$421.73 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$71.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.76
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$421.73
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Commercial |
$96.01
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.27
|
| Rate for Payer: Priority Health Medicare |
$68.58
|
| Rate for Payer: Priority Health Narrow Network |
$128.27
|
| Rate for Payer: Priority Health SBD |
$128.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$991.04 |
| Rate for Payer: Aetna Commercial |
$127.43
|
| Rate for Payer: Aetna Medicare |
$98.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.94
|
| Rate for Payer: BCBS Complete |
$67.10
|
| Rate for Payer: BCBS MAPPO |
$95.10
|
| Rate for Payer: BCBS Trust/PPO |
$383.02
|
| Rate for Payer: BCN Commercial |
$991.04
|
| Rate for Payer: BCN Medicare Advantage |
$95.10
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.86
|
| Rate for Payer: Meridian Medicaid |
$67.10
|
| Rate for Payer: Nomi Health Commercial |
$114.12
|
| Rate for Payer: PACE SWMI |
$95.10
|
| Rate for Payer: PHP Commercial |
$133.14
|
| Rate for Payer: PHP Medicare Advantage |
$95.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.97
|
| Rate for Payer: Priority Health Medicare |
$95.10
|
| Rate for Payer: Priority Health Narrow Network |
$178.97
|
| Rate for Payer: Priority Health SBD |
$178.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.10
|
| Rate for Payer: UHC Medicare Advantage |
$95.10
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
| Rate for Payer: UMR Bronson Commercial |
$204.24
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$407.06 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.92
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$407.06
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.21
|
| Rate for Payer: Meridian Medicaid |
$70.00
|
| Rate for Payer: Nomi Health Commercial |
$119.10
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Commercial |
$138.95
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.73
|
| Rate for Payer: Priority Health Medicare |
$99.25
|
| Rate for Payer: Priority Health Narrow Network |
$186.73
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
| Rate for Payer: UHCCP Medicaid |
$66.67
|
| Rate for Payer: UMR Bronson Commercial |
$239.20
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$100.56 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna American Axle |
$338.00
|
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$738.64
|
| Rate for Payer: BCN Commercial |
$738.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$364.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.00
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$327.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.62
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$100.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$192.40
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.00
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$520.00
|
|
|
Service Code
|
HCPCS 45332
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$407.06 |
| Rate for Payer: Aetna Commercial |
$133.00
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.92
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$99.25
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$407.06
|
| Rate for Payer: BCN Medicare Advantage |
$99.25
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$133.00
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.21
|
| Rate for Payer: Meridian Medicaid |
$70.00
|
| Rate for Payer: Nomi Health Commercial |
$119.10
|
| Rate for Payer: PACE SWMI |
$99.25
|
| Rate for Payer: PHP Commercial |
$138.95
|
| Rate for Payer: PHP Medicare Advantage |
$99.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.73
|
| Rate for Payer: Priority Health Medicare |
$99.25
|
| Rate for Payer: Priority Health Narrow Network |
$186.73
|
| Rate for Payer: Priority Health SBD |
$186.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.25
|
| Rate for Payer: UHC Medicare Advantage |
$99.25
|
| Rate for Payer: UHCCP Medicaid |
$66.67
|
| Rate for Payer: UMR Bronson Commercial |
$239.20
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$228.80 |
| Max. Negotiated Rate |
$468.00 |
| Rate for Payer: Aetna American Axle |
$338.00
|
| Rate for Payer: Aetna Commercial |
$442.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Cofinity Commercial |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$447.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.00
|
| Rate for Payer: Healthscope Commercial |
$468.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.00
|
| Rate for Payer: PHP Commercial |
$442.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.00
|
| Rate for Payer: Priority Health SBD |
$327.60
|
| Rate for Payer: UMR Bronson Commercial |
$228.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.00
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$119.55
|
| Rate for Payer: Aetna Medicare |
$92.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.48
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS MAPPO |
$89.22
|
| Rate for Payer: BCBS Trust/PPO |
$297.83
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: BCN Medicare Advantage |
$89.22
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$128.48
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.68
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE SWMI |
$89.22
|
| Rate for Payer: PHP Commercial |
$124.91
|
| Rate for Payer: PHP Medicare Advantage |
$89.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.06
|
| Rate for Payer: Priority Health Medicare |
$89.22
|
| Rate for Payer: Priority Health Narrow Network |
$167.06
|
| Rate for Payer: Priority Health SBD |
$167.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.22
|
| Rate for Payer: UHC Medicare Advantage |
$89.22
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
| Rate for Payer: UMR Bronson Commercial |
$345.46
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Facility
|
OP
|
$751.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$90.10 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna American Axle |
$488.15
|
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| 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 |
$561.94
|
| Rate for Payer: BCN Commercial |
$561.94
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$525.70
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| 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 |
$638.35
|
| 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 |
$638.35
|
| 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 |
$488.15
|
| 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 |
$473.13
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.11
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$90.10
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$277.87
|
| Rate for Payer: VA VA |
$893.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45333
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Commercial |
$119.55
|
| Rate for Payer: Aetna Medicare |
$92.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.48
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS MAPPO |
$89.22
|
| Rate for Payer: BCBS Trust/PPO |
$297.83
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: BCN Medicare Advantage |
$89.22
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Commercial |
$128.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.68
|
| Rate for Payer: Meridian Medicaid |
$62.84
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE SWMI |
$89.22
|
| Rate for Payer: PHP Commercial |
$124.91
|
| Rate for Payer: PHP Medicare Advantage |
$89.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.06
|
| Rate for Payer: Priority Health Medicare |
$89.22
|
| Rate for Payer: Priority Health Narrow Network |
$167.06
|
| Rate for Payer: Priority Health SBD |
$167.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.22
|
| Rate for Payer: UHC Medicare Advantage |
$89.22
|
| Rate for Payer: UHCCP Medicaid |
$59.85
|
| Rate for Payer: UMR Bronson Commercial |
$345.46
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Facility
|
IP
|
$751.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
45333
|
| Min. Negotiated Rate |
$330.44 |
| Max. Negotiated Rate |
$675.90 |
| Rate for Payer: Aetna American Axle |
$488.15
|
| Rate for Payer: Aetna Commercial |
$638.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.15
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$525.70
|
| Rate for Payer: Cofinity Commercial |
$645.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$525.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.80
|
| Rate for Payer: Healthscope Commercial |
$675.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.35
|
| Rate for Payer: PHP Commercial |
$638.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
| Rate for Payer: Priority Health SBD |
$473.13
|
| Rate for Payer: UMR Bronson Commercial |
$330.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.25
|
|
|
PR SIGMOIDOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 45345
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: UMR Bronson Commercial |
$151.80
|
|
|
PR SIGMOIDOSCOPY W/STENT
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS G6023
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: UMR Bronson Commercial |
$151.80
|
|
|
PR SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 93278
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$981.33 |
| Rate for Payer: Aetna Commercial |
$38.70
|
| Rate for Payer: Aetna Medicare |
$30.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.59
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$28.88
|
| Rate for Payer: BCBS Trust/PPO |
$981.33
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$28.88
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.32
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Nomi Health Commercial |
$34.66
|
| Rate for Payer: PACE SWMI |
$28.88
|
| Rate for Payer: PHP Commercial |
$40.43
|
| Rate for Payer: PHP Medicare Advantage |
$28.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.73
|
| Rate for Payer: Priority Health Medicare |
$28.88
|
| Rate for Payer: Priority Health Narrow Network |
$44.73
|
| Rate for Payer: Priority Health SBD |
$17.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.88
|
| Rate for Payer: UHC Medicare Advantage |
$28.88
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
PR SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 51725
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$642.41 |
| Rate for Payer: Aetna Commercial |
$253.09
|
| Rate for Payer: Aetna Medicare |
$196.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.97
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$188.87
|
| Rate for Payer: BCBS Trust/PPO |
$642.41
|
| Rate for Payer: BCN Commercial |
$335.23
|
| Rate for Payer: BCN Medicare Advantage |
$188.87
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$253.09
|
| Rate for Payer: Cofinity Commercial |
$271.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.31
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Nomi Health Commercial |
$226.64
|
| Rate for Payer: PACE SWMI |
$188.87
|
| Rate for Payer: PHP Commercial |
$264.42
|
| Rate for Payer: PHP Medicare Advantage |
$188.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$363.76
|
| Rate for Payer: Priority Health Medicare |
$188.87
|
| Rate for Payer: Priority Health Narrow Network |
$363.76
|
| Rate for Payer: Priority Health SBD |
$119.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.87
|
| Rate for Payer: UHC Medicare Advantage |
$188.87
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
| Rate for Payer: UMR Bronson Commercial |
$247.02
|
|
|
PR SIMPLE IMPLANT REMOVAL, BILATERAL
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 00522
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$612.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Aetna Medicare |
$765.00
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: UMR Bronson Commercial |
$703.80
|
|
|
PR SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$9,729.00
|
|
|
Service Code
|
HCPCS 61700
|
| Min. Negotiated Rate |
$1,257.35 |
| Max. Negotiated Rate |
$6,912.88 |
| Rate for Payer: Aetna Commercial |
$4,524.71
|
| Rate for Payer: Aetna Medicare |
$3,511.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,524.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,862.38
|
| Rate for Payer: BCBS Complete |
$2,319.92
|
| Rate for Payer: BCBS MAPPO |
$3,376.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.35
|
| Rate for Payer: BCN Commercial |
$6,912.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,376.65
|
| Rate for Payer: Cash Price |
$7,783.20
|
| Rate for Payer: Cash Price |
$7,783.20
|
| Rate for Payer: Cofinity Commercial |
$4,524.71
|
| Rate for Payer: Cofinity Commercial |
$4,862.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,376.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,545.48
|
| Rate for Payer: Meridian Medicaid |
$2,319.92
|
| Rate for Payer: Nomi Health Commercial |
$4,051.98
|
| Rate for Payer: PACE SWMI |
$3,376.65
|
| Rate for Payer: PHP Commercial |
$4,727.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,376.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,209.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,323.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,882.79
|
| Rate for Payer: Priority Health Medicare |
$3,376.65
|
| Rate for Payer: Priority Health Narrow Network |
$5,882.79
|
| Rate for Payer: Priority Health SBD |
$5,882.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,376.65
|
| Rate for Payer: UHC Medicare Advantage |
$3,376.65
|
| Rate for Payer: UHCCP Medicaid |
$2,209.45
|
| Rate for Payer: UMR Bronson Commercial |
$4,475.34
|
|
|
PR SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$8,669.00
|
|
|
Service Code
|
HCPCS 61702
|
| Min. Negotiated Rate |
$1,072.45 |
| Max. Negotiated Rate |
$8,192.82 |
| Rate for Payer: Aetna Commercial |
$5,337.27
|
| Rate for Payer: Aetna Medicare |
$4,142.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,337.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,735.58
|
| Rate for Payer: BCBS Complete |
$2,733.00
|
| Rate for Payer: BCBS MAPPO |
$3,983.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$8,192.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,983.04
|
| Rate for Payer: Cash Price |
$6,935.20
|
| Rate for Payer: Cash Price |
$6,935.20
|
| Rate for Payer: Cofinity Commercial |
$5,337.27
|
| Rate for Payer: Cofinity Commercial |
$5,735.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,983.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,182.19
|
| Rate for Payer: Meridian Medicaid |
$2,733.00
|
| Rate for Payer: Nomi Health Commercial |
$4,779.65
|
| Rate for Payer: PACE SWMI |
$3,983.04
|
| Rate for Payer: PHP Commercial |
$5,576.26
|
| Rate for Payer: PHP Medicare Advantage |
$3,983.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,602.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,634.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,921.83
|
| Rate for Payer: Priority Health Medicare |
$3,983.04
|
| Rate for Payer: Priority Health Narrow Network |
$6,921.83
|
| Rate for Payer: Priority Health SBD |
$6,921.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,983.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,983.04
|
| Rate for Payer: UHCCP Medicaid |
$2,602.86
|
| Rate for Payer: UMR Bronson Commercial |
$3,987.74
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM
|
Professional
|
Both
|
$664.00
|
|
|
Service Code
|
HCPCS 12016
|
| Min. Negotiated Rate |
$81.15 |
| Max. Negotiated Rate |
$431.60 |
| Rate for Payer: Aetna Commercial |
$167.03
|
| Rate for Payer: Aetna Medicare |
$129.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.50
|
| Rate for Payer: BCBS Complete |
$85.21
|
| Rate for Payer: BCBS MAPPO |
$124.65
|
| Rate for Payer: BCBS Trust/PPO |
$117.56
|
| Rate for Payer: BCN Commercial |
$322.53
|
| Rate for Payer: BCN Medicare Advantage |
$124.65
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cash Price |
$531.20
|
| Rate for Payer: Cofinity Commercial |
$167.03
|
| Rate for Payer: Cofinity Commercial |
$179.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.88
|
| Rate for Payer: Meridian Medicaid |
$85.21
|
| Rate for Payer: Nomi Health Commercial |
$149.58
|
| Rate for Payer: PACE SWMI |
$124.65
|
| Rate for Payer: PHP Commercial |
$174.51
|
| Rate for Payer: PHP Medicare Advantage |
$124.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Medicare |
$124.65
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: Priority Health SBD |
$172.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.65
|
| Rate for Payer: UHC Medicare Advantage |
$124.65
|
| Rate for Payer: UHCCP Medicaid |
$81.15
|
| Rate for Payer: UMR Bronson Commercial |
$305.44
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 12017
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$223.32 |
| Rate for Payer: Aetna Commercial |
$201.51
|
| Rate for Payer: Aetna Medicare |
$156.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.55
|
| Rate for Payer: BCBS Complete |
$102.88
|
| Rate for Payer: BCBS MAPPO |
$150.38
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$223.32
|
| Rate for Payer: BCN Medicare Advantage |
$150.38
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$201.51
|
| Rate for Payer: Cofinity Commercial |
$216.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.90
|
| Rate for Payer: Meridian Medicaid |
$102.88
|
| Rate for Payer: Nomi Health Commercial |
$180.46
|
| Rate for Payer: PACE SWMI |
$150.38
|
| Rate for Payer: PHP Commercial |
$210.53
|
| Rate for Payer: PHP Medicare Advantage |
$150.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.69
|
| Rate for Payer: Priority Health Medicare |
$150.38
|
| Rate for Payer: Priority Health Narrow Network |
$207.69
|
| Rate for Payer: Priority Health SBD |
$207.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.38
|
| Rate for Payer: UHC Medicare Advantage |
$150.38
|
| Rate for Payer: UHCCP Medicaid |
$97.98
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 12011
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$212.16 |
| Rate for Payer: Aetna Commercial |
$72.45
|
| Rate for Payer: Aetna Medicare |
$56.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.86
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$54.07
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$165.18
|
| Rate for Payer: BCN Medicare Advantage |
$54.07
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$72.45
|
| Rate for Payer: Cofinity Commercial |
$77.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.77
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Nomi Health Commercial |
$64.88
|
| Rate for Payer: PACE SWMI |
$54.07
|
| Rate for Payer: PHP Commercial |
$75.70
|
| Rate for Payer: PHP Medicare Advantage |
$54.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.96
|
| Rate for Payer: Priority Health Medicare |
$54.07
|
| Rate for Payer: Priority Health Narrow Network |
$74.96
|
| Rate for Payer: Priority Health SBD |
$74.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.07
|
| Rate for Payer: UHC Medicare Advantage |
$54.07
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
| Rate for Payer: UMR Bronson Commercial |
$140.76
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 12013
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$351.25 |
| Rate for Payer: Aetna Commercial |
$75.75
|
| Rate for Payer: Aetna Medicare |
$58.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.40
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$56.53
|
| Rate for Payer: BCBS Trust/PPO |
$351.25
|
| Rate for Payer: BCN Commercial |
$172.99
|
| Rate for Payer: BCN Medicare Advantage |
$56.53
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Cofinity Commercial |
$81.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.36
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Nomi Health Commercial |
$67.84
|
| Rate for Payer: PACE SWMI |
$56.53
|
| Rate for Payer: PHP Commercial |
$79.14
|
| Rate for Payer: PHP Medicare Advantage |
$56.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.12
|
| Rate for Payer: Priority Health Medicare |
$56.53
|
| Rate for Payer: Priority Health Narrow Network |
$78.12
|
| Rate for Payer: Priority Health SBD |
$78.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.53
|
| Rate for Payer: UHC Medicare Advantage |
$56.53
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$164.68
|
|
