|
COLESEVELAM 625 MG TABLET
|
Facility
|
IP
|
$12.57
|
|
|
Service Code
|
NDC 60687038595
|
| Hospital Charge Code |
28372
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$11.31 |
| Rate for Payer: Aetna American Axle |
$8.17
|
| Rate for Payer: Aetna Commercial |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.17
|
| Rate for Payer: Cash Price |
$10.06
|
| Rate for Payer: Cofinity Advantage |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$10.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.06
|
| Rate for Payer: Healthscope Commercial |
$11.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.43
|
| Rate for Payer: PHP Commercial |
$10.68
|
| Rate for Payer: Priority Health SBD |
$7.92
|
| Rate for Payer: UMR Bronson Commercial |
$5.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.43
|
|
|
COLESEVELAM 625 MG TABLET
|
Facility
|
IP
|
$528.39
|
|
|
Service Code
|
NDC 68462043318
|
| Hospital Charge Code |
28372
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$232.49 |
| Max. Negotiated Rate |
$475.55 |
| Rate for Payer: Aetna American Axle |
$343.45
|
| Rate for Payer: Aetna Commercial |
$449.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.45
|
| Rate for Payer: Cash Price |
$422.71
|
| Rate for Payer: Cofinity Advantage |
$369.87
|
| Rate for Payer: Cofinity Commercial |
$454.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$422.71
|
| Rate for Payer: Healthscope Commercial |
$475.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$369.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.29
|
| Rate for Payer: PHP Commercial |
$449.13
|
| Rate for Payer: Priority Health SBD |
$332.89
|
| Rate for Payer: UMR Bronson Commercial |
$232.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.29
|
|
|
COLESEVELAM 625 MG TABLET
|
Facility
|
OP
|
$376.85
|
|
|
Service Code
|
NDC 60687038525
|
| Hospital Charge Code |
28372
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.43 |
| Max. Negotiated Rate |
$339.17 |
| Rate for Payer: Aetna American Axle |
$244.95
|
| Rate for Payer: Aetna Commercial |
$320.32
|
| Rate for Payer: Aetna Medicare |
$188.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.95
|
| Rate for Payer: BCBS Complete |
$150.74
|
| Rate for Payer: Cash Price |
$301.48
|
| Rate for Payer: Cofinity Advantage |
$263.80
|
| Rate for Payer: Cofinity Commercial |
$324.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.48
|
| Rate for Payer: Healthscope Commercial |
$339.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$263.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$301.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.64
|
| Rate for Payer: PHP Commercial |
$320.32
|
| Rate for Payer: Priority Health SBD |
$237.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.95
|
| Rate for Payer: UHC Core |
$196.34
|
| Rate for Payer: UHC Exchange |
$148.10
|
| Rate for Payer: UMR Bronson Commercial |
$139.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.64
|
|
|
COLESTIPOL 1 GRAM TABLET
|
Facility
|
OP
|
$563.91
|
|
|
Service Code
|
NDC 59762045001
|
| Hospital Charge Code |
13884
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$208.65 |
| Max. Negotiated Rate |
$507.52 |
| Rate for Payer: Aetna American Axle |
$366.54
|
| Rate for Payer: Aetna Commercial |
$479.32
|
| Rate for Payer: Aetna Medicare |
$281.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.54
|
| Rate for Payer: BCBS Complete |
$225.56
|
| Rate for Payer: Cash Price |
$451.13
|
| Rate for Payer: Cofinity Advantage |
$394.74
|
| Rate for Payer: Cofinity Commercial |
$484.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.13
|
| Rate for Payer: Healthscope Commercial |
$507.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.93
|
| Rate for Payer: PHP Commercial |
$479.32
|
| Rate for Payer: Priority Health SBD |
$355.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.54
|
| Rate for Payer: UHC Core |
$293.80
|
| Rate for Payer: UHC Exchange |
$221.62
|
| Rate for Payer: UMR Bronson Commercial |
$208.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.93
|
|
|
COLESTIPOL 1 GRAM TABLET
|
Facility
|
OP
|
$383.62
|
|
|
Service Code
|
NDC 00115521116
|
| Hospital Charge Code |
13884
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.94 |
| Max. Negotiated Rate |
$345.26 |
| Rate for Payer: Aetna American Axle |
$249.35
|
| Rate for Payer: Aetna Commercial |
$326.08
|
| Rate for Payer: Aetna Medicare |
$191.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.35
|
| Rate for Payer: BCBS Complete |
$153.45
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cofinity Advantage |
$268.53
|
| Rate for Payer: Cofinity Commercial |
$329.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.90
|
| Rate for Payer: Healthscope Commercial |
$345.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$306.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.71
|
| Rate for Payer: PHP Commercial |
$326.08
|
| Rate for Payer: Priority Health SBD |
$241.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.35
|
| Rate for Payer: UHC Core |
$199.87
|
| Rate for Payer: UHC Exchange |
$150.76
|
| Rate for Payer: UMR Bronson Commercial |
$141.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.71
|
|
|
COLESTIPOL 1 GRAM TABLET
|
Facility
|
IP
|
$383.62
|
|
|
Service Code
|
NDC 00115521116
|
| Hospital Charge Code |
13884
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$168.79 |
| Max. Negotiated Rate |
$345.26 |
| Rate for Payer: Aetna American Axle |
$249.35
|
| Rate for Payer: Aetna Commercial |
$326.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.35
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cofinity Advantage |
$268.53
|
| Rate for Payer: Cofinity Commercial |
$329.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.90
|
| Rate for Payer: Healthscope Commercial |
$345.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.71
|
| Rate for Payer: PHP Commercial |
$326.08
|
| Rate for Payer: Priority Health SBD |
$241.68
|
| Rate for Payer: UMR Bronson Commercial |
$168.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.71
|
|
|
COLESTIPOL 1 GRAM TABLET
|
Facility
|
IP
|
$563.91
|
|
|
Service Code
|
NDC 59762045001
|
| Hospital Charge Code |
13884
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.12 |
| Max. Negotiated Rate |
$507.52 |
| Rate for Payer: Aetna American Axle |
$366.54
|
| Rate for Payer: Aetna Commercial |
$479.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.54
|
| Rate for Payer: Cash Price |
$451.13
|
| Rate for Payer: Cofinity Advantage |
$394.74
|
| Rate for Payer: Cofinity Commercial |
$484.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.13
|
| Rate for Payer: Healthscope Commercial |
$507.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.93
|
| Rate for Payer: PHP Commercial |
$479.32
|
| Rate for Payer: Priority Health SBD |
$355.26
|
| Rate for Payer: UMR Bronson Commercial |
$248.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.93
|
|
|
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION
|
Facility
|
OP
|
$115.84
|
|
|
Service Code
|
HCPCS J0770
|
| Hospital Charge Code |
9681
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.93 |
| Max. Negotiated Rate |
$104.26 |
| Rate for Payer: Aetna American Axle |
$75.30
|
| Rate for Payer: Aetna American Axle |
$27.58
|
| Rate for Payer: Aetna American Axle |
$27.57
|
| Rate for Payer: Aetna American Axle |
$75.82
|
| Rate for Payer: Aetna American Axle |
$28.26
|
| Rate for Payer: Aetna Commercial |
$98.46
|
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: Aetna Commercial |
$36.96
|
| Rate for Payer: Aetna Commercial |
$36.07
|
| Rate for Payer: Aetna Commercial |
$36.05
|
| Rate for Payer: Aetna Medicare |
$21.74
|
| Rate for Payer: Aetna Medicare |
$58.32
|
| Rate for Payer: Aetna Medicare |
$57.92
|
| Rate for Payer: Aetna Medicare |
$21.20
|
| Rate for Payer: Aetna Medicare |
$21.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.26
|
| Rate for Payer: BCBS Complete |
$16.97
|
| Rate for Payer: BCBS Complete |
$46.34
|
| Rate for Payer: BCBS Complete |
$46.66
|
| Rate for Payer: BCBS Complete |
$16.96
|
| Rate for Payer: BCBS Complete |
$17.39
|
| Rate for Payer: BCBS Trust/PPO |
$39.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.15
|
| Rate for Payer: BCN Commercial |
$39.15
|
| Rate for Payer: BCN Commercial |
$39.15
|
| Rate for Payer: BCN Commercial |
$39.15
|
| Rate for Payer: BCN Commercial |
$39.15
|
| Rate for Payer: BCN Commercial |
$39.15
|
| Rate for Payer: Cash Price |
$33.94
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cash Price |
$93.31
|
| Rate for Payer: Cash Price |
$92.67
|
| Rate for Payer: Cash Price |
$33.93
|
| Rate for Payer: Cash Price |
$92.67
|
| Rate for Payer: Cash Price |
$33.93
|
| Rate for Payer: Cash Price |
$33.94
|
| Rate for Payer: Cash Price |
$93.31
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cofinity Advantage |
$29.70
|
| Rate for Payer: Cofinity Advantage |
$81.65
|
| Rate for Payer: Cofinity Advantage |
$29.69
|
| Rate for Payer: Cofinity Advantage |
$30.44
|
| Rate for Payer: Cofinity Advantage |
$81.09
|
| Rate for Payer: Cofinity Commercial |
$36.49
|
| Rate for Payer: Cofinity Commercial |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$100.31
|
| Rate for Payer: Cofinity Commercial |
$36.47
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.93
|
| Rate for Payer: Healthscope Commercial |
$38.17
|
| Rate for Payer: Healthscope Commercial |
$39.13
|
| Rate for Payer: Healthscope Commercial |
$38.19
|
| Rate for Payer: Healthscope Commercial |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$104.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.61
|
| Rate for Payer: PHP Commercial |
$99.14
|
| Rate for Payer: PHP Commercial |
$36.05
|
| Rate for Payer: PHP Commercial |
$36.96
|
| Rate for Payer: PHP Commercial |
$36.07
|
| Rate for Payer: PHP Commercial |
$98.46
|
| Rate for Payer: Priority Health SBD |
$26.72
|
| Rate for Payer: Priority Health SBD |
$72.98
|
| Rate for Payer: Priority Health SBD |
$26.73
|
| Rate for Payer: Priority Health SBD |
$27.39
|
| Rate for Payer: Priority Health SBD |
$73.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.93
|
| Rate for Payer: UHC Core |
$19.93
|
| Rate for Payer: UHC Core |
$19.93
|
| Rate for Payer: UHC Core |
$19.93
|
| Rate for Payer: UHC Core |
$19.93
|
| Rate for Payer: UHC Core |
$19.93
|
| Rate for Payer: UHC Exchange |
$19.93
|
| Rate for Payer: UHC Exchange |
$19.93
|
| Rate for Payer: UHC Exchange |
$19.93
|
| Rate for Payer: UHC Exchange |
$19.93
|
| Rate for Payer: UHC Exchange |
$19.93
|
| Rate for Payer: UMR Bronson Commercial |
$42.86
|
| Rate for Payer: UMR Bronson Commercial |
$15.70
|
| Rate for Payer: UMR Bronson Commercial |
$15.69
|
| Rate for Payer: UMR Bronson Commercial |
$16.09
|
| Rate for Payer: UMR Bronson Commercial |
$43.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.88
|
|
|
COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION
|
Facility
|
IP
|
$42.43
|
|
|
Service Code
|
HCPCS J0770
|
| Hospital Charge Code |
9681
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.67 |
| Max. Negotiated Rate |
$38.19 |
| Rate for Payer: Aetna American Axle |
$27.58
|
| Rate for Payer: Aetna American Axle |
$27.57
|
| Rate for Payer: Aetna American Axle |
$28.26
|
| Rate for Payer: Aetna American Axle |
$75.82
|
| Rate for Payer: Aetna American Axle |
$75.30
|
| Rate for Payer: Aetna Commercial |
$98.46
|
| Rate for Payer: Aetna Commercial |
$36.05
|
| Rate for Payer: Aetna Commercial |
$36.07
|
| Rate for Payer: Aetna Commercial |
$36.96
|
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.26
|
| Rate for Payer: Cash Price |
$33.93
|
| Rate for Payer: Cash Price |
$93.31
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cash Price |
$33.94
|
| Rate for Payer: Cash Price |
$92.67
|
| Rate for Payer: Cofinity Advantage |
$81.09
|
| Rate for Payer: Cofinity Advantage |
$30.44
|
| Rate for Payer: Cofinity Advantage |
$81.65
|
| Rate for Payer: Cofinity Advantage |
$29.70
|
| Rate for Payer: Cofinity Advantage |
$29.69
|
| Rate for Payer: Cofinity Commercial |
$37.39
|
| Rate for Payer: Cofinity Commercial |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$100.31
|
| Rate for Payer: Cofinity Commercial |
$36.47
|
| Rate for Payer: Cofinity Commercial |
$36.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Healthscope Commercial |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$104.98
|
| Rate for Payer: Healthscope Commercial |
$38.17
|
| Rate for Payer: Healthscope Commercial |
$38.19
|
| Rate for Payer: Healthscope Commercial |
$39.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.82
|
| Rate for Payer: PHP Commercial |
$36.05
|
| Rate for Payer: PHP Commercial |
$98.46
|
| Rate for Payer: PHP Commercial |
$36.07
|
| Rate for Payer: PHP Commercial |
$36.96
|
| Rate for Payer: PHP Commercial |
$99.14
|
| Rate for Payer: Priority Health SBD |
$26.73
|
| Rate for Payer: Priority Health SBD |
$27.39
|
| Rate for Payer: Priority Health SBD |
$73.48
|
| Rate for Payer: Priority Health SBD |
$72.98
|
| Rate for Payer: Priority Health SBD |
$26.72
|
| Rate for Payer: UMR Bronson Commercial |
$51.32
|
| Rate for Payer: UMR Bronson Commercial |
$19.13
|
| Rate for Payer: UMR Bronson Commercial |
$18.66
|
| Rate for Payer: UMR Bronson Commercial |
$50.97
|
| Rate for Payer: UMR Bronson Commercial |
$18.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.48
|
|
|
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT
|
Facility
|
OP
|
$1,137.57
|
|
|
Service Code
|
NDC 50484001030
|
| Hospital Charge Code |
9682
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$420.90 |
| Max. Negotiated Rate |
$1,023.81 |
| Rate for Payer: Aetna American Axle |
$739.42
|
| Rate for Payer: Aetna Commercial |
$966.93
|
| Rate for Payer: Aetna Medicare |
$568.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.42
|
| Rate for Payer: BCBS Complete |
$455.03
|
| Rate for Payer: Cash Price |
$910.06
|
| Rate for Payer: Cofinity Advantage |
$796.30
|
| Rate for Payer: Cofinity Commercial |
$978.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.06
|
| Rate for Payer: Healthscope Commercial |
$1,023.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$796.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$910.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$853.18
|
| Rate for Payer: PHP Commercial |
$966.93
|
| Rate for Payer: Priority Health SBD |
$716.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$739.42
|
| Rate for Payer: UHC Core |
$592.67
|
| Rate for Payer: UHC Exchange |
$447.07
|
| Rate for Payer: UMR Bronson Commercial |
$420.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.18
|
|
|
COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT
|
Facility
|
IP
|
$1,137.57
|
|
|
Service Code
|
NDC 50484001030
|
| Hospital Charge Code |
9682
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$500.53 |
| Max. Negotiated Rate |
$1,023.81 |
| Rate for Payer: Aetna American Axle |
$739.42
|
| Rate for Payer: Aetna Commercial |
$966.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.42
|
| Rate for Payer: Cash Price |
$910.06
|
| Rate for Payer: Cofinity Advantage |
$796.30
|
| Rate for Payer: Cofinity Commercial |
$978.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.06
|
| Rate for Payer: Healthscope Commercial |
$1,023.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$796.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$966.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$853.18
|
| Rate for Payer: PHP Commercial |
$966.93
|
| Rate for Payer: Priority Health SBD |
$716.67
|
| Rate for Payer: UMR Bronson Commercial |
$500.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.18
|
|
|
COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 36415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCBS Trust/PPO |
$7.80
|
| Rate for Payer: BCN Commercial |
$7.80
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Mclaren Medicare |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.74
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Nomi Health Commercial |
$14.01
|
| Rate for Payer: PACE Medicare |
$8.87
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.09
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health Tiered Network |
$7.27
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Medicaid |
$4.88
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: VA VA |
$9.34
|
|
|
COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,996.60
|
|
|
Service Code
|
CPT 45378
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$484.62 |
| Max. Negotiated Rate |
$2,996.60 |
| Rate for Payer: Aetna Medicare |
$963.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$948.50
|
| Rate for Payer: BCN Commercial |
$948.50
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Mclaren Medicaid |
$926.61
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$972.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Nomi Health Commercial |
$2,779.83
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,996.60
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health Tiered Network |
$2,397.28
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$926.61
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
|
COLONOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45388
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.07
|
| Rate for Payer: BCN Commercial |
$1,041.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH BAND LIGATION(S) (EG, HEMORRHOIDS)
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45398
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45380
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45382
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45381
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 45390
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.50
|
| Rate for Payer: BCN Commercial |
$2,032.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S)
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45379
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.07
|
| Rate for Payer: BCN Commercial |
$1,041.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATION
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45386
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S), INCLUDES ENDOSCOPIC ULTRASOUND EXAMINATION LIMITED TO THE RECTUM, SIGMOID, DESCENDING, TRANSVERSE, OR ASCENDING COLON AND CECUM, AND ADJACENT STRUCTURES
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 45392
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.64
|
| Rate for Payer: BCN Commercial |
$1,040.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$2,996.60
|
|
|
Service Code
|
CPT 44388
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$484.62 |
| Max. Negotiated Rate |
$2,996.60 |
| Rate for Payer: Aetna Medicare |
$963.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$948.50
|
| Rate for Payer: BCN Commercial |
$948.50
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Mclaren Medicaid |
$926.61
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$972.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Nomi Health Commercial |
$2,779.83
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,996.60
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health Tiered Network |
$2,397.28
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$926.61
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
|
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 44389
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.07
|
| Rate for Payer: BCN Commercial |
$1,041.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
