|
PR COLON CA SCRN; BARIUM ENEMA
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS G0120
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$1,971.09 |
| Rate for Payer: Aetna Commercial |
$220.17
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,971.09
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.66
|
| Rate for Payer: Priority Health Narrow Network |
$104.66
|
| Rate for Payer: Priority Health SBD |
$395.70
|
| Rate for Payer: UMR Bronson Commercial |
$179.86
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Facility
|
OP
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$178.78 |
| Max. Negotiated Rate |
$2,557.47 |
| Rate for Payer: Aetna American Axle |
$755.30
|
| Rate for Payer: Aetna Commercial |
$987.70
|
| Rate for Payer: Aetna Medicare |
$844.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$716.25
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$813.40
|
| Rate for Payer: Cofinity Commercial |
$999.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$1,045.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$813.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.50
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$987.70
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$987.70
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
| Rate for Payer: Priority Health SBD |
$732.06
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
| Rate for Payer: UHC Exchange |
$178.78
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: UMR Bronson Commercial |
$429.94
|
| Rate for Payer: VA VA |
$812.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.50
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$2,077.28 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.28
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: Priority Health SBD |
$318.68
|
| Rate for Payer: UMR Bronson Commercial |
$534.52
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Facility
|
IP
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$511.28 |
| Max. Negotiated Rate |
$1,045.80 |
| Rate for Payer: Aetna American Axle |
$755.30
|
| Rate for Payer: Aetna Commercial |
$987.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.30
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$813.40
|
| Rate for Payer: Cofinity Commercial |
$999.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Healthscope Commercial |
$1,045.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$813.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$987.70
|
| Rate for Payer: PHP Commercial |
$987.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health SBD |
$732.06
|
| Rate for Payer: UMR Bronson Commercial |
$511.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.50
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0121
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$2,077.28 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.28
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: Priority Health SBD |
$318.68
|
| Rate for Payer: UMR Bronson Commercial |
$534.52
|
|
|
PR COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 91117
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$917.13 |
| Rate for Payer: Aetna Commercial |
$149.90
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS Trust/PPO |
$917.13
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.66
|
| Rate for Payer: Priority Health Narrow Network |
$179.66
|
| Rate for Payer: Priority Health SBD |
$179.66
|
| Rate for Payer: UMR Bronson Commercial |
$207.46
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 45383
|
| Min. Negotiated Rate |
$593.20 |
| Max. Negotiated Rate |
$1,038.10 |
| Rate for Payer: BCBS Complete |
$593.20
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: UMR Bronson Commercial |
$682.18
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Facility
|
OP
|
$1,483.00
|
|
|
Service Code
|
CPT 45383
|
| Hospital Charge Code |
45383
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$548.71 |
| Max. Negotiated Rate |
$1,334.70 |
| Rate for Payer: Aetna American Axle |
$963.95
|
| Rate for Payer: Aetna Commercial |
$1,260.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.95
|
| Rate for Payer: BCBS Complete |
$593.20
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,038.10
|
| Rate for Payer: Cofinity Commercial |
$1,275.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,334.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,038.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: PHP Commercial |
$1,260.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health SBD |
$934.29
|
| Rate for Payer: UMR Bronson Commercial |
$548.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,112.25
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 45383
|
| Hospital Charge Code |
45383
|
| Min. Negotiated Rate |
$593.20 |
| Max. Negotiated Rate |
$1,038.10 |
| Rate for Payer: BCBS Complete |
$593.20
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: UMR Bronson Commercial |
$682.18
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Facility
|
IP
|
$1,483.00
|
|
|
Service Code
|
CPT 45383
|
| Hospital Charge Code |
45383
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$652.52 |
| Max. Negotiated Rate |
$1,334.70 |
| Rate for Payer: Aetna American Axle |
$963.95
|
| Rate for Payer: Aetna Commercial |
$1,260.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.95
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,038.10
|
| Rate for Payer: Cofinity Commercial |
$1,275.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,334.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,038.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: PHP Commercial |
$1,260.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health SBD |
$934.29
|
| Rate for Payer: UMR Bronson Commercial |
$652.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,112.25
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
IP
|
$1,287.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$566.28 |
| Max. Negotiated Rate |
$1,158.30 |
| Rate for Payer: Aetna American Axle |
$836.55
|
| Rate for Payer: Aetna Commercial |
$1,093.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.55
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$1,106.82
|
| Rate for Payer: Cofinity Commercial |
$900.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.60
|
| Rate for Payer: Healthscope Commercial |
$1,158.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$965.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.95
|
| Rate for Payer: PHP Commercial |
$1,093.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health SBD |
$810.81
|
| Rate for Payer: UMR Bronson Commercial |
$566.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$965.25
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$148.04 |
| Max. Negotiated Rate |
$900.90 |
| Rate for Payer: Aetna Commercial |
$313.45
|
| Rate for Payer: BCBS Complete |
$155.44
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Meridian Medicaid |
$155.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$407.47
|
| Rate for Payer: Priority Health Narrow Network |
$407.47
|
| Rate for Payer: Priority Health SBD |
$407.47
|
| Rate for Payer: UMR Bronson Commercial |
$592.02
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
OP
|
$1,287.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$227.57 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$836.55
|
| Rate for Payer: Aetna Commercial |
$1,093.95
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,240.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$1,106.82
|
| Rate for Payer: Cofinity Commercial |
$900.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,158.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$965.25
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.95
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,093.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$810.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$227.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$476.19
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$965.25
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 45398
|
| Min. Negotiated Rate |
$148.04 |
| Max. Negotiated Rate |
$900.90 |
| Rate for Payer: Aetna Commercial |
$313.45
|
| Rate for Payer: BCBS Complete |
$155.44
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Meridian Medicaid |
$155.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$407.47
|
| Rate for Payer: Priority Health Narrow Network |
$407.47
|
| Rate for Payer: Priority Health SBD |
$407.47
|
| Rate for Payer: UMR Bronson Commercial |
$592.02
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$242.63 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$517.40
|
| Rate for Payer: Aetna Commercial |
$676.60
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$821.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$557.20
|
| Rate for Payer: Cofinity Commercial |
$684.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$716.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$557.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$597.00
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$676.60
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$676.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$501.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$242.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$294.52
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$597.00
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$157.83 |
| Max. Negotiated Rate |
$557.20 |
| Rate for Payer: Aetna Commercial |
$337.78
|
| Rate for Payer: BCBS Complete |
$165.72
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Meridian Medicaid |
$165.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.93
|
| Rate for Payer: Priority Health Narrow Network |
$433.93
|
| Rate for Payer: Priority Health SBD |
$433.93
|
| Rate for Payer: UMR Bronson Commercial |
$366.16
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$350.24 |
| Max. Negotiated Rate |
$716.40 |
| Rate for Payer: Aetna American Axle |
$517.40
|
| Rate for Payer: Aetna Commercial |
$676.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.40
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$557.20
|
| Rate for Payer: Cofinity Commercial |
$684.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.80
|
| Rate for Payer: Healthscope Commercial |
$716.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$557.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$597.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$676.60
|
| Rate for Payer: PHP Commercial |
$676.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.20
|
| Rate for Payer: Priority Health SBD |
$501.48
|
| Rate for Payer: UMR Bronson Commercial |
$350.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$597.00
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$796.00
|
|
|
Service Code
|
HCPCS 45393
|
| Min. Negotiated Rate |
$157.83 |
| Max. Negotiated Rate |
$557.20 |
| Rate for Payer: Aetna Commercial |
$337.78
|
| Rate for Payer: BCBS Complete |
$165.72
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Meridian Medicaid |
$165.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.93
|
| Rate for Payer: Priority Health Narrow Network |
$433.93
|
| Rate for Payer: Priority Health SBD |
$433.93
|
| Rate for Payer: UMR Bronson Commercial |
$366.16
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
OP
|
$1,553.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$260.97 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$1,009.45
|
| Rate for Payer: Aetna Commercial |
$1,320.05
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$821.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,335.58
|
| Rate for Payer: Cofinity Commercial |
$1,087.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,242.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,397.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,087.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,164.75
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,320.05
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,320.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$978.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$260.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$574.61
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,164.75
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$169.76 |
| Max. Negotiated Rate |
$1,087.10 |
| Rate for Payer: Aetna Commercial |
$360.51
|
| Rate for Payer: BCBS Complete |
$178.25
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$467.43
|
| Rate for Payer: Priority Health Narrow Network |
$467.43
|
| Rate for Payer: Priority Health SBD |
$467.43
|
| Rate for Payer: UMR Bronson Commercial |
$714.38
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
IP
|
$1,553.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$683.32 |
| Max. Negotiated Rate |
$1,397.70 |
| Rate for Payer: Aetna American Axle |
$1,009.45
|
| Rate for Payer: Aetna Commercial |
$1,320.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,009.45
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,087.10
|
| Rate for Payer: Cofinity Commercial |
$1,335.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,242.40
|
| Rate for Payer: Healthscope Commercial |
$1,397.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,087.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,164.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,320.05
|
| Rate for Payer: PHP Commercial |
$1,320.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health SBD |
$978.39
|
| Rate for Payer: UMR Bronson Commercial |
$683.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,164.75
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,553.00
|
|
|
Service Code
|
HCPCS 45388
|
| Min. Negotiated Rate |
$169.76 |
| Max. Negotiated Rate |
$1,087.10 |
| Rate for Payer: Aetna Commercial |
$360.51
|
| Rate for Payer: BCBS Complete |
$178.25
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$467.43
|
| Rate for Payer: Priority Health Narrow Network |
$467.43
|
| Rate for Payer: Priority Health SBD |
$467.43
|
| Rate for Payer: UMR Bronson Commercial |
$714.38
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
OP
|
$1,002.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$178.46 |
| Max. Negotiated Rate |
$2,557.47 |
| Rate for Payer: Aetna American Axle |
$651.30
|
| Rate for Payer: Aetna Commercial |
$851.70
|
| Rate for Payer: Aetna Medicare |
$844.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,056.11
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$701.40
|
| Rate for Payer: Cofinity Commercial |
$861.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$801.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$901.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$701.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$751.50
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.70
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$851.70
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
| Rate for Payer: Priority Health SBD |
$631.26
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
| Rate for Payer: UHC Exchange |
$178.46
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: UMR Bronson Commercial |
$370.74
|
| Rate for Payer: VA VA |
$812.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$751.50
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
IP
|
$1,002.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$440.88 |
| Max. Negotiated Rate |
$901.80 |
| Rate for Payer: Aetna American Axle |
$651.30
|
| Rate for Payer: Aetna Commercial |
$851.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.30
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$701.40
|
| Rate for Payer: Cofinity Commercial |
$861.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$801.60
|
| Rate for Payer: Healthscope Commercial |
$901.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$701.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$751.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.70
|
| Rate for Payer: PHP Commercial |
$851.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health SBD |
$631.26
|
| Rate for Payer: UMR Bronson Commercial |
$440.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$751.50
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,002.00
|
|
|
Service Code
|
HCPCS 45378
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$701.40 |
| Rate for Payer: Aetna Commercial |
$246.71
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS Trust/PPO |
$392.53
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$318.68
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: Priority Health SBD |
$318.68
|
| Rate for Payer: UMR Bronson Commercial |
$460.92
|
|
