|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$247.80 |
| Rate for Payer: Aetna Commercial |
$159.65
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: BCBS Trust/PPO |
$246.72
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Meridian Medicaid |
$89.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.47
|
| Rate for Payer: Priority Health Narrow Network |
$187.47
|
| Rate for Payer: Priority Health SBD |
$187.47
|
| Rate for Payer: UMR Bronson Commercial |
$162.84
|
|
|
PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 57456
|
| Min. Negotiated Rate |
$64.54 |
| Max. Negotiated Rate |
$1,290.64 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.64
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.50
|
| Rate for Payer: Priority Health Narrow Network |
$142.50
|
| Rate for Payer: Priority Health SBD |
$142.50
|
| Rate for Payer: UMR Bronson Commercial |
$164.22
|
|
|
PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 57452
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$304.30 |
| Rate for Payer: Aetna Commercial |
$107.71
|
| Rate for Payer: BCBS Complete |
$61.06
|
| Rate for Payer: BCBS Trust/PPO |
$304.30
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Meridian Medicaid |
$61.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.29
|
| Rate for Payer: Priority Health Narrow Network |
$128.29
|
| Rate for Payer: Priority Health SBD |
$128.29
|
| Rate for Payer: UMR Bronson Commercial |
$126.04
|
|
|
PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 57455
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$1,460.22 |
| Rate for Payer: Aetna Commercial |
$130.36
|
| Rate for Payer: BCBS Complete |
$72.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.22
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Meridian Medicaid |
$72.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.92
|
| Rate for Payer: Priority Health Narrow Network |
$152.92
|
| Rate for Payer: Priority Health SBD |
$152.92
|
| Rate for Payer: UMR Bronson Commercial |
$164.22
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 57461
|
| Min. Negotiated Rate |
$116.51 |
| Max. Negotiated Rate |
$1,582.26 |
| Rate for Payer: Aetna Commercial |
$221.07
|
| Rate for Payer: BCBS Complete |
$122.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.26
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Meridian Medicaid |
$122.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.48
|
| Rate for Payer: Priority Health Narrow Network |
$258.48
|
| Rate for Payer: Priority Health SBD |
$258.48
|
| Rate for Payer: UMR Bronson Commercial |
$432.86
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$941.00
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$414.04 |
| Max. Negotiated Rate |
$846.90 |
| Rate for Payer: Aetna American Axle |
$611.65
|
| Rate for Payer: Aetna Commercial |
$799.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.65
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$658.70
|
| Rate for Payer: Cofinity Commercial |
$809.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.80
|
| Rate for Payer: Healthscope Commercial |
$846.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$658.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$799.85
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.70
|
| Rate for Payer: Priority Health SBD |
$592.83
|
| Rate for Payer: UMR Bronson Commercial |
$414.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.75
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$116.51 |
| Max. Negotiated Rate |
$1,582.26 |
| Rate for Payer: Aetna Commercial |
$221.07
|
| Rate for Payer: BCBS Complete |
$122.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.26
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Meridian Medicaid |
$122.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.48
|
| Rate for Payer: Priority Health Narrow Network |
$258.48
|
| Rate for Payer: Priority Health SBD |
$258.48
|
| Rate for Payer: UMR Bronson Commercial |
$432.86
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$941.00
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$179.11 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$611.65
|
| Rate for Payer: Aetna Commercial |
$799.85
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,023.66
|
| Rate for Payer: BCCCP Commercial |
$370.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$809.26
|
| Rate for Payer: Cofinity Commercial |
$658.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$752.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$846.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$658.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$705.75
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$799.85
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$799.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$592.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$179.11
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$348.17
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$705.75
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 57460
|
| Min. Negotiated Rate |
$101.81 |
| Max. Negotiated Rate |
$1,524.15 |
| Rate for Payer: Aetna Commercial |
$191.11
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.15
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.87
|
| Rate for Payer: Priority Health Narrow Network |
$224.87
|
| Rate for Payer: Priority Health SBD |
$224.87
|
| Rate for Payer: UMR Bronson Commercial |
$291.64
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
IP
|
$634.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$278.96 |
| Max. Negotiated Rate |
$570.60 |
| Rate for Payer: Aetna American Axle |
$412.10
|
| Rate for Payer: Aetna Commercial |
$538.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.10
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$443.80
|
| Rate for Payer: Cofinity Commercial |
$545.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.20
|
| Rate for Payer: Healthscope Commercial |
$570.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$443.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$538.90
|
| Rate for Payer: PHP Commercial |
$538.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health SBD |
$399.42
|
| Rate for Payer: UMR Bronson Commercial |
$278.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.50
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$634.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$156.52 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$412.10
|
| Rate for Payer: Aetna Commercial |
$538.90
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,023.66
|
| Rate for Payer: BCCCP Commercial |
$331.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$545.24
|
| Rate for Payer: Cofinity Commercial |
$443.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$507.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$570.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$443.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.50
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$538.90
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$538.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$399.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$156.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$234.58
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.50
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$101.81 |
| Max. Negotiated Rate |
$1,524.15 |
| Rate for Payer: Aetna Commercial |
$191.11
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.15
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.87
|
| Rate for Payer: Priority Health Narrow Network |
$224.87
|
| Rate for Payer: Priority Health SBD |
$224.87
|
| Rate for Payer: UMR Bronson Commercial |
$291.64
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 57420
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$1,752.90 |
| Rate for Payer: Aetna Commercial |
$107.00
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.90
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.93
|
| Rate for Payer: Priority Health Narrow Network |
$125.93
|
| Rate for Payer: Priority Health SBD |
$125.93
|
| Rate for Payer: UMR Bronson Commercial |
$105.80
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 57421
|
| Min. Negotiated Rate |
$77.75 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$144.96
|
| Rate for Payer: BCBS Complete |
$81.64
|
| Rate for Payer: BCBS Trust/PPO |
$122.57
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Meridian Medicaid |
$81.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.90
|
| Rate for Payer: Priority Health Narrow Network |
$170.90
|
| Rate for Payer: Priority Health SBD |
$170.90
|
| Rate for Payer: UMR Bronson Commercial |
$137.54
|
|
|
PR COLPOSCOPY VULVA
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 56820
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$1,801.50 |
| Rate for Payer: Aetna Commercial |
$100.46
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.50
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.31
|
| Rate for Payer: Priority Health Narrow Network |
$119.31
|
| Rate for Payer: Priority Health SBD |
$119.31
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 56821
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$135.19
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.02
|
| Rate for Payer: Priority Health Narrow Network |
$160.02
|
| Rate for Payer: Priority Health SBD |
$160.02
|
| Rate for Payer: UMR Bronson Commercial |
$158.24
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 56821
|
| Hospital Charge Code |
56821
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$135.19
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.02
|
| Rate for Payer: Priority Health Narrow Network |
$160.02
|
| Rate for Payer: Priority Health SBD |
$160.02
|
| Rate for Payer: UMR Bronson Commercial |
$158.24
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$344.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$151.36 |
| Max. Negotiated Rate |
$309.60 |
| Rate for Payer: Aetna American Axle |
$223.60
|
| Rate for Payer: Aetna Commercial |
$292.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.60
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$295.84
|
| Rate for Payer: Cofinity Commercial |
$240.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Healthscope Commercial |
$309.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.40
|
| Rate for Payer: PHP Commercial |
$292.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.80
|
| Rate for Payer: Priority Health SBD |
$216.72
|
| Rate for Payer: UMR Bronson Commercial |
$151.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.00
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$344.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$84.20 |
| Max. Negotiated Rate |
$897.69 |
| Rate for Payer: Aetna American Axle |
$223.60
|
| Rate for Payer: Aetna Commercial |
$292.40
|
| Rate for Payer: Aetna Medicare |
$296.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$84.20
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$295.84
|
| Rate for Payer: Cofinity Commercial |
$240.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$309.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.00
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.40
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$292.40
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.69
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$718.15
|
| Rate for Payer: Priority Health SBD |
$216.72
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.16
|
| Rate for Payer: UHC Exchange |
$111.33
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: UMR Bronson Commercial |
$127.28
|
| Rate for Payer: VA VA |
$285.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.00
|
|
|
PR COLPOTOMY W/DRAINAGE PELVIC ABSCESS
|
Professional
|
Both
|
$983.00
|
|
|
Service Code
|
HCPCS 57010
|
| Min. Negotiated Rate |
$295.43 |
| Max. Negotiated Rate |
$1,747.09 |
| Rate for Payer: Aetna Commercial |
$541.29
|
| Rate for Payer: BCBS Complete |
$310.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,747.09
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Cash Price |
$786.40
|
| Rate for Payer: Meridian Medicaid |
$310.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$688.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.85
|
| Rate for Payer: Priority Health Narrow Network |
$652.85
|
| Rate for Payer: Priority Health SBD |
$652.85
|
| Rate for Payer: UMR Bronson Commercial |
$452.18
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
OP
|
$1,396.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$249.51 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$907.40
|
| Rate for Payer: Aetna Commercial |
$1,186.60
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.40
|
| 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 |
$1,373.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$977.20
|
| Rate for Payer: Cofinity Commercial |
$1,200.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,256.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$977.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,047.00
|
| 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 |
$1,186.60
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,186.60
|
| 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 |
$977.20
|
| 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 |
$879.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$249.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$516.52
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,047.00
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$162.31 |
| Max. Negotiated Rate |
$977.20 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: BCBS Complete |
$170.43
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Meridian Medicaid |
$170.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$977.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.26
|
| Rate for Payer: Priority Health Narrow Network |
$446.26
|
| Rate for Payer: Priority Health SBD |
$446.26
|
| Rate for Payer: UMR Bronson Commercial |
$642.16
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 45382
|
| Min. Negotiated Rate |
$162.31 |
| Max. Negotiated Rate |
$977.20 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: BCBS Complete |
$170.43
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Meridian Medicaid |
$170.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$977.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.26
|
| Rate for Payer: Priority Health Narrow Network |
$446.26
|
| Rate for Payer: Priority Health SBD |
$446.26
|
| Rate for Payer: UMR Bronson Commercial |
$642.16
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
IP
|
$1,396.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$614.24 |
| Max. Negotiated Rate |
$1,256.40 |
| Rate for Payer: Aetna American Axle |
$907.40
|
| Rate for Payer: Aetna Commercial |
$1,186.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.40
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$1,200.56
|
| Rate for Payer: Cofinity Commercial |
$977.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,116.80
|
| Rate for Payer: Healthscope Commercial |
$1,256.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$977.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,047.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,186.60
|
| Rate for Payer: PHP Commercial |
$1,186.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$977.20
|
| Rate for Payer: Priority Health SBD |
$879.48
|
| Rate for Payer: UMR Bronson Commercial |
$614.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,047.00
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$905.80 |
| Rate for Payer: Aetna Commercial |
$281.59
|
| Rate for Payer: BCBS Complete |
$139.79
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Meridian Medicaid |
$139.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.13
|
| Rate for Payer: Priority Health Narrow Network |
$365.13
|
| Rate for Payer: Priority Health SBD |
$365.13
|
| Rate for Payer: UMR Bronson Commercial |
$595.24
|
|
