|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
IP
|
$2,687.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$1,182.28 |
| Max. Negotiated Rate |
$2,418.30 |
| Rate for Payer: Aetna American Axle |
$1,746.55
|
| Rate for Payer: Aetna Commercial |
$2,283.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,746.55
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,310.82
|
| Rate for Payer: Cofinity Commercial |
$1,880.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,149.60
|
| Rate for Payer: Healthscope Commercial |
$2,418.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,880.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,015.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,283.95
|
| Rate for Payer: PHP Commercial |
$2,283.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health SBD |
$1,692.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,182.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,015.25
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN
|
Facility
|
OP
|
$2,687.00
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
36478
|
| Min. Negotiated Rate |
$266.87 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,746.55
|
| Rate for Payer: Aetna Commercial |
$2,283.95
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,746.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,471.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cash Price |
$2,149.60
|
| Rate for Payer: Cofinity Commercial |
$2,310.82
|
| Rate for Payer: Cofinity Commercial |
$1,880.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,418.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,880.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,015.25
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,283.95
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,283.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,692.81
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$266.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$994.19
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,015.25
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,087.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$173.60 |
| Max. Negotiated Rate |
$2,160.90 |
| Rate for Payer: Aetna Commercial |
$374.63
|
| Rate for Payer: BCBS Complete |
$182.28
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Cash Price |
$2,469.60
|
| Rate for Payer: Meridian Medicaid |
$182.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,160.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.48
|
| Rate for Payer: Priority Health Narrow Network |
$432.48
|
| Rate for Payer: Priority Health SBD |
$432.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,420.02
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$83.07 |
| Max. Negotiated Rate |
$510.87 |
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: BCBS Complete |
$87.22
|
| Rate for Payer: BCBS Trust/PPO |
$510.87
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Meridian Medicaid |
$87.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.53
|
| Rate for Payer: Priority Health Narrow Network |
$208.53
|
| Rate for Payer: Priority Health SBD |
$208.53
|
| Rate for Payer: UMR Bronson Commercial |
$147.20
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$1,138.20 |
| Rate for Payer: Aetna Commercial |
$326.50
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.90
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.23
|
| Rate for Payer: Priority Health Narrow Network |
$419.23
|
| Rate for Payer: Priority Health SBD |
$419.23
|
| Rate for Payer: UMR Bronson Commercial |
$747.96
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,428.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$749.76 |
| Max. Negotiated Rate |
$2,399.60 |
| Rate for Payer: Aetna Commercial |
$1,588.54
|
| Rate for Payer: BCBS Complete |
$787.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.51
|
| Rate for Payer: Cash Price |
$2,742.40
|
| Rate for Payer: Cash Price |
$2,742.40
|
| Rate for Payer: Meridian Medicaid |
$787.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,399.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,056.15
|
| Rate for Payer: Priority Health Narrow Network |
$2,056.15
|
| Rate for Payer: Priority Health SBD |
$2,056.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,576.88
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,821.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$876.50 |
| Max. Negotiated Rate |
$2,198.72 |
| Rate for Payer: Aetna Commercial |
$1,776.46
|
| Rate for Payer: BCBS Complete |
$920.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Cash Price |
$2,256.80
|
| Rate for Payer: Meridian Medicaid |
$920.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,198.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,198.72
|
| Rate for Payer: Priority Health SBD |
$2,198.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,297.66
|
|
|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,110.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$2,305.45 |
| Rate for Payer: Aetna Commercial |
$1,773.78
|
| Rate for Payer: BCBS Complete |
$881.63
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Cash Price |
$2,488.00
|
| Rate for Payer: Meridian Medicaid |
$881.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,177.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,305.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,305.45
|
| Rate for Payer: Priority Health SBD |
$2,305.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,430.60
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,761.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,021.57 |
| Max. Negotiated Rate |
$3,822.42 |
| Rate for Payer: Aetna American Axle |
$1,794.65
|
| Rate for Payer: Aetna Commercial |
$2,346.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,794.65
|
| Rate for Payer: BCBS Complete |
$1,104.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,822.42
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,932.70
|
| Rate for Payer: Cofinity Commercial |
$2,374.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,208.80
|
| Rate for Payer: Healthscope Commercial |
$2,484.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,932.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,070.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,346.85
|
| Rate for Payer: PHP Commercial |
$2,346.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health SBD |
$1,739.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,178.17
|
| Rate for Payer: UHC Exchange |
$1,071.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,021.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,070.75
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$1,932.70 |
| Rate for Payer: Aetna Commercial |
$1,475.02
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,913.26
|
| Rate for Payer: Priority Health SBD |
$1,913.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,270.06
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,761.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,214.84 |
| Max. Negotiated Rate |
$2,484.90 |
| Rate for Payer: Aetna American Axle |
$1,794.65
|
| Rate for Payer: Aetna Commercial |
$2,346.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,794.65
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cofinity Commercial |
$1,932.70
|
| Rate for Payer: Cofinity Commercial |
$2,374.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,208.80
|
| Rate for Payer: Healthscope Commercial |
$2,484.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,932.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,070.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,346.85
|
| Rate for Payer: PHP Commercial |
$2,346.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health SBD |
$1,739.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,214.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,070.75
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,761.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$696.72 |
| Max. Negotiated Rate |
$1,932.70 |
| Rate for Payer: Aetna Commercial |
$1,475.02
|
| Rate for Payer: BCBS Complete |
$731.56
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Cash Price |
$2,208.80
|
| Rate for Payer: Meridian Medicaid |
$731.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$696.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,932.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,913.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,913.26
|
| Rate for Payer: Priority Health SBD |
$1,913.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,270.06
|
|
|
PR ENTERORRHAPHY MULTIPLE PERFORATIONS
|
Professional
|
Both
|
$3,021.00
|
|
|
Service Code
|
HCPCS 44603
|
| Min. Negotiated Rate |
$220.30 |
| Max. Negotiated Rate |
$2,826.39 |
| Rate for Payer: Aetna Commercial |
$2,183.13
|
| Rate for Payer: BCBS Complete |
$1,079.56
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Meridian Medicaid |
$1,079.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,028.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,114.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,826.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,826.39
|
| Rate for Payer: Priority Health SBD |
$2,826.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,389.66
|
|
|
PR ENTERORRHAPHY SINGLE PERFORATION
|
Professional
|
Both
|
$2,377.00
|
|
|
Service Code
|
HCPCS 44602
|
| Min. Negotiated Rate |
$894.81 |
| Max. Negotiated Rate |
$2,461.85 |
| Rate for Payer: Aetna Commercial |
$1,903.43
|
| Rate for Payer: BCBS Complete |
$939.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.39
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Cash Price |
$1,901.60
|
| Rate for Payer: Meridian Medicaid |
$939.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$894.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,663.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,461.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,461.85
|
| Rate for Payer: Priority Health SBD |
$2,461.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,093.42
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,114.00
|
|
|
Service Code
|
HCPCS 44377
|
| Min. Negotiated Rate |
$187.65 |
| Max. Negotiated Rate |
$1,573.28 |
| Rate for Payer: Aetna Commercial |
$397.53
|
| Rate for Payer: BCBS Complete |
$197.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.28
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Cash Price |
$891.20
|
| Rate for Payer: Meridian Medicaid |
$197.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.65
|
| Rate for Payer: Priority Health Narrow Network |
$515.65
|
| Rate for Payer: Priority Health SBD |
$515.65
|
| Rate for Payer: UMR Bronson Commercial |
$512.44
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 44376
|
| Min. Negotiated Rate |
$177.86 |
| Max. Negotiated Rate |
$1,925.65 |
| Rate for Payer: Aetna Commercial |
$377.32
|
| Rate for Payer: BCBS Complete |
$186.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,925.65
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Meridian Medicaid |
$186.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.19
|
| Rate for Payer: Priority Health Narrow Network |
$489.19
|
| Rate for Payer: Priority Health SBD |
$489.19
|
| Rate for Payer: UMR Bronson Commercial |
$467.36
|
|
|
PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 44369
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$768.60 |
| Rate for Payer: Aetna Commercial |
$326.36
|
| Rate for Payer: BCBS Complete |
$161.70
|
| Rate for Payer: BCBS Trust/PPO |
$593.28
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Meridian Medicaid |
$161.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$422.75
|
| Rate for Payer: Priority Health Narrow Network |
$422.75
|
| Rate for Payer: Priority Health SBD |
$422.75
|
| Rate for Payer: UMR Bronson Commercial |
$505.08
|
|
|
PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE
|
Professional
|
Both
|
$904.00
|
|
|
Service Code
|
HCPCS 44373
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$1,809.96 |
| Rate for Payer: Aetna Commercial |
$255.47
|
| Rate for Payer: BCBS Complete |
$126.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.96
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Cash Price |
$723.20
|
| Rate for Payer: Meridian Medicaid |
$126.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.45
|
| Rate for Payer: Priority Health Narrow Network |
$330.45
|
| Rate for Payer: Priority Health SBD |
$330.45
|
| Rate for Payer: UMR Bronson Commercial |
$415.84
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 44378
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$511.57
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.47
|
| Rate for Payer: Priority Health Narrow Network |
$661.47
|
| Rate for Payer: Priority Health SBD |
$661.47
|
| Rate for Payer: UMR Bronson Commercial |
$698.28
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
IP
|
$1,518.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$667.92 |
| Max. Negotiated Rate |
$1,366.20 |
| Rate for Payer: Aetna American Axle |
$986.70
|
| Rate for Payer: Aetna Commercial |
$1,290.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.70
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$1,062.60
|
| Rate for Payer: Cofinity Commercial |
$1,305.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.40
|
| Rate for Payer: Healthscope Commercial |
$1,366.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,062.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.30
|
| Rate for Payer: PHP Commercial |
$1,290.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health SBD |
$956.34
|
| Rate for Payer: UMR Bronson Commercial |
$667.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.50
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
OP
|
$1,518.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$370.34 |
| Max. Negotiated Rate |
$5,324.53 |
| Rate for Payer: Aetna American Axle |
$986.70
|
| Rate for Payer: Aetna Commercial |
$1,290.30
|
| Rate for Payer: Aetna Medicare |
$1,759.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,053.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$1,062.60
|
| Rate for Payer: Cofinity Commercial |
$1,305.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,366.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,062.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.50
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.30
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,290.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,324.53
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,259.62
|
| Rate for Payer: Priority Health SBD |
$956.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,691.37
|
| Rate for Payer: UHC Exchange |
$370.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: UMR Bronson Commercial |
$561.66
|
| Rate for Payer: VA VA |
$1,691.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.50
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$240.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$511.57
|
| Rate for Payer: BCBS Complete |
$252.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Meridian Medicaid |
$252.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.47
|
| Rate for Payer: Priority Health Narrow Network |
$661.47
|
| Rate for Payer: Priority Health SBD |
$661.47
|
| Rate for Payer: UMR Bronson Commercial |
$698.28
|
|
|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$167.63 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: Aetna Commercial |
$352.95
|
| Rate for Payer: BCBS Complete |
$176.01
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Meridian Medicaid |
$176.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$459.80
|
| Rate for Payer: Priority Health Narrow Network |
$459.80
|
| Rate for Payer: Priority Health SBD |
$459.80
|
| Rate for Payer: UMR Bronson Commercial |
$624.22
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,292.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$150.38 |
| Max. Negotiated Rate |
$904.40 |
| Rate for Payer: Aetna Commercial |
$318.57
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Cash Price |
$1,033.60
|
| Rate for Payer: Meridian Medicaid |
$157.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$904.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.35
|
| Rate for Payer: Priority Health Narrow Network |
$413.35
|
| Rate for Payer: Priority Health SBD |
$413.35
|
| Rate for Payer: UMR Bronson Commercial |
$594.32
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,502.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$1,943.09 |
| Rate for Payer: Aetna Commercial |
$543.16
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.09
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Cash Price |
$1,201.60
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.80
|
| Rate for Payer: Priority Health Narrow Network |
$703.80
|
| Rate for Payer: Priority Health SBD |
$703.80
|
| Rate for Payer: UMR Bronson Commercial |
$690.92
|
|
