|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$1,529.43 |
| Rate for Payer: Aetna Commercial |
$11.48
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$8.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.43
|
| Rate for Payer: BCN Commercial |
$2.86
|
| Rate for Payer: BCN Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$11.48
|
| Rate for Payer: Cofinity Commercial |
$12.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.57
|
| Rate for Payer: Healthscope Commercial |
$10.28
|
| Rate for Payer: Healthscope Whirlpool |
$10.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.00
|
| Rate for Payer: PACE SWMI |
$8.57
|
| Rate for Payer: PHP Medicare Advantage |
$8.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.30
|
| Rate for Payer: Priority Health Medicare |
$8.57
|
| Rate for Payer: Priority Health Narrow Network |
$13.30
|
| Rate for Payer: UHC Medicare Advantage |
$8.83
|
|
|
PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 99091
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$780.83 |
| Rate for Payer: Aetna Commercial |
$71.23
|
| Rate for Payer: Aetna Medicare |
$53.16
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$53.16
|
| Rate for Payer: BCBS Trust/PPO |
$780.83
|
| Rate for Payer: BCN Commercial |
$78.19
|
| Rate for Payer: BCN Medicare Advantage |
$53.16
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$71.23
|
| Rate for Payer: Cofinity Commercial |
$76.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.16
|
| Rate for Payer: Healthscope Commercial |
$63.79
|
| Rate for Payer: Healthscope Whirlpool |
$63.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.82
|
| Rate for Payer: PACE SWMI |
$53.16
|
| Rate for Payer: PHP Medicare Advantage |
$53.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.86
|
| Rate for Payer: Priority Health Medicare |
$53.16
|
| Rate for Payer: Priority Health Narrow Network |
$71.86
|
| Rate for Payer: UHC Medicare Advantage |
$54.75
|
|
|
PR COLON CA SCREEN;BARIUM ENEMA
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
HCPCS G0106
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$1,824.22 |
| Rate for Payer: Aetna Commercial |
$284.17
|
| Rate for Payer: Aetna Medicare |
$212.07
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$212.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,824.22
|
| Rate for Payer: BCN Commercial |
$264.26
|
| Rate for Payer: BCN Medicare Advantage |
$212.07
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cofinity Commercial |
$305.38
|
| Rate for Payer: Cofinity Commercial |
$284.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.07
|
| Rate for Payer: Healthscope Commercial |
$254.48
|
| Rate for Payer: Healthscope Whirlpool |
$254.48
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.67
|
| Rate for Payer: PACE SWMI |
$212.07
|
| Rate for Payer: PHP Medicare Advantage |
$212.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.70
|
| Rate for Payer: Priority Health Medicare |
$212.07
|
| Rate for Payer: Priority Health Narrow Network |
$395.70
|
| Rate for Payer: UHC Medicare Advantage |
$218.43
|
|
|
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 |
$284.17
|
| Rate for Payer: Aetna Medicare |
$212.07
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$212.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,971.09
|
| Rate for Payer: BCN Commercial |
$264.26
|
| Rate for Payer: BCN Medicare Advantage |
$212.07
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cofinity Commercial |
$284.17
|
| Rate for Payer: Cofinity Commercial |
$305.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.07
|
| Rate for Payer: Healthscope Commercial |
$254.48
|
| Rate for Payer: Healthscope Whirlpool |
$254.48
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.67
|
| Rate for Payer: PACE SWMI |
$212.07
|
| Rate for Payer: PHP Medicare Advantage |
$212.07
|
| 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 |
$395.70
|
| Rate for Payer: Priority Health Medicare |
$212.07
|
| Rate for Payer: Priority Health Narrow Network |
$395.70
|
| Rate for Payer: UHC Medicare Advantage |
$218.43
|
|
|
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 |
$444.38 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: Aetna Commercial |
$1,045.80
|
| Rate for Payer: Aetna Medicare |
$812.40
|
| 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: ASR ASR |
$1,127.14
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$900.90
|
| Rate for Payer: BCN Commercial |
$900.90
|
| 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 |
$1,092.28
|
| 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 |
$1,162.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$812.40
|
| Rate for Payer: Mclaren Commercial |
$1,045.80
|
| 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 |
$893.64
|
| Rate for Payer: PHP Medicaid |
$444.38
|
| 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 |
$1,057.42
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$825.02
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.56
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: VA VA |
$812.40
|
|
|
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 |
$241.03
|
| Rate for Payer: Aetna Medicare |
$179.87
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$179.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.28
|
| Rate for Payer: BCN Commercial |
$498.45
|
| Rate for Payer: BCN Medicare Advantage |
$179.87
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$259.01
|
| Rate for Payer: Cofinity Commercial |
$241.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.87
|
| Rate for Payer: Healthscope Commercial |
$215.84
|
| Rate for Payer: Healthscope Whirlpool |
$215.84
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.86
|
| Rate for Payer: PACE SWMI |
$179.87
|
| Rate for Payer: PHP Medicare Advantage |
$179.87
|
| 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 Medicare |
$179.87
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: UHC Medicare Advantage |
$185.27
|
|
|
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 |
$813.40 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: Aetna Commercial |
$1,045.80
|
| Rate for Payer: ASR ASR |
$1,127.14
|
| Rate for Payer: BCBS Trust/PPO |
$900.90
|
| Rate for Payer: BCN Commercial |
$900.90
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$1,092.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Healthscope Commercial |
$1,162.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.14
|
| Rate for Payer: Mclaren Commercial |
$1,045.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$987.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.56
|
|
|
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 |
$241.03
|
| Rate for Payer: Aetna Medicare |
$179.87
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$179.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.28
|
| Rate for Payer: BCN Commercial |
$498.45
|
| Rate for Payer: BCN Medicare Advantage |
$179.87
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$259.01
|
| Rate for Payer: Cofinity Commercial |
$241.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.87
|
| Rate for Payer: Healthscope Commercial |
$215.84
|
| Rate for Payer: Healthscope Whirlpool |
$215.84
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.86
|
| Rate for Payer: PACE SWMI |
$179.87
|
| Rate for Payer: PHP Medicare Advantage |
$179.87
|
| 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 Medicare |
$179.87
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: UHC Medicare Advantage |
$185.27
|
|
|
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 |
$176.72
|
| Rate for Payer: Aetna Medicare |
$131.88
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$131.88
|
| Rate for Payer: BCBS Trust/PPO |
$917.13
|
| Rate for Payer: BCN Commercial |
$195.47
|
| Rate for Payer: BCN Medicare Advantage |
$131.88
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Cofinity Commercial |
$189.91
|
| Rate for Payer: Cofinity Commercial |
$176.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.88
|
| Rate for Payer: Healthscope Commercial |
$158.26
|
| Rate for Payer: Healthscope Whirlpool |
$158.26
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.47
|
| Rate for Payer: PACE SWMI |
$131.88
|
| Rate for Payer: PHP Medicare Advantage |
$131.88
|
| 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 Medicare |
$131.88
|
| Rate for Payer: Priority Health Narrow Network |
$179.66
|
| Rate for Payer: UHC Medicare Advantage |
$135.84
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Facility
|
IP
|
$1,483.00
|
|
|
Service Code
|
CPT 45383
|
| Hospital Charge Code |
45383
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,038.10 |
| Max. Negotiated Rate |
$1,483.00 |
| Rate for Payer: Aetna Commercial |
$1,334.70
|
| Rate for Payer: ASR ASR |
$1,438.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.77
|
| Rate for Payer: BCN Commercial |
$1,149.77
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,394.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,483.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,438.51
|
| Rate for Payer: Mclaren Commercial |
$1,334.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,305.04
|
|
|
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
|
|
|
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
|
|
|
PR COLONOSCOPY,ABLATE LESION
|
Facility
|
OP
|
$1,483.00
|
|
|
Service Code
|
CPT 45383
|
| Hospital Charge Code |
45383
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$593.20 |
| Max. Negotiated Rate |
$1,483.00 |
| Rate for Payer: Aetna Commercial |
$1,334.70
|
| Rate for Payer: ASR ASR |
$1,438.51
|
| Rate for Payer: BCBS Complete |
$593.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.77
|
| Rate for Payer: BCN Commercial |
$1,149.77
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,394.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,483.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,438.51
|
| Rate for Payer: Mclaren Commercial |
$1,334.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,349.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,052.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,305.04
|
|
|
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 |
$1,219.25 |
| Rate for Payer: Aetna Commercial |
$308.44
|
| Rate for Payer: Aetna Medicare |
$230.18
|
| Rate for Payer: BCBS Complete |
$155.44
|
| Rate for Payer: BCBS MAPPO |
$230.18
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$1,219.25
|
| Rate for Payer: BCN Medicare Advantage |
$230.18
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$308.44
|
| Rate for Payer: Cofinity Commercial |
$331.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.18
|
| Rate for Payer: Healthscope Commercial |
$276.22
|
| Rate for Payer: Healthscope Whirlpool |
$276.22
|
| Rate for Payer: Meridian Medicaid |
$155.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$241.69
|
| Rate for Payer: PACE SWMI |
$230.18
|
| Rate for Payer: PHP Medicare Advantage |
$230.18
|
| 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 Medicare |
$230.18
|
| Rate for Payer: Priority Health Narrow Network |
$407.47
|
| Rate for Payer: UHC Medicare Advantage |
$237.09
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
OP
|
$1,287.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$1,311.18 |
| Rate for Payer: Aetna Commercial |
$1,158.30
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| 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: ASR ASR |
$1,248.39
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$997.81
|
| Rate for Payer: BCN Commercial |
$997.81
|
| 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 |
$1,209.78
|
| 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 |
$1,287.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,248.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$1,158.30
|
| 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 |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| 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 |
$1,171.17
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$913.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,132.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
IP
|
$1,287.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$900.90 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Aetna Commercial |
$1,158.30
|
| Rate for Payer: ASR ASR |
$1,248.39
|
| Rate for Payer: BCBS Trust/PPO |
$997.81
|
| Rate for Payer: BCN Commercial |
$997.81
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$1,209.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.60
|
| Rate for Payer: Healthscope Commercial |
$1,287.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,248.39
|
| Rate for Payer: Mclaren Commercial |
$1,158.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,132.56
|
|
|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Professional
|
Both
|
$1,287.00
|
|
|
Service Code
|
HCPCS 45398
|
| Min. Negotiated Rate |
$148.04 |
| Max. Negotiated Rate |
$1,219.25 |
| Rate for Payer: Aetna Commercial |
$308.44
|
| Rate for Payer: Aetna Medicare |
$230.18
|
| Rate for Payer: BCBS Complete |
$155.44
|
| Rate for Payer: BCBS MAPPO |
$230.18
|
| Rate for Payer: BCBS Trust/PPO |
$232.45
|
| Rate for Payer: BCN Commercial |
$1,219.25
|
| Rate for Payer: BCN Medicare Advantage |
$230.18
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cofinity Commercial |
$331.46
|
| Rate for Payer: Cofinity Commercial |
$308.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.18
|
| Rate for Payer: Healthscope Commercial |
$276.22
|
| Rate for Payer: Healthscope Whirlpool |
$276.22
|
| Rate for Payer: Meridian Medicaid |
$155.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$241.69
|
| Rate for Payer: PACE SWMI |
$230.18
|
| Rate for Payer: PHP Medicare Advantage |
$230.18
|
| 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 Medicare |
$230.18
|
| Rate for Payer: Priority Health Narrow Network |
$407.47
|
| Rate for Payer: UHC Medicare Advantage |
$237.09
|
|
|
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 |
$328.62
|
| Rate for Payer: Aetna Medicare |
$245.24
|
| Rate for Payer: BCBS Complete |
$165.72
|
| Rate for Payer: BCBS MAPPO |
$245.24
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$360.65
|
| Rate for Payer: BCN Medicare Advantage |
$245.24
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$328.62
|
| Rate for Payer: Cofinity Commercial |
$353.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.24
|
| Rate for Payer: Healthscope Commercial |
$294.29
|
| Rate for Payer: Healthscope Whirlpool |
$294.29
|
| Rate for Payer: Meridian Medicaid |
$165.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$257.50
|
| Rate for Payer: PACE SWMI |
$245.24
|
| Rate for Payer: PHP Medicare Advantage |
$245.24
|
| 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 Medicare |
$245.24
|
| Rate for Payer: Priority Health Narrow Network |
$433.93
|
| Rate for Payer: UHC Medicare Advantage |
$252.60
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$557.20 |
| Max. Negotiated Rate |
$796.00 |
| Rate for Payer: Aetna Commercial |
$716.40
|
| Rate for Payer: ASR ASR |
$772.12
|
| Rate for Payer: BCBS Trust/PPO |
$617.14
|
| Rate for Payer: BCN Commercial |
$617.14
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$748.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.80
|
| Rate for Payer: Healthscope Commercial |
$796.00
|
| Rate for Payer: Healthscope Whirlpool |
$772.12
|
| Rate for Payer: Mclaren Commercial |
$716.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$676.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$700.48
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$557.20 |
| Max. Negotiated Rate |
$1,311.18 |
| Rate for Payer: Aetna Commercial |
$716.40
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| 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: ASR ASR |
$772.12
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$617.14
|
| Rate for Payer: BCN Commercial |
$617.14
|
| 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 |
$748.24
|
| 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 |
$796.00
|
| Rate for Payer: Healthscope Whirlpool |
$772.12
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$716.40
|
| 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 |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| 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 |
$724.36
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$565.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$700.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
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 |
$328.62
|
| Rate for Payer: Aetna Medicare |
$245.24
|
| Rate for Payer: BCBS Complete |
$165.72
|
| Rate for Payer: BCBS MAPPO |
$245.24
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$360.65
|
| Rate for Payer: BCN Medicare Advantage |
$245.24
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cash Price |
$636.80
|
| Rate for Payer: Cofinity Commercial |
$353.15
|
| Rate for Payer: Cofinity Commercial |
$328.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.24
|
| Rate for Payer: Healthscope Commercial |
$294.29
|
| Rate for Payer: Healthscope Whirlpool |
$294.29
|
| Rate for Payer: Meridian Medicaid |
$165.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$257.50
|
| Rate for Payer: PACE SWMI |
$245.24
|
| Rate for Payer: PHP Medicare Advantage |
$245.24
|
| 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 Medicare |
$245.24
|
| Rate for Payer: Priority Health Narrow Network |
$433.93
|
| Rate for Payer: UHC Medicare Advantage |
$252.60
|
|
|
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 |
$3,627.94 |
| Rate for Payer: Aetna Commercial |
$353.38
|
| Rate for Payer: Aetna Medicare |
$263.72
|
| Rate for Payer: BCBS Complete |
$178.25
|
| Rate for Payer: BCBS MAPPO |
$263.72
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: BCN Commercial |
$3,627.94
|
| Rate for Payer: BCN Medicare Advantage |
$263.72
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$379.76
|
| Rate for Payer: Cofinity Commercial |
$353.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.72
|
| Rate for Payer: Healthscope Commercial |
$316.46
|
| Rate for Payer: Healthscope Whirlpool |
$316.46
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.91
|
| Rate for Payer: PACE SWMI |
$263.72
|
| Rate for Payer: PHP Medicare Advantage |
$263.72
|
| 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 Medicare |
$263.72
|
| Rate for Payer: Priority Health Narrow Network |
$467.43
|
| Rate for Payer: UHC Medicare Advantage |
$271.63
|
|
|
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 |
$3,627.94 |
| Rate for Payer: Aetna Commercial |
$353.38
|
| Rate for Payer: Aetna Medicare |
$263.72
|
| Rate for Payer: BCBS Complete |
$178.25
|
| Rate for Payer: BCBS MAPPO |
$263.72
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: BCN Commercial |
$3,627.94
|
| Rate for Payer: BCN Medicare Advantage |
$263.72
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$353.38
|
| Rate for Payer: Cofinity Commercial |
$379.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.72
|
| Rate for Payer: Healthscope Commercial |
$316.46
|
| Rate for Payer: Healthscope Whirlpool |
$316.46
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.91
|
| Rate for Payer: PACE SWMI |
$263.72
|
| Rate for Payer: PHP Medicare Advantage |
$263.72
|
| 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 Medicare |
$263.72
|
| Rate for Payer: Priority Health Narrow Network |
$467.43
|
| Rate for Payer: UHC Medicare Advantage |
$271.63
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
OP
|
$1,553.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$1,553.00 |
| Rate for Payer: Aetna Commercial |
$1,397.70
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| 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: ASR ASR |
$1,506.41
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.04
|
| Rate for Payer: BCN Commercial |
$1,204.04
|
| 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 |
$1,459.82
|
| 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 |
$1,553.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,506.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$1,397.70
|
| 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 |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| 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 |
$1,413.23
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,102.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,366.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
IP
|
$1,553.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$1,087.10 |
| Max. Negotiated Rate |
$1,553.00 |
| Rate for Payer: Aetna Commercial |
$1,397.70
|
| Rate for Payer: ASR ASR |
$1,506.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.04
|
| Rate for Payer: BCN Commercial |
$1,204.04
|
| Rate for Payer: Cash Price |
$1,242.40
|
| Rate for Payer: Cofinity Commercial |
$1,459.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,242.40
|
| Rate for Payer: Healthscope Commercial |
$1,553.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,506.41
|
| Rate for Payer: Mclaren Commercial |
$1,397.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,320.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,366.64
|
|
