|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Facility
|
IP
|
$1,344.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
44394
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$940.80 |
| Max. Negotiated Rate |
$1,344.00 |
| Rate for Payer: Aetna Commercial |
$1,209.60
|
| Rate for Payer: ASR ASR |
$1,303.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.00
|
| Rate for Payer: BCN Commercial |
$1,042.00
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$1,263.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,075.20
|
| Rate for Payer: Healthscope Commercial |
$1,344.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,303.68
|
| Rate for Payer: Mclaren Commercial |
$1,209.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,142.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,182.72
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Facility
|
OP
|
$1,344.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
44394
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$1,344.00 |
| Rate for Payer: Aetna Commercial |
$1,209.60
|
| 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 |
$1,303.68
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.00
|
| Rate for Payer: BCN Commercial |
$1,042.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$1,263.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,075.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,344.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,303.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$1,209.60
|
| 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 |
$1,142.40
|
| 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 |
$940.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,223.04
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$954.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,182.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 44394
|
| Hospital Charge Code |
44394
|
| Min. Negotiated Rate |
$141.65 |
| Max. Negotiated Rate |
$3,036.67 |
| Rate for Payer: Aetna Commercial |
$294.18
|
| Rate for Payer: Aetna Medicare |
$219.54
|
| Rate for Payer: BCBS Complete |
$148.73
|
| Rate for Payer: BCBS MAPPO |
$219.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,036.67
|
| Rate for Payer: BCN Commercial |
$643.59
|
| Rate for Payer: BCN Medicare Advantage |
$219.54
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$294.18
|
| Rate for Payer: Cofinity Commercial |
$316.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.54
|
| Rate for Payer: Healthscope Commercial |
$263.45
|
| Rate for Payer: Healthscope Whirlpool |
$263.45
|
| Rate for Payer: Meridian Medicaid |
$148.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.52
|
| Rate for Payer: PACE SWMI |
$219.54
|
| Rate for Payer: PHP Medicare Advantage |
$219.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.23
|
| Rate for Payer: Priority Health Medicare |
$219.54
|
| Rate for Payer: Priority Health Narrow Network |
$389.23
|
| Rate for Payer: UHC Medicare Advantage |
$226.13
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 44393
|
| Min. Negotiated Rate |
$537.60 |
| Max. Negotiated Rate |
$940.80 |
| Rate for Payer: BCBS Complete |
$537.60
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$537.60 |
| Max. Negotiated Rate |
$940.80 |
| Rate for Payer: BCBS Complete |
$537.60
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Facility
|
OP
|
$1,344.00
|
|
|
Service Code
|
CPT 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$537.60 |
| Max. Negotiated Rate |
$1,344.00 |
| Rate for Payer: Aetna Commercial |
$1,209.60
|
| Rate for Payer: ASR ASR |
$1,303.68
|
| Rate for Payer: BCBS Complete |
$537.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.00
|
| Rate for Payer: BCN Commercial |
$1,042.00
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$1,263.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,075.20
|
| Rate for Payer: Healthscope Commercial |
$1,344.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,303.68
|
| Rate for Payer: Mclaren Commercial |
$1,209.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,142.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,223.04
|
| Rate for Payer: Priority Health Narrow Network |
$954.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,182.72
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Facility
|
IP
|
$1,344.00
|
|
|
Service Code
|
CPT 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$940.80 |
| Max. Negotiated Rate |
$1,344.00 |
| Rate for Payer: Aetna Commercial |
$1,209.60
|
| Rate for Payer: ASR ASR |
$1,303.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.00
|
| Rate for Payer: BCN Commercial |
$1,042.00
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$1,263.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,075.20
|
| Rate for Payer: Healthscope Commercial |
$1,344.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,303.68
|
| Rate for Payer: Mclaren Commercial |
$1,209.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,142.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,182.72
|
|
|
PR COLONOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 45387
|
| Min. Negotiated Rate |
$628.40 |
| Max. Negotiated Rate |
$1,099.70 |
| Rate for Payer: BCBS Complete |
$628.40
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,099.70
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 45380
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$772.10 |
| Rate for Payer: Aetna Commercial |
$261.34
|
| Rate for Payer: Aetna Medicare |
$195.03
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$195.03
|
| Rate for Payer: BCBS Trust/PPO |
$226.11
|
| Rate for Payer: BCN Commercial |
$637.23
|
| Rate for Payer: BCN Medicare Advantage |
$195.03
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$280.84
|
| Rate for Payer: Cofinity Commercial |
$261.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.03
|
| Rate for Payer: Healthscope Commercial |
$234.04
|
| Rate for Payer: Healthscope Whirlpool |
$234.04
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.78
|
| Rate for Payer: PACE SWMI |
$195.03
|
| Rate for Payer: PHP Medicare Advantage |
$195.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.32
|
| Rate for Payer: Priority Health Medicare |
$195.03
|
| Rate for Payer: Priority Health Narrow Network |
$346.32
|
| Rate for Payer: UHC Medicare Advantage |
$200.88
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
45380
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$1,311.18 |
| Rate for Payer: Aetna Commercial |
$992.70
|
| 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 |
$1,069.91
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$855.16
|
| Rate for Payer: BCN Commercial |
$855.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$1,036.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,103.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,069.91
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$992.70
|
| 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 |
$937.55
|
| 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 |
$772.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.73
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$783.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$970.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$1,103.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
45380
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$772.10 |
| Max. Negotiated Rate |
$1,103.00 |
| Rate for Payer: Aetna Commercial |
$992.70
|
| Rate for Payer: ASR ASR |
$1,069.91
|
| Rate for Payer: BCBS Trust/PPO |
$855.16
|
| Rate for Payer: BCN Commercial |
$855.16
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$1,036.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.40
|
| Rate for Payer: Healthscope Commercial |
$1,103.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,069.91
|
| Rate for Payer: Mclaren Commercial |
$992.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$970.64
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,103.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
45380
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$772.10 |
| Rate for Payer: Aetna Commercial |
$261.34
|
| Rate for Payer: Aetna Medicare |
$195.03
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$195.03
|
| Rate for Payer: BCBS Trust/PPO |
$226.11
|
| Rate for Payer: BCN Commercial |
$637.23
|
| Rate for Payer: BCN Medicare Advantage |
$195.03
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cash Price |
$882.40
|
| Rate for Payer: Cofinity Commercial |
$280.84
|
| Rate for Payer: Cofinity Commercial |
$261.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.03
|
| Rate for Payer: Healthscope Commercial |
$234.04
|
| Rate for Payer: Healthscope Whirlpool |
$234.04
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.78
|
| Rate for Payer: PACE SWMI |
$195.03
|
| Rate for Payer: PHP Medicare Advantage |
$195.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.32
|
| Rate for Payer: Priority Health Medicare |
$195.03
|
| Rate for Payer: Priority Health Narrow Network |
$346.32
|
| Rate for Payer: UHC Medicare Advantage |
$200.88
|
|
|
PR COLONOSCOPY W/STENT
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS G6025
|
| Min. Negotiated Rate |
$628.40 |
| Max. Negotiated Rate |
$1,099.70 |
| Rate for Payer: BCBS Complete |
$628.40
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,099.70
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$2,245.28 |
| Rate for Payer: Aetna Commercial |
$240.53
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: BCBS Complete |
$61.06
|
| Rate for Payer: BCBS MAPPO |
$179.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.28
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: BCN Medicare Advantage |
$179.50
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$258.48
|
| Rate for Payer: Cofinity Commercial |
$240.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.50
|
| Rate for Payer: Healthscope Commercial |
$215.40
|
| Rate for Payer: Healthscope Whirlpool |
$215.40
|
| Rate for Payer: Meridian Medicaid |
$61.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.48
|
| Rate for Payer: PACE SWMI |
$179.50
|
| Rate for Payer: PHP Medicare Advantage |
$179.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.15
|
| 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 |
$179.50
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: UHC Medicare Advantage |
$184.88
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Facility
|
IP
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
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 COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
| Min. Negotiated Rate |
$58.15 |
| Max. Negotiated Rate |
$2,245.28 |
| Rate for Payer: Aetna Commercial |
$240.53
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: BCBS Complete |
$61.06
|
| Rate for Payer: BCBS MAPPO |
$179.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.28
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: BCN Medicare Advantage |
$179.50
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$258.48
|
| Rate for Payer: Cofinity Commercial |
$240.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.50
|
| Rate for Payer: Healthscope Commercial |
$215.40
|
| Rate for Payer: Healthscope Whirlpool |
$215.40
|
| Rate for Payer: Meridian Medicaid |
$61.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.48
|
| Rate for Payer: PACE SWMI |
$179.50
|
| Rate for Payer: PHP Medicare Advantage |
$179.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.15
|
| 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 |
$179.50
|
| Rate for Payer: Priority Health Narrow Network |
$318.68
|
| Rate for Payer: UHC Medicare Advantage |
$184.88
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Facility
|
OP
|
$1,162.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
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 COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 92283
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$1,441.20 |
| Rate for Payer: Aetna Commercial |
$67.44
|
| Rate for Payer: Aetna Medicare |
$50.33
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS MAPPO |
$50.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.20
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$50.33
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$67.44
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.33
|
| Rate for Payer: Healthscope Commercial |
$60.40
|
| Rate for Payer: Healthscope Whirlpool |
$60.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.85
|
| Rate for Payer: PACE SWMI |
$50.33
|
| Rate for Payer: PHP Medicare Advantage |
$50.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.64
|
| Rate for Payer: Priority Health Medicare |
$50.33
|
| Rate for Payer: Priority Health Narrow Network |
$64.64
|
| Rate for Payer: UHC Medicare Advantage |
$51.84
|
|
|
PR COLOSTOMY/SKIN LEVEL CECOSTOMY
|
Professional
|
Both
|
$2,642.00
|
|
|
Service Code
|
HCPCS 44320
|
| Min. Negotiated Rate |
$262.57 |
| Max. Negotiated Rate |
$2,100.24 |
| Rate for Payer: Aetna Commercial |
$1,590.85
|
| Rate for Payer: Aetna Medicare |
$1,187.20
|
| Rate for Payer: BCBS Complete |
$804.03
|
| Rate for Payer: BCBS MAPPO |
$1,187.20
|
| Rate for Payer: BCBS Trust/PPO |
$262.57
|
| Rate for Payer: BCN Commercial |
$1,745.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,187.20
|
| Rate for Payer: Cash Price |
$2,113.60
|
| Rate for Payer: Cash Price |
$2,113.60
|
| Rate for Payer: Cofinity Commercial |
$1,590.85
|
| Rate for Payer: Cofinity Commercial |
$1,709.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,187.20
|
| Rate for Payer: Healthscope Commercial |
$1,424.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,424.64
|
| Rate for Payer: Meridian Medicaid |
$804.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,246.56
|
| Rate for Payer: PACE SWMI |
$1,187.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,187.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$765.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,849.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.24
|
| Rate for Payer: Priority Health Medicare |
$1,187.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,100.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.82
|
|
|
PR COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX
|
Professional
|
Both
|
$2,712.00
|
|
|
Service Code
|
HCPCS 44322
|
| Min. Negotiated Rate |
$643.69 |
| Max. Negotiated Rate |
$1,898.40 |
| Rate for Payer: Aetna Commercial |
$1,324.35
|
| Rate for Payer: Aetna Medicare |
$988.32
|
| Rate for Payer: BCBS Complete |
$675.87
|
| Rate for Payer: BCBS MAPPO |
$988.32
|
| Rate for Payer: BCBS Trust/PPO |
$955.17
|
| Rate for Payer: BCN Commercial |
$1,471.41
|
| Rate for Payer: BCN Medicare Advantage |
$988.32
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cash Price |
$2,169.60
|
| Rate for Payer: Cofinity Commercial |
$1,423.18
|
| Rate for Payer: Cofinity Commercial |
$1,324.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$988.32
|
| Rate for Payer: Healthscope Commercial |
$1,185.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,185.98
|
| Rate for Payer: Meridian Medicaid |
$675.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,037.74
|
| Rate for Payer: PACE SWMI |
$988.32
|
| Rate for Payer: PHP Medicare Advantage |
$988.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,898.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,770.38
|
| Rate for Payer: Priority Health Medicare |
$988.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,770.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,017.97
|
|
|
PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44025
|
| Min. Negotiated Rate |
$627.07 |
| Max. Negotiated Rate |
$2,143.84 |
| Rate for Payer: Aetna Commercial |
$1,303.58
|
| Rate for Payer: Aetna Medicare |
$972.82
|
| Rate for Payer: BCBS Complete |
$658.42
|
| Rate for Payer: BCBS MAPPO |
$972.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,143.84
|
| Rate for Payer: BCN Commercial |
$1,427.91
|
| Rate for Payer: BCN Medicare Advantage |
$972.82
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,400.86
|
| Rate for Payer: Cofinity Commercial |
$1,303.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.82
|
| Rate for Payer: Healthscope Commercial |
$1,167.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,167.38
|
| Rate for Payer: Meridian Medicaid |
$658.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,021.46
|
| Rate for Payer: PACE SWMI |
$972.82
|
| Rate for Payer: PHP Medicare Advantage |
$972.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,971.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.05
|
| Rate for Payer: Priority Health Medicare |
$972.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,002.00
|
|
|
PR COLPOCENTESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 57020
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$2,675.31 |
| Rate for Payer: Aetna Commercial |
$105.98
|
| Rate for Payer: Aetna Medicare |
$79.09
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$79.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,675.31
|
| Rate for Payer: BCN Commercial |
$185.69
|
| Rate for Payer: BCN Medicare Advantage |
$79.09
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$113.89
|
| Rate for Payer: Cofinity Commercial |
$105.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.09
|
| Rate for Payer: Healthscope Commercial |
$94.91
|
| Rate for Payer: Healthscope Whirlpool |
$94.91
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.04
|
| Rate for Payer: PACE SWMI |
$79.09
|
| Rate for Payer: PHP Medicare Advantage |
$79.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.20
|
| Rate for Payer: Priority Health Medicare |
$79.09
|
| Rate for Payer: Priority Health Narrow Network |
$112.20
|
| Rate for Payer: UHC Medicare Advantage |
$81.46
|
|
|
PR COLPOCLEISIS LE FORT TYPE
|
Professional
|
Both
|
$2,584.00
|
|
|
Service Code
|
HCPCS 57120
|
| Min. Negotiated Rate |
$341.87 |
| Max. Negotiated Rate |
$1,901.88 |
| Rate for Payer: Aetna Commercial |
$703.43
|
| Rate for Payer: Aetna Medicare |
$524.95
|
| Rate for Payer: BCBS Complete |
$358.96
|
| Rate for Payer: BCBS MAPPO |
$524.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.88
|
| Rate for Payer: BCN Commercial |
$779.93
|
| Rate for Payer: BCN Medicare Advantage |
$524.95
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cofinity Commercial |
$755.93
|
| Rate for Payer: Cofinity Commercial |
$703.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.95
|
| Rate for Payer: Healthscope Commercial |
$629.94
|
| Rate for Payer: Healthscope Whirlpool |
$629.94
|
| Rate for Payer: Meridian Medicaid |
$358.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.20
|
| Rate for Payer: PACE SWMI |
$524.95
|
| Rate for Payer: PHP Medicare Advantage |
$524.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,808.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$755.59
|
| Rate for Payer: Priority Health Medicare |
$524.95
|
| Rate for Payer: Priority Health Narrow Network |
$755.59
|
| Rate for Payer: UHC Medicare Advantage |
$540.70
|
|
|
PR COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
HCPCS 57210
|
| Min. Negotiated Rate |
$253.90 |
| Max. Negotiated Rate |
$2,571.24 |
| Rate for Payer: Aetna Commercial |
$519.28
|
| Rate for Payer: Aetna Medicare |
$387.52
|
| Rate for Payer: BCBS Complete |
$266.60
|
| Rate for Payer: BCBS MAPPO |
$387.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.24
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$387.52
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cash Price |
$846.40
|
| Rate for Payer: Cofinity Commercial |
$519.28
|
| Rate for Payer: Cofinity Commercial |
$558.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.52
|
| Rate for Payer: Healthscope Commercial |
$465.02
|
| Rate for Payer: Healthscope Whirlpool |
$465.02
|
| Rate for Payer: Meridian Medicaid |
$266.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$406.90
|
| Rate for Payer: PACE SWMI |
$387.52
|
| Rate for Payer: PHP Medicare Advantage |
$387.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$740.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.07
|
| Rate for Payer: Priority Health Medicare |
$387.52
|
| Rate for Payer: Priority Health Narrow Network |
$560.07
|
| Rate for Payer: UHC Medicare Advantage |
$399.15
|
|
|
PR COLPOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,062.00
|
|
|
Service Code
|
HCPCS 57280
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$2,847.01 |
| Rate for Payer: Aetna Commercial |
$1,282.27
|
| Rate for Payer: Aetna Medicare |
$956.92
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS MAPPO |
$956.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,847.01
|
| Rate for Payer: BCN Commercial |
$1,412.28
|
| Rate for Payer: BCN Medicare Advantage |
$956.92
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cash Price |
$1,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,377.96
|
| Rate for Payer: Cofinity Commercial |
$1,282.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.92
|
| Rate for Payer: Healthscope Commercial |
$1,148.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,148.30
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,004.77
|
| Rate for Payer: PACE SWMI |
$956.92
|
| Rate for Payer: PHP Medicare Advantage |
$956.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,368.20
|
| Rate for Payer: Priority Health Medicare |
$956.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,368.20
|
| Rate for Payer: UHC Medicare Advantage |
$985.63
|
|
