|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,990.00
|
|
|
Service Code
|
HCPCS 44140
|
| Min. Negotiated Rate |
$797.26 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Aetna Commercial |
$1,667.50
|
| Rate for Payer: Aetna Medicare |
$1,244.40
|
| Rate for Payer: BCBS Complete |
$837.12
|
| Rate for Payer: BCBS MAPPO |
$1,244.40
|
| Rate for Payer: BCN Commercial |
$2,010.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,244.40
|
| Rate for Payer: Cash Price |
$3,192.00
|
| Rate for Payer: Cash Price |
$3,192.00
|
| Rate for Payer: Cofinity Commercial |
$1,791.94
|
| Rate for Payer: Cofinity Commercial |
$1,667.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,244.40
|
| Rate for Payer: Healthscope Commercial |
$1,493.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,493.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,306.62
|
| Rate for Payer: Meridian Medicaid |
$837.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,368.84
|
| Rate for Payer: Nomi Health Commercial |
$1,493.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,992.50
|
| Rate for Payer: PACE SWMI |
$1,244.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,244.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$797.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,450.08
|
| Rate for Payer: Priority Health Medicare |
$1,244.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,450.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,244.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,392.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,244.40
|
| Rate for Payer: UHC Exchange |
$2,392.38
|
| Rate for Payer: UHC Medicaid |
$797.26
|
| Rate for Payer: UHCCP DNSP |
$1,244.40
|
| Rate for Payer: UHCCP Medicaid |
$797.26
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,990.00
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
44140
|
| Min. Negotiated Rate |
$797.26 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Aetna Commercial |
$1,667.50
|
| Rate for Payer: Aetna Medicare |
$1,244.40
|
| Rate for Payer: BCBS Complete |
$837.12
|
| Rate for Payer: BCBS MAPPO |
$1,244.40
|
| Rate for Payer: BCN Commercial |
$2,010.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,244.40
|
| Rate for Payer: Cash Price |
$3,192.00
|
| Rate for Payer: Cash Price |
$3,192.00
|
| Rate for Payer: Cofinity Commercial |
$1,791.94
|
| Rate for Payer: Cofinity Commercial |
$1,667.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,244.40
|
| Rate for Payer: Healthscope Commercial |
$1,493.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,493.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,306.62
|
| Rate for Payer: Meridian Medicaid |
$837.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,368.84
|
| Rate for Payer: Nomi Health Commercial |
$1,493.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,992.50
|
| Rate for Payer: PACE SWMI |
$1,244.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,244.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$797.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,450.08
|
| Rate for Payer: Priority Health Medicare |
$1,244.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,450.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,244.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,392.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,244.40
|
| Rate for Payer: UHC Exchange |
$2,392.38
|
| Rate for Payer: UHC Medicaid |
$797.26
|
| Rate for Payer: UHCCP DNSP |
$1,244.40
|
| Rate for Payer: UHCCP Medicaid |
$797.26
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Facility
|
OP
|
$3,990.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
44140
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,476.30 |
| Max. Negotiated Rate |
$3,990.00 |
| Rate for Payer: Aetna Commercial |
$3,591.00
|
| Rate for Payer: Aetna Medicare |
$1,476.30
|
| Rate for Payer: ASR ASR |
$3,870.30
|
| Rate for Payer: BCBS Complete |
$1,596.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,289.76
|
| Rate for Payer: BCN Commercial |
$3,289.76
|
| Rate for Payer: Cash Price |
$3,192.00
|
| Rate for Payer: Cofinity Commercial |
$3,750.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,192.00
|
| Rate for Payer: Healthscope Commercial |
$3,870.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,990.00
|
| Rate for Payer: Mclaren Commercial |
$3,591.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,192.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,391.50
|
| Rate for Payer: Nomi Health Commercial |
$3,271.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,992.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,496.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,796.99
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Facility
|
IP
|
$3,990.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
44140
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,992.50 |
| Max. Negotiated Rate |
$3,990.00 |
| Rate for Payer: Aetna Commercial |
$3,591.00
|
| Rate for Payer: ASR ASR |
$3,870.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,276.59
|
| Rate for Payer: BCN Commercial |
$3,276.59
|
| Rate for Payer: Cash Price |
$3,192.00
|
| Rate for Payer: Cofinity Commercial |
$3,750.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,192.00
|
| Rate for Payer: Healthscope Commercial |
$3,870.30
|
| Rate for Payer: Healthscope Whirlpool |
$3,990.00
|
| Rate for Payer: Mclaren Commercial |
$3,591.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,391.50
|
| Rate for Payer: Nomi Health Commercial |
$3,271.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,992.50
|
|
|
PR COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH
|
Professional
|
Both
|
$2,835.00
|
|
|
Service Code
|
HCPCS 44147
|
| Min. Negotiated Rate |
$1,121.66 |
| Max. Negotiated Rate |
$3,519.80 |
| Rate for Payer: Aetna Commercial |
$2,350.83
|
| Rate for Payer: Aetna Medicare |
$1,754.35
|
| Rate for Payer: BCBS Complete |
$1,177.74
|
| Rate for Payer: BCBS MAPPO |
$1,754.35
|
| Rate for Payer: BCN Commercial |
$2,888.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,754.35
|
| Rate for Payer: Cash Price |
$2,268.00
|
| Rate for Payer: Cash Price |
$2,268.00
|
| Rate for Payer: Cofinity Commercial |
$2,526.26
|
| Rate for Payer: Cofinity Commercial |
$2,350.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,754.35
|
| Rate for Payer: Healthscope Commercial |
$2,105.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,105.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,842.07
|
| Rate for Payer: Meridian Medicaid |
$1,177.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,929.79
|
| Rate for Payer: Nomi Health Commercial |
$2,105.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,126.25
|
| Rate for Payer: PACE SWMI |
$1,754.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,754.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,121.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,519.80
|
| Rate for Payer: Priority Health Medicare |
$1,754.35
|
| Rate for Payer: Priority Health Narrow Network |
$3,519.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,754.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,459.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,754.35
|
| Rate for Payer: UHC Exchange |
$3,459.03
|
| Rate for Payer: UHC Medicaid |
$1,121.66
|
| Rate for Payer: UHCCP DNSP |
$1,754.35
|
| Rate for Payer: UHCCP Medicaid |
$1,121.66
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY
|
Professional
|
Both
|
$3,522.00
|
|
|
Service Code
|
HCPCS 44145
|
| Min. Negotiated Rate |
$966.38 |
| Max. Negotiated Rate |
$2,997.39 |
| Rate for Payer: Aetna Commercial |
$2,022.14
|
| Rate for Payer: Aetna Medicare |
$1,509.06
|
| Rate for Payer: BCBS Complete |
$1,014.70
|
| Rate for Payer: BCBS MAPPO |
$1,509.06
|
| Rate for Payer: BCN Commercial |
$2,460.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,509.06
|
| Rate for Payer: Cash Price |
$2,817.60
|
| Rate for Payer: Cash Price |
$2,817.60
|
| Rate for Payer: Cofinity Commercial |
$2,173.05
|
| Rate for Payer: Cofinity Commercial |
$2,022.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,509.06
|
| Rate for Payer: Healthscope Commercial |
$1,810.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,810.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,584.51
|
| Rate for Payer: Meridian Medicaid |
$1,014.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,659.97
|
| Rate for Payer: Nomi Health Commercial |
$1,810.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,641.50
|
| Rate for Payer: PACE SWMI |
$1,509.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,509.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$966.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,997.39
|
| Rate for Payer: Priority Health Medicare |
$1,509.06
|
| Rate for Payer: Priority Health Narrow Network |
$2,997.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,509.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,945.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,509.06
|
| Rate for Payer: UHC Exchange |
$2,945.23
|
| Rate for Payer: UHC Medicaid |
$966.38
|
| Rate for Payer: UHCCP DNSP |
$1,509.06
|
| Rate for Payer: UHCCP Medicaid |
$966.38
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY
|
Professional
|
Both
|
$5,299.00
|
|
|
Service Code
|
HCPCS 44146
|
| Min. Negotiated Rate |
$1,238.38 |
| Max. Negotiated Rate |
$3,974.25 |
| Rate for Payer: Aetna Commercial |
$2,586.20
|
| Rate for Payer: Aetna Medicare |
$1,930.00
|
| Rate for Payer: BCBS Complete |
$1,300.30
|
| Rate for Payer: BCBS MAPPO |
$1,930.00
|
| Rate for Payer: BCN Commercial |
$3,126.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,930.00
|
| Rate for Payer: Cash Price |
$4,239.20
|
| Rate for Payer: Cash Price |
$4,239.20
|
| Rate for Payer: Cofinity Commercial |
$2,779.20
|
| Rate for Payer: Cofinity Commercial |
$2,586.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,930.00
|
| Rate for Payer: Healthscope Commercial |
$2,316.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,316.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,026.50
|
| Rate for Payer: Meridian Medicaid |
$1,300.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,123.00
|
| Rate for Payer: Nomi Health Commercial |
$2,316.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,974.25
|
| Rate for Payer: PACE SWMI |
$1,930.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,930.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,238.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,809.84
|
| Rate for Payer: Priority Health Medicare |
$1,930.00
|
| Rate for Payer: Priority Health Narrow Network |
$3,809.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,930.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,747.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,930.00
|
| Rate for Payer: UHC Exchange |
$3,747.07
|
| Rate for Payer: UHC Medicaid |
$1,238.38
|
| Rate for Payer: UHCCP DNSP |
$1,930.00
|
| Rate for Payer: UHCCP Medicaid |
$1,238.38
|
|
|
PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA
|
Professional
|
Both
|
$4,102.00
|
|
|
Service Code
|
HCPCS 44144
|
| Min. Negotiated Rate |
$1,042.42 |
| Max. Negotiated Rate |
$3,207.93 |
| Rate for Payer: Aetna Commercial |
$2,181.27
|
| Rate for Payer: Aetna Medicare |
$1,627.81
|
| Rate for Payer: BCBS Complete |
$1,094.54
|
| Rate for Payer: BCBS MAPPO |
$1,627.81
|
| Rate for Payer: BCN Commercial |
$2,632.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,627.81
|
| Rate for Payer: Cash Price |
$3,281.60
|
| Rate for Payer: Cash Price |
$3,281.60
|
| Rate for Payer: Cofinity Commercial |
$2,344.05
|
| Rate for Payer: Cofinity Commercial |
$2,181.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,627.81
|
| Rate for Payer: Healthscope Commercial |
$1,953.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,953.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,709.20
|
| Rate for Payer: Meridian Medicaid |
$1,094.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,790.59
|
| Rate for Payer: Nomi Health Commercial |
$1,953.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.50
|
| Rate for Payer: PACE SWMI |
$1,627.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,627.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,042.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,207.93
|
| Rate for Payer: Priority Health Medicare |
$1,627.81
|
| Rate for Payer: Priority Health Narrow Network |
$3,207.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,627.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,149.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,627.81
|
| Rate for Payer: UHC Exchange |
$3,149.80
|
| Rate for Payer: UHC Medicaid |
$1,042.42
|
| Rate for Payer: UHCCP DNSP |
$1,627.81
|
| Rate for Payer: UHCCP Medicaid |
$1,042.42
|
|
|
PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT
|
Professional
|
Both
|
$4,326.00
|
|
|
Service Code
|
HCPCS 44143
|
| Min. Negotiated Rate |
$976.18 |
| Max. Negotiated Rate |
$3,244.50 |
| Rate for Payer: Aetna Commercial |
$2,042.09
|
| Rate for Payer: Aetna Medicare |
$1,523.95
|
| Rate for Payer: BCBS Complete |
$1,024.99
|
| Rate for Payer: BCBS MAPPO |
$1,523.95
|
| Rate for Payer: BCN Commercial |
$2,465.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,523.95
|
| Rate for Payer: Cash Price |
$3,460.80
|
| Rate for Payer: Cash Price |
$3,460.80
|
| Rate for Payer: Cofinity Commercial |
$2,194.49
|
| Rate for Payer: Cofinity Commercial |
$2,042.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,523.95
|
| Rate for Payer: Healthscope Commercial |
$1,828.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,828.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,600.15
|
| Rate for Payer: Meridian Medicaid |
$1,024.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,676.35
|
| Rate for Payer: Nomi Health Commercial |
$1,828.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,244.50
|
| Rate for Payer: PACE SWMI |
$1,523.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,523.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$976.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,003.45
|
| Rate for Payer: Priority Health Medicare |
$1,523.95
|
| Rate for Payer: Priority Health Narrow Network |
$3,003.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,523.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,962.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,523.95
|
| Rate for Payer: UHC Exchange |
$2,962.91
|
| Rate for Payer: UHC Medicaid |
$976.18
|
| Rate for Payer: UHCCP DNSP |
$1,523.95
|
| Rate for Payer: UHCCP Medicaid |
$976.18
|
|
|
PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS
|
Professional
|
Both
|
$4,084.00
|
|
|
Service Code
|
HCPCS 44160
|
| Min. Negotiated Rate |
$738.05 |
| Max. Negotiated Rate |
$3,063.00 |
| Rate for Payer: Aetna Commercial |
$1,542.61
|
| Rate for Payer: Aetna Medicare |
$1,151.20
|
| Rate for Payer: BCBS Complete |
$774.95
|
| Rate for Payer: BCBS MAPPO |
$1,151.20
|
| Rate for Payer: BCN Commercial |
$1,860.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,151.20
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cash Price |
$3,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,657.73
|
| Rate for Payer: Cofinity Commercial |
$1,542.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,151.20
|
| Rate for Payer: Healthscope Commercial |
$1,381.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,381.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,208.76
|
| Rate for Payer: Meridian Medicaid |
$774.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,266.32
|
| Rate for Payer: Nomi Health Commercial |
$1,381.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,063.00
|
| Rate for Payer: PACE SWMI |
$1,151.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,151.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,267.45
|
| Rate for Payer: Priority Health Medicare |
$1,151.20
|
| Rate for Payer: Priority Health Narrow Network |
$2,267.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,151.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,212.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,151.20
|
| Rate for Payer: UHC Exchange |
$2,212.46
|
| Rate for Payer: UHC Medicaid |
$738.05
|
| Rate for Payer: UHCCP DNSP |
$1,151.20
|
| Rate for Payer: UHCCP Medicaid |
$738.05
|
|
|
PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY
|
Professional
|
Both
|
$3,950.00
|
|
|
Service Code
|
HCPCS 44141
|
| Min. Negotiated Rate |
$1,078.42 |
| Max. Negotiated Rate |
$3,292.86 |
| Rate for Payer: Aetna Commercial |
$2,251.67
|
| Rate for Payer: Aetna Medicare |
$1,680.35
|
| Rate for Payer: BCBS Complete |
$1,132.34
|
| Rate for Payer: BCBS MAPPO |
$1,680.35
|
| Rate for Payer: BCN Commercial |
$2,702.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,680.35
|
| Rate for Payer: Cash Price |
$3,160.00
|
| Rate for Payer: Cash Price |
$3,160.00
|
| Rate for Payer: Cofinity Commercial |
$2,419.70
|
| Rate for Payer: Cofinity Commercial |
$2,251.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,680.35
|
| Rate for Payer: Healthscope Commercial |
$2,016.42
|
| Rate for Payer: Healthscope Whirlpool |
$2,016.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,764.37
|
| Rate for Payer: Meridian Medicaid |
$1,132.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,848.38
|
| Rate for Payer: Nomi Health Commercial |
$2,016.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,962.50
|
| Rate for Payer: PACE SWMI |
$1,680.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,680.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,078.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,292.86
|
| Rate for Payer: Priority Health Medicare |
$1,680.35
|
| Rate for Payer: Priority Health Narrow Network |
$3,292.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,680.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,242.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,680.35
|
| Rate for Payer: UHC Exchange |
$3,242.84
|
| Rate for Payer: UHC Medicaid |
$1,078.42
|
| Rate for Payer: UHCCP DNSP |
$1,680.35
|
| Rate for Payer: UHCCP Medicaid |
$1,078.42
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST
|
Professional
|
Both
|
$7,025.00
|
|
|
Service Code
|
HCPCS 44156
|
| Min. Negotiated Rate |
$1,369.59 |
| Max. Negotiated Rate |
$5,268.75 |
| Rate for Payer: Aetna Commercial |
$2,864.21
|
| Rate for Payer: Aetna Medicare |
$2,137.47
|
| Rate for Payer: BCBS Complete |
$1,438.07
|
| Rate for Payer: BCBS MAPPO |
$2,137.47
|
| Rate for Payer: BCN Commercial |
$3,432.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,137.47
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cofinity Commercial |
$3,077.96
|
| Rate for Payer: Cofinity Commercial |
$2,864.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,137.47
|
| Rate for Payer: Healthscope Commercial |
$2,564.96
|
| Rate for Payer: Healthscope Whirlpool |
$2,564.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,244.34
|
| Rate for Payer: Meridian Medicaid |
$1,438.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,351.22
|
| Rate for Payer: Nomi Health Commercial |
$2,564.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.75
|
| Rate for Payer: PACE SWMI |
$2,137.47
|
| Rate for Payer: PHP Medicare Advantage |
$2,137.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,369.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4,182.37
|
| Rate for Payer: Priority Health Medicare |
$2,137.47
|
| Rate for Payer: Priority Health Narrow Network |
$4,182.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2,137.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,120.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,137.47
|
| Rate for Payer: UHC Exchange |
$4,120.48
|
| Rate for Payer: UHC Medicaid |
$1,369.59
|
| Rate for Payer: UHCCP DNSP |
$2,137.47
|
| Rate for Payer: UHCCP Medicaid |
$1,369.59
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$5,997.00
|
|
|
Service Code
|
HCPCS 44155
|
| Min. Negotiated Rate |
$1,224.54 |
| Max. Negotiated Rate |
$4,497.75 |
| Rate for Payer: Aetna Commercial |
$2,552.12
|
| Rate for Payer: Aetna Medicare |
$1,904.57
|
| Rate for Payer: BCBS Complete |
$1,285.77
|
| Rate for Payer: BCBS MAPPO |
$1,904.57
|
| Rate for Payer: BCN Commercial |
$3,076.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.57
|
| Rate for Payer: Cash Price |
$4,797.60
|
| Rate for Payer: Cash Price |
$4,797.60
|
| Rate for Payer: Cofinity Commercial |
$2,742.58
|
| Rate for Payer: Cofinity Commercial |
$2,552.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.57
|
| Rate for Payer: Healthscope Commercial |
$2,285.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,285.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.80
|
| Rate for Payer: Meridian Medicaid |
$1,285.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,095.03
|
| Rate for Payer: Nomi Health Commercial |
$2,285.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,497.75
|
| Rate for Payer: PACE SWMI |
$1,904.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,224.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,748.55
|
| Rate for Payer: Priority Health Medicare |
$1,904.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,748.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,670.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,904.57
|
| Rate for Payer: UHC Exchange |
$3,670.53
|
| Rate for Payer: UHC Medicaid |
$1,224.54
|
| Rate for Payer: UHCCP DNSP |
$1,904.57
|
| Rate for Payer: UHCCP Medicaid |
$1,224.54
|
|
|
PR COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST
|
Professional
|
Both
|
$4,704.00
|
|
|
Service Code
|
HCPCS 44157
|
| Min. Negotiated Rate |
$1,302.28 |
| Max. Negotiated Rate |
$3,979.73 |
| Rate for Payer: Aetna Commercial |
$2,724.03
|
| Rate for Payer: Aetna Medicare |
$2,032.86
|
| Rate for Payer: BCBS Complete |
$1,367.39
|
| Rate for Payer: BCBS MAPPO |
$2,032.86
|
| Rate for Payer: BCN Commercial |
$3,266.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,032.86
|
| Rate for Payer: Cash Price |
$3,763.20
|
| Rate for Payer: Cash Price |
$3,763.20
|
| Rate for Payer: Cofinity Commercial |
$2,927.32
|
| Rate for Payer: Cofinity Commercial |
$2,724.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,032.86
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Healthscope Whirlpool |
$2,439.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,134.50
|
| Rate for Payer: Meridian Medicaid |
$1,367.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,236.15
|
| Rate for Payer: Nomi Health Commercial |
$2,439.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,528.00
|
| Rate for Payer: PACE SWMI |
$2,032.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,032.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,302.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,979.73
|
| Rate for Payer: Priority Health Medicare |
$2,032.86
|
| Rate for Payer: Priority Health Narrow Network |
$3,979.73
|
| Rate for Payer: Railroad Medicare Medicare |
$2,032.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,909.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,032.86
|
| Rate for Payer: UHC Exchange |
$3,909.12
|
| Rate for Payer: UHC Medicaid |
$1,302.28
|
| Rate for Payer: UHCCP DNSP |
$2,032.86
|
| Rate for Payer: UHCCP Medicaid |
$1,302.28
|
|
|
PR COLLAGENASE, CLOST HIST INJ
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS J0775
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$112.82 |
| Rate for Payer: Aetna Commercial |
$104.99
|
| Rate for Payer: Aetna Medicare |
$78.35
|
| Rate for Payer: BCBS MAPPO |
$78.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.17
|
| Rate for Payer: BCN Commercial |
$74.75
|
| Rate for Payer: BCN Medicare Advantage |
$78.35
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.35
|
| Rate for Payer: Healthscope Commercial |
$94.02
|
| Rate for Payer: Healthscope Whirlpool |
$94.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.19
|
| Rate for Payer: Nomi Health Commercial |
$94.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: PACE SWMI |
$78.35
|
| Rate for Payer: PHP Medicare Advantage |
$78.35
|
| Rate for Payer: Priority Health Medicare |
$78.35
|
| Rate for Payer: Railroad Medicare Medicare |
$78.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$75.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.35
|
| Rate for Payer: UHC Exchange |
$75.75
|
| Rate for Payer: UHCCP DNSP |
$78.35
|
|
|
PR COLLECT BLOOD FROM CATHETER VENOUS NOS
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 36592
|
| Min. Negotiated Rate |
$30.87 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Medicare |
$30.87
|
| Rate for Payer: BCBS MAPPO |
$30.87
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$30.87
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$44.45
|
| Rate for Payer: Cofinity Commercial |
$41.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.87
|
| Rate for Payer: Healthscope Commercial |
$37.04
|
| Rate for Payer: Healthscope Whirlpool |
$37.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$37.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.75
|
| Rate for Payer: PACE SWMI |
$30.87
|
| Rate for Payer: PHP Medicare Advantage |
$30.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.66
|
| Rate for Payer: Priority Health Medicare |
$30.87
|
| Rate for Payer: Priority Health Narrow Network |
$47.66
|
| Rate for Payer: Railroad Medicare Medicare |
$30.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.87
|
| Rate for Payer: UHC Exchange |
$45.45
|
| Rate for Payer: UHCCP DNSP |
$30.87
|
|
|
PR COLLECTION CAPILLARY BLOOD SPECIMEN
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 36416
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Aetna Commercial |
$2.72
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCN Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15.00
|
| Rate for Payer: Priority Health Narrow Network |
$15.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.00
|
| Rate for Payer: UHC Exchange |
$3.00
|
|
|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Aetna Commercial |
$12.52
|
| Rate for Payer: Aetna Medicare |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCN Commercial |
$6.31
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.52
|
| Rate for Payer: Cofinity Commercial |
$13.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$11.21
|
| Rate for Payer: Healthscope Whirlpool |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Nomi Health Commercial |
$11.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.25
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$15.00
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health Narrow Network |
$15.00
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$3.00
|
| Rate for Payer: UHCCP DNSP |
$9.34
|
|
|
PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 99091
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$93.01 |
| Rate for Payer: Aetna Commercial |
$62.98
|
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS MAPPO |
$47.00
|
| Rate for Payer: BCN Commercial |
$79.68
|
| Rate for Payer: BCN Medicare Advantage |
$47.00
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$67.68
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.00
|
| Rate for Payer: Healthscope Commercial |
$56.40
|
| Rate for Payer: Healthscope Whirlpool |
$56.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.70
|
| Rate for Payer: Nomi Health Commercial |
$56.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$47.00
|
| Rate for Payer: PHP Medicare Advantage |
$47.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$73.47
|
| Rate for Payer: Priority Health Medicare |
$47.00
|
| Rate for Payer: Priority Health Narrow Network |
$73.47
|
| Rate for Payer: Railroad Medicare Medicare |
$47.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.00
|
| Rate for Payer: UHC Exchange |
$93.01
|
| Rate for Payer: UHCCP DNSP |
$47.00
|
|
|
PR COLON CA SCREEN;BARIUM ENEMA
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS G0106
|
| Min. Negotiated Rate |
$220.17 |
| Max. Negotiated Rate |
$486.00 |
| Rate for Payer: Aetna Commercial |
$220.17
|
| Rate for Payer: BCBS Complete |
$259.20
|
| Rate for Payer: BCN Commercial |
$255.24
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.00
|
|
|
PR COLON CA SCRN; BARIUM ENEMA
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS G0120
|
| Min. Negotiated Rate |
$164.40 |
| Max. Negotiated Rate |
$308.25 |
| Rate for Payer: Aetna Commercial |
$220.17
|
| Rate for Payer: BCBS Complete |
$164.40
|
| Rate for Payer: BCN Commercial |
$255.24
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$308.25
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Facility
|
IP
|
$1,221.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$915.75 |
| Max. Negotiated Rate |
$1,221.00 |
| Rate for Payer: Aetna Commercial |
$1,098.90
|
| Rate for Payer: ASR ASR |
$1,184.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.69
|
| Rate for Payer: BCN Commercial |
$1,002.69
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$1,147.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.80
|
| Rate for Payer: Healthscope Commercial |
$1,184.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.00
|
| Rate for Payer: Mclaren Commercial |
$1,098.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.85
|
| Rate for Payer: Nomi Health Commercial |
$1,001.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
| Min. Negotiated Rate |
$105.22 |
| Max. Negotiated Rate |
$915.75 |
| Rate for Payer: Aetna Commercial |
$218.31
|
| Rate for Payer: Aetna Medicare |
$162.92
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$162.92
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$162.92
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$234.60
|
| Rate for Payer: Cofinity Commercial |
$218.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.92
|
| Rate for Payer: Healthscope Commercial |
$195.50
|
| Rate for Payer: Healthscope Whirlpool |
$195.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.07
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.21
|
| Rate for Payer: Nomi Health Commercial |
$195.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: PACE SWMI |
$162.92
|
| Rate for Payer: PHP Medicare Advantage |
$162.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$333.11
|
| Rate for Payer: Priority Health Medicare |
$162.92
|
| Rate for Payer: Priority Health Narrow Network |
$333.11
|
| Rate for Payer: Railroad Medicare Medicare |
$162.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.92
|
| Rate for Payer: UHC Exchange |
$327.59
|
| Rate for Payer: UHC Medicaid |
$105.22
|
| Rate for Payer: UHCCP DNSP |
$162.92
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS G0121
|
| Min. Negotiated Rate |
$105.22 |
| Max. Negotiated Rate |
$915.75 |
| Rate for Payer: Aetna Commercial |
$218.31
|
| Rate for Payer: Aetna Medicare |
$162.92
|
| Rate for Payer: BCBS Complete |
$110.48
|
| Rate for Payer: BCBS MAPPO |
$162.92
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$162.92
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$218.31
|
| Rate for Payer: Cofinity Commercial |
$234.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.92
|
| Rate for Payer: Healthscope Commercial |
$195.50
|
| Rate for Payer: Healthscope Whirlpool |
$195.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.07
|
| Rate for Payer: Meridian Medicaid |
$110.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.21
|
| Rate for Payer: Nomi Health Commercial |
$195.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: PACE SWMI |
$162.92
|
| Rate for Payer: PHP Medicare Advantage |
$162.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$333.11
|
| Rate for Payer: Priority Health Medicare |
$162.92
|
| Rate for Payer: Priority Health Narrow Network |
$333.11
|
| Rate for Payer: Railroad Medicare Medicare |
$162.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.92
|
| Rate for Payer: UHC Exchange |
$327.59
|
| Rate for Payer: UHC Medicaid |
$105.22
|
| Rate for Payer: UHCCP DNSP |
$162.92
|
| Rate for Payer: UHCCP Medicaid |
$105.22
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Facility
|
OP
|
$1,221.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$484.62 |
| Max. Negotiated Rate |
$1,221.00 |
| Rate for Payer: Aetna Commercial |
$1,098.90
|
| Rate for Payer: Aetna Medicare |
$926.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: ASR ASR |
$1,184.37
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.71
|
| Rate for Payer: BCN Commercial |
$1,006.71
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$1,147.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Healthscope Commercial |
$1,184.37
|
| Rate for Payer: Healthscope Whirlpool |
$1,221.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$926.61
|
| Rate for Payer: Mclaren Commercial |
$1,098.90
|
| Rate for Payer: Mclaren Medicaid |
$926.61
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$508.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.85
|
| Rate for Payer: Nomi Health Commercial |
$1,001.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Commercial |
$1,019.27
|
| Rate for Payer: PHP Medicaid |
$496.66
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,069.84
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health Narrow Network |
$855.92
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP DNSP |
$926.61
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: VA VA |
$926.61
|
|
